Sep 11, 2021 Volume 398 Number 10304 p931-1020, e14
What are the obligations of pharmaceutical companies in a global health emergency?
Ezekiel J Emanuel, et al.
During a global health emergency, everyone is morally required to help to combat the disease. With approximately 8000–10 000 people dying every day from COVID-19, as of writing, only rapid and globally distributed vaccinations will end the pandemic. With the support of national governments, pharmaceutical companies have produced more than 250 vaccine candidates to date.
WHO, the Coalition for Epidemic Preparedness Innovations, and Gavi, the Vaccine Alliance have established COVID-19 Vaccines Global Access (COVAX) to procure and fairly distribute vaccines.1
But much vaccine development, production, procurement, and distribution is ad hoc, generating controversy and inconsistency. Pharmaceutical companies have been criticised for knowledge hoarding, secret pricing, unreasonable profits, unfair bilateral deals, and extortionate demands for indemnification against liability.2, 3 COVAX has been criticised for an absence of transparency and accountability and for ignoring need in COVID-19 vaccine distribution.4, 5, 6, 7 All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies’ obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic…