by Frank Schnittger
Thu Feb 4th, 2021 at 01:14:00 AM EST
The Irish Times: EU and vaccination
A chara,- A sub-committee of the European Commission makes a rushed decision in the middle of a crisis to try and ensure that vaccines are not being exported out of the EU in breach of the pharmaceutical companies' contractual commitments to its own vaccination programme.
When the serious implications of one aspect of the proposal are pointed out to it, it admits its mistake, and changes the decision. Ursula von der Leyen, president of the commission, takes full responsibility for the mistake and commits to ensuring it doesn't happen again. What more can we expect of our leaders? If only it were always so.
Healthcare provision is generally a national competency within the EU, and this is the first time the commission has taken the lead role in EU-wide vaccine procurement. In doing so it has helped us to avoid the kind of toxic vaccine nationalism which has broken out between the UK and the EU also breaking out between member states of the EU.
If that had happened, you can be sure that Ireland, as a smaller member state without our own vaccine manufacturing capability, would have been paying top-dollar prices at the back of the queue.
We have all learned a lot about managing a pandemic, and still have a lot to learn. Making mistakes is part of that process. It's how you recover from a mistake that matters. - Yours, etc,
The UK media has gone into a feeding frenzy having finally found something to crow about. The Johnson regime has managed to out-perform the EU in its vaccine roll-out programme and now, finally, after years of out manoeuvring the UK in the Brexit negotiations, the EU Commission has made a very specific and obvious mistake. Never mind that Boris Johnson, too, was threatening to invoke Article 16 of the Ireland and N. Ireland Protocol in the House of Commons only two weeks ago.
Brexiteers and nationalists of every hue are calling on Ursula Van Der Leyen to resign, and the media are doing their usual routine of who knew what when and why they didn't do anything to stop it. But the Article 16 fiasco is but a minor footnote in the pandemic management process as a whole, and at least it was speedily corrected. Of more lasting significance is that it has led to even sympathetic observers questioning the competence of the commission as a whole. So what went wrong?
Part of the problem is the nature of the Commission itself. By and large it is concerned with the arcane details of trade, internal market regulation, regional funds, agricultural policy, competition policy etc. Typically it moves at a glacial pace, as a consensus of 27 member states is required to action anything, and it can be years before a proposal actually becomes law.
Now, for the first time, it has been thrust into the centre of a raging pandemic and given an operational role in managing a Crisis. This came about largely because member states didn't want a repeat of the free-for-all that developed over PPE and testing reagent which had member states literally stealing supplies and contracts from each other. In any case, the Commission was only mandated to lead the vaccine procurement process last June, and had to deal with ongoing suspicions in some member states that it was favouring and throwing money at other member states with large Pharmaceutical companies.
But the whole commission culture simply isn't suited for this kind of operational fire-fighting role. They are expert at teasing out the finer points of competition law, less so in actually negotiating contracts with potential suppliers whose products hadn't even been tested extensively at the time and where nowhere hear formal approval yet. In prioritising the issues of price, liability, and pre-ordering a wide selection of potential vaccines, the Commission probably took a prudent course, but it was also a course that led to much more difficult negotiations with the pharmaceutical companies, and delayed agreements by several weeks or months.
The Johnson Government, meanwhile, has become notorious for handing out lucrative contracts, willy nilly, to private interests, mostly Tory party donors and friends, many of whom never had any substantial experience of delivering the services or products being contracted for. But in this case they got lucky, and two of the companies they bet heavily on, Pfizer and AstraZeneca came good with approved products before anyone else, (albeit less good with their production planning, in the case of AstraZeneca).
So the moral of the story is that sometimes, perhaps rarely, and particularly in a crisis, it can pay to throw caution and legal niceties to the wind and take a punt on a few companies. Well done UK, you got lucky. The EU needs to learn learn from this debacle and develop more operational capabilities if it is to take on such crisis management roles in the future.
I would favour the establishment of a separate pharmaceutical procurement agency (EPPA) to complement the European Medicines Agency (which approves drugs) and which, on the EU wide basis, would negotiate the prices of key medical equipment and medicines directly with Pharmaceutical companies on an ongoing basis.
Irish drug costs are among the highest in the world because we have so little bargaining leverage with global pharmaceutical companies and they charge us huge prices for any new and vital drug that comes on the market. Politicians then come under pressure to pay these inflated prices because otherwise the best treatments are not available to seriously ill patients.
But if the EU were to negotiate as one block, it, as the largest drug market in the world would have much better negotiating leverage. Prices in Spain are already about a third of those in Ireland. The Pharmaceutical Procurement Agency could also ensure that the EU has adequate manufacturing capacity for key drugs and equipment within EU, so the US cannot, as happened with PPE, literally commandeer consignments of PP intended for the EU at Chinese airports.
When you are up to your neck in crocodiles, it can be hard to remember that the original objective was to drain the swamp. But this is the sort of long term planning and execution that the Commission excels in. Ad hoc, crisis mode improvisation is probably best left to the member states whose governments are more attuned to the day to day concerns of their respective voting publics. Maintaining a core competency of a vibrant pharmaceutical and medical technology industry should be one of the objectives of EU policy. But so should ensuring that citizens have timely and cost effective access to those medicines.
A pandemic doesn't come around very often, and preparing for them can be expensive. But this crisis has shown that we have all got a lot to learn about anticipating and planning for future healthcare emergencies. Having a permanent European Pharmaceutical Procurement Agency in place could improve our responsiveness to such crises, while enabling ongoing efficiencies and economies of scale.