Gorodensky Ariel, Kohler Jillian C
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
WHO Collaborating Centre (WHO CC) for Governance, Accountability and Transparency in the Pharmaceutical Sector, Leslie Dan Faculty of Pharmacy, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
J Pharm Policy Pract. 2022 Aug 19;15(1):50. doi: 10.1186/s40545-022-00442-y.
State capture by the pharmaceutical industry is a form of corruption whereby pharmaceutical companies shift laws or policies about their products away from the best interest of the public and toward their private benefit. State capture often limits equitable access to pharmaceutical products by inflating drug prices and increasing barriers to entry into the pharmaceutical industry. During the COVID-19 pandemic, the high demand and low supply of COVID-19 vaccines has put governments that manage vaccine procurement at risk of capture by COVID-19 vaccine manufacturers, both through bilateral deals and the COVID-19 Vaccine Global Access (COVAX) Facility; this threatens equity in the global distribution of these products. The purpose of this study is to determine whether COVID-19 vaccine manufacturers have been engaging in state capture and, if so, to examine the implications of state capture on equitable access to COVID-19 vaccines.
A targeted rapid literature search was conducted on state capture by the pharmaceutical industry. Results were limited to journal articles, books, and grey literature published between 2000 and 2021 in or translated to English. A literature search was also conducted for information about state capture during the COVID-19 pandemic. Results were limited to media articles published between March 2020 and July 2021 in or translated to English. All articles were qualitatively analyzed using thematic analysis.
COVID-19 vaccine manufacturers have demanded financial indemnification from national governments who procure their vaccines. While most high-income countries are legislatively capable of indemnifying vaccine manufacturers, many low- and middle-income countries (LMICs) are not. A number of LMICs have thus changed their legislations to permit for manufacturers' indemnification demands. Amending legislation in this way is state capture and has led to delays in LMICs and vaccine manufacturers signing procurement contracts. This has critically stalled access to vaccines in LMICs and created disparities in access to vaccines between high-income countries and LMICs.
COVID-19 vaccine manufacturers' indemnification demands constitute state capture in many LMICs though not in high-income countries; this has enhanced global COVID-19 vaccine inequities. Results underscore the need to find alternatives to financial indemnification that do not hinder critical efforts to end the pandemic.
制药行业的国家俘获是一种腐败形式，即制药公司将有关其产品的法律或政策从公众的最大利益转向其私人利益。国家俘获通常通过抬高药品价格和增加进入制药行业的壁垒来限制药品的公平获取。在新冠疫情期间，新冠疫苗的高需求和低供应使负责疫苗采购的政府面临被新冠疫苗制造商俘获的风险，无论是通过双边交易还是新冠疫苗全球获取机制（COVAX）；这威胁到这些产品在全球分配的公平性。本研究的目的是确定新冠疫苗制造商是否一直在进行国家俘获，如果是，则研究国家俘获对公平获取新冠疫苗的影响。
针对制药行业的国家俘获进行了有针对性的快速文献检索。结果限于2000年至2021年期间发表或翻译成英文的期刊文章、书籍和灰色文献。还进行了文献检索以获取有关新冠疫情期间国家俘获的信息。结果限于2020年3月至2021年7月期间发表或翻译成英文的媒体文章。所有文章均采用主题分析进行定性分析。
新冠疫苗制造商要求采购其疫苗的国家政府给予财务赔偿。虽然大多数高收入国家在立法上有能力赔偿疫苗制造商，但许多低收入和中等收入国家（LMICs）则没有。因此，一些低收入和中等收入国家改变了其立法，以允许满足制造商的赔偿要求。以这种方式修改立法属于国家俘获行为，并导致低收入和中等收入国家以及疫苗制造商签署采购合同出现延迟。这严重阻碍了低收入和中等收入国家获取疫苗，并造成了高收入国家和低收入和中等收入国家在疫苗获取方面的差距。
新冠疫苗制造商的赔偿要求在许多低收入和中等收入国家构成国家俘获行为，而在高收入国家则不然；这加剧了全球新冠疫苗的不平等。结果强调需要找到不阻碍结束疫情关键努力的财务赔偿替代方案。
