It has taken just 10 months, in UK prime minister Boris Johnson’s flamboyant assessment, for “the scientific cavalry” to arrive.
When three groups announced in quick succession this month that the vaccines they had developed against Covid-19 had proved highly effective in clinical trials, the news offered not only a blazing ray of hope for a pandemic-bound world, but a moment of vindication for a beleaguered pharmaceutical industry.
In recent years, the industry has more often been assailed for its alleged price-gouging than praised for its panaceas. Only this week, in a dismal counterpoint to the stunning vaccines news, came a fresh reminder of its role in America’s opioid addiction crisis, when Purdue Pharma pleaded guilty to criminal charges over sales of its painkiller OxyContin.
Dan Mahony, a leading UK life sciences investor, argues the industry has provided a riposte to critics of its pricing strategies, with its record-breaking pace — from the sequencing of the novel coronavirus in January to vaccines submitted for regulatory approval in November — and efficacy levels that exceeded the expectations of politicians, medics and markets.
“The argument of the industry for a long time has been ‘we’re innovative, you’ve got to pay up for innovation’. That premise has been put to the test this year and the industry has over-delivered,” says Mr Mahony, who is co-head of healthcare for Polar Capital, which has an investment in AstraZeneca.
But even as it basks in global plaudits, there are signs that its rehabilitation is conditional. A gathering row over the presentation of data by Oxford university and AstraZeneca about the performance of their vaccine has illustrated the perils of such relentless public and political scrutiny.
The claim that their vaccine was 90 per cent effective when using a particular dosing regime turned out to be based on people aged 55 or younger, rather than older ages at higher risk from the disease. Neither the company nor the university disclosed that detail, prompting criticism from some scientists and analysts when it was revealed by Moncef Slaoui, the head of Operation Warp Speed, the US government’s funding programme for vaccine development.
The Oxford/AstraZeneca vaccine’s cheap price and the fact that, unlike Pfizer’s version, it does not have to be stored at ultra-low temperatures, make it particularly well-suited to the developing world, an advantage that is likely to outweigh any controversy.
Beyond that dispute, reputational risk lies in wait for the wider industry. Any evidence that deep-pocketed nations are being favoured over poorer ones to receive consignments of one of the vaccines, or even a simple malfunctioning of manufacturing or distribution chains, could spark a backlash as big as the hopes invested in any immunisation programme.
Nor can the sector look forward to a complete easing of political hostilities under a Joe Biden administration; reform of the pharmaceutical industry is a rare area of bipartisan consensus. Last week Donald Trump coupled an announcement of drug pricing reforms with an attack on Pfizer — whose vaccine has proved 95 per cent effective — alleging that it had delayed the release of its positive data until after his defeat in the November 3 presidential election as part of a “corrupt game”.
Jeremy Levin, chair of the US biotech trade association BIO, says Mr Trump was “seemingly vindictive”, trying to harm the entire sector. “It was a broad-base shotgun, but it was aimed at the industry at exactly the time that the industry is innovating.”
The incoming administration looks set to persist with plans for significant reforms, despite any vaccine afterglow, but could take a more conciliatory approach. Geoffrey Porges, an analyst at SVB Leerink, an investment bank focused on healthcare, says Mr Trump clearly had “grievances” with Big Pharma but expects the Biden administration to pursue more “palatable” attempts at reducing drug prices, which he believes the industry is prepared for.
When David met Goliath
Jack Scannell, an expert on the economics of drug research and development, cautions against handing too rapturous a report card to the industry, pointing to the large sums governments have committed to underwrite clinical trials, support manufacturing and place advance orders.
“Before we pat the drug industry on the back too much, one has to recognise it got involved in this partly because the whole thing has been de-risked by government,” he says.
Virginia Acha, head of global regulatory policy at MSD, the name by which the US group Merck is known in the UK, disputes that it took the lure of government cash to persuade the industry to enter the Covid fight. “Quite a number of the investments under way happened before [government schemes] were even announced and some have not necessarily been availing themselves of those funds so I don’t think that is the rationale for why companies acted.”
Ms Acha, whose company has two vaccines in early-stage studies, and an antiviral medicine in more advanced trials, says it was not simply a question of money “but of having the capabilities and capacity to get that work done”, crediting “a phenomenal response from across the industry, where companies have put all other work or planning aside to focus on the pandemic, to get to an answer”.
