Is science a public service, and are scientists public servants?
By Max Lawson
Sometimes Davos has a way of creating moments of great theatre; where the elites who run the world can be in some ways held to account, or at least called out.
On a panel this week at Davos, my boss, Gabriela Bucher the Executive Director of Oxfam, was on a panel with Stéphane Bancel, the Chief Executive of Moderna. Moderna have a monopoly on one of the most successful Covid-19 vaccines, using the new MRNA technology. The company received billions of dollars in public money for their vaccine. It was sold to rich nations almost exclusively and for a huge profit. It made Mr Bancel a billionaire overnight.
The World Health Organisation (WHO) has set up and MRNA hub in South Africa. The WHO, and even the Head of the WHO, Dr Tedros, has asked Moderna to work with them and share technology, but they have consistently refused. In the film, when challenged, he says simply that he feels ‘it is not a priority right now’.
https://twitter.com/peoplesvaccine/status/1529457517176180738?s=20&t=TLugzVfVStiurZwCcBl6_g
In a really interesting thread about Davos by David McNair at ONE, I was struck by one of his tweets, which really jarred with me:
It really got me thinking about the nature of reward, and with this the view of human nature.
I am not a scientist, but I couldn’t help thinking if you were a scientist that invents a vaccine that saves billions of lives, then that is surely the primary reward?
The idea that you should also need to become a millionaire or a billionaire, that somehow this extra financial reward is necessary- seems strange to me.
I think probably scientists, and maybe even more scientists who are working on innovations in health, are often driven by a desire to help people, and to make humanity healthier. That the reward for saving billions of lives is saving billions of lives.
Is science a public service, and are scientists public servants? Or is science private enterprise, where brave innovators are rewarded by becoming billionaires? Is being a scientist more like a teacher or a nurse; a vocation primarily based on public service? Or is being a scientist more about brave entrepreneurialism and financial reward?
I don’t know, but I suspect that if you were to do an opinion poll, most of the public would think that science, and perhaps particularly science linked to improving health, was primarily a public good. That those working on new medicines, new vaccines, new drugs are doing so with this public good primarily in mind. But I could be wrong.
I did find one poll in the UK from 2019 that showed that the public overwhelmingly believed that science was publicly funded, and massively underestimated the role of private sector funding, which perhaps says something.
The role of money in human progress
In response, many would probably say that such a view, even if it is widely held, is naïve and impractical in our modern world. The more positive would say that the two things, financial incentives, and a desire to do good, can go hand in hand. That a truly win-win outcome is possible. The more hard-nosed might say that yes, mixing money and peoples’ health has its downsides, but how else can we attract the billions of dollars in investment required to support scientists in their quest for new cures?
All would agree that without massive private investment, and with that the guaranteed high returns from monopolies and intellectual property, new scientific discoveries would be thin on the ground, and humanity would be a lot worse off.
Once again, this assumes that only by aligning monetary reward and science, can we secure progress.
The trouble is that this isn’t necessarily true at all, and it certainly wasn’t true for COVID-19 vaccines.
The Moderna vaccine was developed in close collaboration with US government scientists, salaried public servants, and amazing innovators, funded by public money. Moderna tried to dispute this in court and failed.
This public investment in MRNA technology predated COVID-19, but when the virus took hold, an immense amount of additional public money was poured into the quest for a successful vaccine. It was an incredible effort, using taxpayers’ money.
It was also a team effort, with multiple discoveries by multiple teams building a foundation on which the successful Moderna vaccine was developed. It seems to me scientific discoveries are in fact much more the product of teams of people working together, collaborating over many years, many of whom work as employees of public universities and research institutes, rather than individual geniuses beavering away alone in private sector companies, dreaming of billions of dollars.
Yet as we now know well, this publicly funded vaccine, once discovered, was immediately privatised, locked up behind a wall of monopoly and intellectual property.
Public sector entrepreneurs
Equally, it is in no way the case that the private sector is necessarily the only place where innovation happens; as Mariana Mazzucato has famously showed, many significant innovations in recent decades, for example iPhones or Google searches, relied on publicly funded research and scientists employed by government.
The monopoly power of industry can and does in fact regularly stifle innovation, and lead to sub-optimal outcomes. How long has the fossil fuel industry held back innovation into renewable alternatives using all the power at their disposal? Why don’t we talk more about how the private sector deliberately slows innovation?
Back in the field of health, of course it is well documented that our system of developing medicines sees money and research poured into fixing problems like the erectile disfunction of middle aged men in the global north whilst neglecting diseases like malaria or dengue fever.
Industry and the private sector can have a really important role to play, particularly in producing at scale, and in efficient ways. The MRNA hub is working in partnership with a broad range of different pharma companies from across the developing world. But I think it is a mistake to put the private sector on top, as the ones ultimately in charge. Industry are the engine that often powers the car, but the private sector makes a very bad driver, taking us down the wrong road regularly.
So it seems to me that it is not clear at all that this is the best way to drive innovation and new science, and it is certainly not the only way available to us, as the WHO MRNA hub demonstrates.
Anyhow, beyond these practical arguments, I really think that there is also a powerful moral debate here. It seems a desperately sad and limited view of human nature that the only reward that truly matters and truly motivates is financial.
And conversely, putting a price on such endeavour in many ways corrupts it. It undermines from the beginning what I think should be the primary role of technology and scientific innovation. I think it should primarily be a route to human progress, a way to collectively tackle the immense challenges that humanity faces. That the benefits of new technologies should be made available to all of humanity equally, as fast as possible, not only to rich people and rich nations. That they should lead to people leading happier, longer lives and having to work less, rather than driving growing inequality and huge wealth at the top whilst those at the bottom lead harder lives.
This is perhaps most clear in health, but it does not end there. COVID-19 clearly showed the limits of this private monopoly, money driven approach in the face of a collective crisis for humanity. How many new technologies that could drive a low-carbon future could be locked up behind monopolies and patents, their widespread use all over the world prevented, their cheap production delayed decades at huge cost to the planet?
Imagine a world where we had followed up on the public investment in vaccines, by conditioning that money on Moderna sharing its technology with the WHO MRNA hub and through this investing in new MRNA manufacturing plants worldwide. Moderna showed that it could, in the space of a few months, repurpose factories that had never even made vaccines before, to the point where they were producing hundreds of millions of doses. It was a stunning achievement. Instead of only doing that in Europe and the United States, imagine if it had been done worldwide. It is not unreasonable to think that millions of lives would have been saved as a result, and an amazing legacy of expertise and capacity would have been created to help us tackle other diseases and the next pandemic.
The good news is that despite the derision of Davos man, the WHO scientists have managed to reengineer the Moderna vaccine, and through this develop MRNA expertise that is patent free and dedicated to the public good. It is too late for the millions who died, but it can still be the foundation of a truly public alternative. A demonstration that a different way is possible, a more public way, where doing the maximum good for humanity is the primary motivation of science. We should do all we can to support them.
Max is the Head of Inequality Policy at Oxfam International & EQUALS Podcast co-host. He is also Chair of the global People’s Vaccine Alliance.
Image Credits
Featured image: Researchers at Afrigen Biologics and Vaccines are attempting to replicate Moderna’s vaccine. Credit: Afrigen Biologics. Source: https://www.nature.com/articles/d41586-022-00293-2
Cover, "The Entrepreneurial State" by Mariana Mazzucato https://marianamazzucato.com/books/the-entrepreneurial-state
Scientists at the WHO MRNA Hub