The success of the vaccines could finally help the industry to silence criticism that it is too slow to bring novel medicines to market. Mr Mahony suggests this is an outdated view, tied to a time when many companies were facing a “patent cliff” as their rights to once-lucrative medicines expired, tanking their share prices.
“In 2009-10, pharma companies were priced as if they were going to go out of business, as if they were never going to have a [new] drug again,” he says. “Investors were scared; they couldn’t see where the growth was coming from.”
However, even during the bleakest years, he adds, the industry as a whole never ceased to innovate: activity simply switched from big pharmaceutical groups to agile, cutting edge biotechnology companies, which often went on to be acquired by, or partner with, traditional companies.
This David versus Goliath narrative has been prominently on display in the vaccines saga: two biotech companies, Germany’s BioNTech and Boston-based Moderna, have played starring roles bringing a more nimble approach.
The question now is whether that turn of pace, which has so impressed the world, can deliver a lasting boost to the industry’s long-stagnant productivity levels.
The blueprint developed in recent months to fight coronavirus could have a durable impact on how the industry works, says Richard Torbett, chief executive of the Association of the British Pharmaceutical Industry. “There has been the most extraordinary global effort: collaboration like we’ve never seen before, redeployment of resources we’ve never seen before and sharing of data.”
Mr Scannell acknowledges “some great case studies of how things can be done quicker. It may be that regulators and governments learn from that.” But the main reason development has moved so fast, he claims, is “a complete imperviousness to financial risks”, helped by government support “and probably more tolerance of risk in the clinical trials”. Volunteers had entered late-stage trials with less information than is usual from early stage trials, due to the compressed timetable.
There is no suggestion that the phase 3 trials themselves have been other than robust, but “going so fast to phase 3 would not be acceptable outside a public health emergency”, he adds.
Ms Acha hopes one legacy will be a willingness, on the part of companies, governments and academia, to continue the co-operation that has seen even corporate rivals work together in recent months. “It would be great if we could form the same kinds of collaborations to tackle big issues like [anti-microbial resistance] or rare diseases or cancer,” she says.
Reflecting on the questions raised by the Oxford-AstraZeneca furore, she adds the fast pace of development in the pandemic means companies are releasing data about their drugs and vaccines at far earlier stages than they normally would, to satisfy the appetite for knowledge of regulators as well as the public.
She adds: “I think for any company, that’s a difficult challenge. Everyone’s trying to be very transparent but we don’t have everything done and dusted, so it’s about working with us on a real-time basis to understand interim data and that will take some getting used to.” Such debates could be a good thing, she argues, providing the public with insights about how the drug development process works.
Mr Scannell remains sceptical that the crisis will deliver any lasting change to the way the industry is regarded. But he adds: “For me the big test will be around access. If we find the poor parts of the world are vaccinated pretty quickly and at low cost, that will possibly change some views.”
Robin Feldman, a law professor and the author of Drugs, Money, and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices, says that in the US, government money has come with few strings attached on price or intellectual property. “That could come back to haunt both pharma and the government if prices [for other drugs] continue to soar when Covid-19 is behind us.”
For now, says Ms Acha, the vaccine will provide the only litmus test that counts for trust in the industry, as each citizen grapples with the decision of whether or not to take it. “We need the support of the public and society at large,” she says. “What we’re doing has to make sense at every step of the process and at every level of society.”
Taiwan seizes chance to host foreign reporters kicked out of China
Taiwan is courting journalists fleeing China, spotting an opportunity to boost its visibility and build international support as concerns mount that Beijing is flirting with the idea of invading the country.
Last year, more than 20 journalists made the journey across the Taiwan Strait from China. Many had published articles critical of human rights abuses against the Uyghur Muslim minority in Xinjiang and the government’s early handling of the coronavirus outbreak in Wuhan.
They came at the invitation of the Taiwanese government, a move that has infuriated China, which claims the island as part of its territory.
Jojje Olsson, a freelance journalist living in Taipei since being denied re-entry to Beijing in 2016, said that Beijing’s reaction to critical reporting carried risks for the regime.
“China is shooting itself in the foot by expelling lots of journalists,” he said. When reporters come to Taiwan, he argued, “they are exposed to views that don’t reflect well on China”.
Steven Butler, the Asian head at the New York-based Committee to Protect Journalists, said that “Beijing is surely very unhappy about journalists moving to Taiwan”.
China, he added, was sensitive to the foreign media being in Taiwan, citing a case two years ago involving a prominent newspaper that was warned against setting up a regional headquarters in Taipei.
Beijing said the newspaper’s offices in the Chinese capital would be forced to close if it went ahead with its expansion plans.
Michael Smith of the Australian Financial Review, who was forced to leave China in September after being questioned by state security officials, said Taiwan’s consulate officials in Sydney “made it very clear that we [journalists] were welcome”.
He declined the invitation but many others accepted.
Last year, journalists from The New York Times, The Wall Street Journal and The Washington Post arrived in Taiwan after being expelled from China, which Beijing said was a response to Washington’s blacklisting of its state media reporters.
They were joined three weeks ago by RTÉ’s Yvonne Murray and her husband John Sudworth of the BBC following threats of legal actions over his reporting on Xinjiang.
Taiwan’s Ministry of Foreign Affairs and China’s Ministry of Foreign Affairs did not respond to requests for comment from the Financial Times.
Hong Kong had been the city of choice for journalists covering the Chinese state from afar. Western journalists booted out of China after Mao Zedong came to power in 1949 decamped to the British colony, leaving behind reporters from the Soviet bloc.
Seventy years later, Olsson said Taiwan was assuming Hong Kong’s former role. The introduction of China’s sweeping national security law on Hong Kong last year meant that the territory no longer afforded protection from Beijing.
“There is no other place in the world that follows developments in China as closely as Taiwan,” argued Olsson, adding that finding out what the Chinese Communist party was up to was a matter of existential concern for the Taiwanese.
Taipei’s early detection of the pandemic is a case in point. Taiwanese officials were alerted to the novel coronavirus circulating in Wuhan through close monitoring of Chinese social media and introduced containment measures before any other foreign government.
Taiwan boasts expertise in China across its government and private sector, and shares a language and timezone. But reporting from across the Taiwan Strait has its limitations. Journalists have experienced difficulties securing interviews and personal stories that present a more nuanced picture of China.
Their jobs have been additionally complicated by the absence of news assistants — China-based journalists and researchers employed by international media — who face more severe legal consequences and lack the privileges of a foreign passport.
Reporters have also been forced to operate without the support of a bureau, as media executives are wary of provoking China by opening offices in Taiwan. Deutsche Welle, the German broadcaster, was the last foreign media outlet to do so in 2018. Tokyo and Seoul are viewed as alternative east Asian headquarters, industry insiders said.
The size of Taiwan’s economy is another factor that has given foreign outlets pause. Despite being home to some of the world’s most important technology companies, only a handful of news organisations provide consistent coverage of the Taiwanese market, which is often overlooked by foreign investors.
But China’s escalating military posturing towards Taiwan has kept the island in global headlines, as the two sides battle to dominate the international narrative around its contested status.
Beijing has used its economic and political might to entice Taipei’s few remaining diplomatic allies to switch recognition, undermining Taiwan’s sovereignty with promises of investment deals.
But by welcoming foreign journalists, the Taiwanese government has also exposed itself to critical coverage of the marginalisation of its aboriginal communities and migrant workers as well as a sluggish vaccination rollout. Journalists, after all, as one Taiwanese politician joked to the FT, “are hard to control”.
Defund the police: how a protest slogan triggered a policy debate
Eleven months ago “Defund the police” was a slogan that appeared on placards at protests; now it is being debated by American city councils.
Polls show only a small portion of Americans support the idea of defunding the police, a flexible phrase that can mean redirecting funds to social services or outright elimination of the department. Yet as lawyers prepare to deliver closing arguments on Monday in the trial of the officer accused of murdering George Floyd in Minneapolis, and in the wake of yet more deaths at the hands of police, what was previously a fringe concept has become part of mainstream US political discussion.
Minneapolis has three proposals to diminish the police department’s power that supporters are attempting to place on the ballot in November. Two would replace the police department with a department of public safety, with the police as one division of it. The third would place the police department under the control of a 13-member civilian commission, with the power to hire the police chief and discipline officers for misconduct.
Austin, Texas cut its police budget in August by 35 per cent, with 5 per cent taking immediate effect. Seattle cut the police budget by 20 per cent in December. City councils have cut police budgets in nearly two dozen other cities, although mostly because the pandemic has battered municipal finances.
“People will look back at this year and say this was a real turning point,” said Alexander Weiss, a consultant who has advised police departments in Chicago and New Orleans, in reference to police accountability.
Floyd’s death last May set off protests around the world at the disproportionate number of people of colour killed by police. A key demand for many activists was to abolish police departments entirely, or cut their funding and redirect it to social services. In Minneapolis, nine city council members stood on a stage and pledged to defund the police. When Washington, DC Mayor Muriel Bowser ordered that the words “Black Lives Matter” be painted on a city street blocks from the White House, demonstrators used the same yellow paint to add: “Defund the Police”.
With more people killed by police in the past three weeks, the demands to defund have escalated. Chicago community organiser Rey Wences told non-profit news outlet Democracy Now! that following the killing of 13-year-old Adam Toledo last month by a Chicago police officer: “What we’re asking for is the same thing we’ve been asking for years . . . Defund the police and invest in our communities.”
In 2017, state and local governments around the US spent $115bn on police — some 4 per cent of state and local direct general expenditures — according to the Urban Institute. That share has stayed constant for the past four decades, even as the rising cost of healthcare means other big-ticket items, such as elementary education, now constitute a smaller portion of municipal budgets.
Most of the money is used to pay salaries and benefits to police officers, so cutting more than 15 per cent of a department’s budget often means cutting the size of the force, Weiss said.
Police officer pay has increased as police unions have grown in power and unions are some of the defunding movement’s most dedicated opponents. After Austin City Council in August voted to cut the police budget by $150m, the Texas Municipal Police Association put up a billboard outside the city, saying, “Warning!!! Austin Police Defunded Enter at Your Own Risk”.
Critics have warned that crime will rise if police budgets are cut. The number of homicides did rise in most US cities last year. Although the reasons are unclear, that increase seems to be unrelated to police budget cuts, which in most cases had not yet taken effect.
Some Democrats have been critical too. President Joe Biden said in a meeting with civil rights leaders that talk of defunding the police was how Republicans “beat the living hell out of us across the country” in the November elections.
An Ipsos/USA Today poll released last month found that 18 per cent of Americans support defunding the police, and only 11 per cent support abolition. About 57 per cent support fully funding their own local police department, while 43 per cent support redirecting some of that money to social services.
Richard Auxier, a tax and budget expert at the Urban-Brookings Tax Policy Center, said that since police budgets were set by local governments: “there are literally thousands of them across the country, . . . and they all have their own politics”.
The politics have been particularly intense in Minneapolis. Three of the councillors who took the pledge in June backed away from it. The Minneapolis Charter Commission, a previously obscure body, killed an attempt last year by council members to place a proposal on the ballot that would replace the police department with a new public safety agency. The Minneapolis City Council launched a second attempt in January.
Activist Antonio Williams is a canvas director for the Yes 4 Minneapolis coalition, which is trying to land an initiative on the ballot that is similar to the city council’s. (A third group, Twin Cities Coalition for Justice 4 Jamar, also is pursuing a ballot initiative.) So far more than 20,000 residents have signed the Yes 4 Minneapolis petition.
Williams said some of the residents he had spoken to thought the petition’s language went too far, while others thought it did too little. He sees all those conversations as a first step in the process of persuading someone to sign, then to show up at the polls in November to support the initiative.
For him and other activists, the killings of Daunte Wright by a Brooklyn Center police officer, or of Toledo in Chicago, add no urgency to their cause, because it has always been urgent. But perhaps for some, the fact that Wright’s death occurred while former police officer Derek Chauvin is being tried for Floyd’s death, when the world is watching Minneapolis, underlines “a dire need for some change”.
“It’s going to continue to happen all over the country until policing as we know it and see it is done away with,” said Williams.
Certainly Floyd’s death “galvanised” the city’s residents on the issue of police misconduct, Williams said. He doubts the signature drive could have succeeded 11 months ago. “The conversation could have been had for sure, but the next step, the commitment, the action part of it?” he said. “I don’t see it happening.”
UK business groups call for mandatory reporting of ethnicity pay gap
A duty for large companies to publish the pay gap between staff of different ethnicities would be a straightforward step to tackle racial inequality in the workplace, according to UK business groups and economists who accuse the government-commissioned race report of downplaying the extent of problems in the labour market.
A storm of criticism greeted the report by the Commission on Race and Ethnic Disparities (Cred), after it concluded last month that the UK was not “rigged” against minorities and that “very few” disparities were linked to racism. But the main complaint from business groups was its failure to recommend a statutory reporting obligation of the kind in place since 2017 for gender pay disclosure.
The report said there had been a “broadly positive story” on ethnic minorities’ place in the labour market over the past 25 years, with “a gradual convergence on the white average in employment, pay and entry into the middle class”.
But Jonathan Portes, professor at King’s College London, said Cred had relied on “crude sleight of hand” in presenting statistics to back up its narrative.
A headline gap of 2.3 per cent between the hourly median pay of all minorities and white British employees hides a much bigger gap for certain groups — with those of Bangladeshi and Pakistani ethnicity at particular disadvantage, and black men suffering a far bigger shortfall than black women.
Alan Manning, a professor at the London School of Economics, said that after adjusting the data for personal characteristics such as age, qualifications and family status, there was “no evidence for pay gaps being smaller . . . than they were 25 years ago”, and that while the ethnic penalties for some groups had improved over time, “the overriding impression is of stasis”.
These persistent pay disparities partly reflect occupational segregation, with many ethnic minorities clustered in low-paid jobs with little chance of progression. Andrea Barry, an analyst at the Joseph Rowntree Foundation, notes Bangladeshi men are three times as likely as white British men to work as chefs and waiters, while Pakistani men are more than 10 times as likely to work as taxi drivers.
But they also reflect the barriers to career progression in professional life. Ethnicity pay gaps are largest in managerial, professional and skilled occupations — and when employers examine pay differentials within their organisations, they generally find ethnic minority employees are concentrated in frontline roles, and under-represented at senior level.
A growing number of employers — from law and accountancy firms to local authorities and large companies such as Sainsbury and Network Rail — now report ethnicity pay gaps on a voluntary basis.
Cred endorsed this voluntary approach, arguing that there were statistical “pitfalls” in trying to impose the framework used for gender pay to report outcomes for many ethnic groups.
However, business groups have repeatedly urged the government to introduce a mandatory reporting requirement, modelled on gender pay disclosure, arguing that practical difficulties can be overcome.
Matthew Fell, CBI chief UK policy director, said pay gap disclosure was “one of the most transformative steps a company can take to address race inequality at work”.
Peter Cheese, chief executive of the Chartered Institute of Personnel and Development, criticised Cred for a “missed opportunity” to press for mandatory disclosure, adding: “Racial equality at work is not just about participation in employment but also about progression into more senior roles. Pay reporting can highlight organisations and sectors where this is not happening.”
Sandra Kerr, race director at the charity Business in the Community, which has campaigned for mandatory reporting, said that while disclosure was not a “silver bullet”, it prompted companies to examine where people were sitting in their organisation, and was a way of “ensuring that the conversation is had at the top table”.
BITC has found that barely one in 10 large companies reports on its ethnicity pay gap voluntarily, and points to a sharp drop-off in gender pay reporting last year, when the pandemic led to a suspension of the usual requirement to disclose the pay gap between male and female staff.
The government consulted in 2018 on options to introduce a mandatory requirement, and has tested possible approaches to reporting with various businesses, but it has not yet taken further action. The Department for Business, Energy and Industrial Strategy said that it would respond to the consultation “in due course”.
Ethnicity pay reporting is more complicated than for gender. One issue is disclosure: many companies hold only patchy data because employees do not have to disclose their ethnicity and some are reluctant to do so — or unable to find a box to tick that matches their heritage.
A bigger issue is sample sizes. Ideally, employers would give a detailed breakdown of outcomes for different ethnic groups, but it is not always possible to do this while preserving anonymity. Cred argued that many employers recruiting from predominantly white areas do not have enough ethnic minority staff for a median pay comparison to be meaningful.
But business groups say these issues are manageable, if companies also put the headline figures in context and explain how they plan to close pay gaps.
Network Rail, for example, has published figures showing the pay gap for black employees is much bigger than for Asian colleagues, based on disclosure by 90 per cent of staff. With more than 100 nationalities among its staff, it collects more granular data to inform internal policy but does not publish figures where the sample size is too small to be reliable.
Sainsbury, meanwhile, has published figures showing that median pay for black employees is higher than for white colleagues — explaining that more black staff work in London stores with a higher pay weighting. Mean pay for black employees, who are under-represented at senior level, still lags.
Without an accompanying narrative of this kind, a pay report is “not worth the paper it’s printed on”, Kerr said.
The complexity of reporting ethnicity pay data is no reason not to report it, as Andy Haldane, the Bank of England’s chief economist, has argued.
“Published pay gaps are a starting point for corporate and national accountability and explanation, not an end point,” he said in 2019. “No single metric can perfectly summarise all dimensions of diversity. But publication of a single metric can, and has, served as the catalyst for an explanation and action.”
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