When it came to solving the crisis, progressive policies took a back seat to the institutions and forces that actually got the job done.
Assuming that the COVID-19 vaccines work, their development will be the biggest, most high-profile public-health success story since the polio vaccine in the 1950s. A weary world has waited many trying months for this. Yet in the media’s coverage, there are a lot of mixed messages about how this happened — because the story is not one that fits comfortably with liberal narratives. Consider the big, splashy New York Times story by six reporters (Sharon LaFraniere, Katie Thomas, Noah Weiland, David Gelles, Sheryl Gay Stolberg, and Denise Grady) on the Pfizer/BioNTech and Moderna vaccines, and the Stat story by Damian Garde and Jonathan Saltzman on the technology behind them. When you dig into the details, the heroes are largely (1) big American pharmaceutical corporations, (2) the Trump administration, and (3) the U.S. military. The lessons to be drawn support the conservative view of government, business, and their proper roles and relationships.
The tension is obvious early in the Times story, when it announces its intended theme: “In an era of polarized politics, science was able to break down barriers between government, countries and industry to produce one of the few pieces of good news in a year of suffering and division.” This is not supported by the facts. “Science” did not produce a vaccine, in the sense of a Jonas Salk figure having a “eureka!” moment in a laboratory some time in 2020. The Times does not bother introducing us to any of the individual researchers who actually developed the vaccine. Nor does it illustrate the breaking of barriers between countries, except by big business. The facts are more stubborn.
In fact, as the Stat story illustrates, the core concept of making messenger RNA (or mRNA) synthetically and using it to produce vaccines has been kicking around for three decades, and the crucial breakthrough came in 2005. While there were still some daunting scientific hurdles to overcome, the broader problem facing synthetic mRNA was its risky, experimental nature; only a change in the economics and available resources would make it economically viable to invest in scaling up a major trial of an mRNA-based vaccine to see if it would work.
When Moderna — a small but lavishly capitalized American pharmaceutical company dedicated to synthetic mRNA solutions — set to the task of developing a COVID-19 vaccine upon receiving the genetic code of the virus from China in mid January, the company’s researchers “plugged that data into its computers and came up with the design for an mRNA vaccine. The entire process took two days.”
Two days. Moderna had hundreds of vials of its vaccine shipped to the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland by February 24. Everything that has happened since — 1.4 million deaths worldwide, crippling lockdowns — has gone on while we were waiting for that vaccine to be tested, approved, and distributed.
Why did two American companies — out of all those in the race — take the global lead? Mind you, there are more American companies involved too: The list of companies pursuing other vaccines includes American companies Novavax, Inovio Pharmaceuticals, Johnson & Johnson, Arcturus Therapeutics (which has partnered with a Chinese manufacturer), Merck (which purchased an Austrian company as well as a Maryland company and recently sold its stake in Moderna), and Translate Bio (which is working with French drugmaker Sanofi). It was not purely a matter of Yankee ingenuity: BioNTech is based in Germany — the woman who runs its research team is from Hungary, and it is run by a husband-and-wife team of Turkish-Germans — and Pfizer’s CEO is from Greece.
Three factors came together to push the Moderna and BioNTech research teams to the front of the line. First was American capitalism. The United States had the private-sector capacity ready to go for this modern Manhattan Project for the same reason it was able to turn the Ford, General Motors, and Chrysler assembly lines to tank production in 1942: our dynamic free-market capitalist economy and, yes, its tolerance for massive for-profit pharmaceutical businesses. Pfizer financed the bulk of the estimated $2 billion research-and-development cost of its partnership with BioNTech out of its own prodigious balance sheet, which brings in $52 billion in revenue a year (although BioNTech also received $445 million from the German government). Moderna raised over two billion dollars in capital in eight years before going public in 2018; by late 2019, its market capitalization was twice that of its German counterpart, BioNTech. Pfizer’s CEO was quite blunt about turning down American government funding to avoid the strings attached when private companies do business with the government. This is how it should be: American business should do it on its own, when it can.
Both Pfizer and Moderna plan to make a profit from the vaccine — and that incentive has surely helped focus their efforts. So has the boom in both companies’ stock prices. Johnson & Johnson has announced its intent to distribute its planned vaccine at cost, but then, J&J is (unlike Pfizer and Moderna) a colossal consumer-products company that has many other ways to profit from the goodwill it generates by doing so. Pfizer is also handling its own distribution, while Moderna and other vaccine companies plan to use a distribution network arranged by the government.
We are endlessly told that America should be more like the rest of the world in the health-care sector, and that we could cut drug costs in particular by cracking down on Big Pharma’s profits. But now, once again, the rest of the world is getting a free ride on the dynamism of America’s health-care sector, which even for all of its government red tape is still one of the freest in the world. American free-market capitalism will save lives, as it has done so many times before, when nobody else could.
One way that Pfizer and Moderna plan to profit is by selling the vaccine to the government. The federal government has contracted with Pfizer to pay $1.95 billion for 100 million doses of the vaccine, with an option for another 500 million doses. (Moderna has its own $2.48 billion deal with the federal government for 100 million doses.) Pfizer also has a deal to sell 300 million doses to the EU, but for half the per-dose price paid by Uncle Sam. Does that mean Americans are getting ripped off? No. We paid for priority in receiving the vaccine. And laying out that kind of taxpayer money to guarantee Pfizer a market gave the company a further financial incentive to develop the vaccine. But it remains true that the rest of the world depends on the relative freedom of our system. The socialized-medicine markets of the EU would face a more difficult health-care landscape if the American marketplace didn’t effectively subsidize the development of so many life-saving medications. If America adopted the European model, who would take our place as the engine of innovation?
American money can be found all over this story. BioNTech’s business was already benefiting from a $55 million philanthropic grant from the Bill & Melinda Gates Foundation for work in other areas, and we all know where Bill Gates’s money came from. Even the European companies pursuing vaccines list their stock on U.S. stock markets. American investors can purchase GlaxoSmithKline stock on the New York Stock Exchange, and Astra Zeneca, Sanofi, and CureVac stock on NASDAQ.
The vaccine story is not only an American private-sector success story, however. A second hero can be found in the most unfashionable of places: the Trump administration and its Operation Warp Speed initiative. For all the public wrangling between the Trump White House and the “deep state” of the federal bureaucracy, Operation Warp Speed would never have happened if the president had not thrown the weight of elected leadership behind recommendations by permanent civil servants. As the Times tells it, Donald Trump not only supported the effort, but pushed it — not least for reasons of political self-interest — to move faster:
Operation Warp Speed was the brainchild of Dr. Peter Marks, the top vaccine regulator for the Food and Drug Administration. A collaboration between the Pentagon and the Department of Health and Human Services, it was devised to support pharmaceutical and biotechnology companies with the full breadth of the government’s expertise from clinical trials to logistics. The goal for a vaccine was October, according to an early memo. The president was especially enthusiastic about that aim. At a March 2 White House meeting, as Mr. Bancel and other pharmaceutical executives outlined their vaccine plans, Dr. Fauci cautioned that it would be a “year to a year and a half” before doses could reach the broader public. Mr. Trump replied, “I like the sound of a couple of months better.”
While Pfizer did not take Operation Warp Speed’s money, Moderna did. That financed Moderna’s research and development at taxpayer expense and paid for it expanding its workforce by 50 percent. Government help was not just money, and not just available to companies who took the money: “Operation Warp Speed had created six teams of around 15 clinical trial specialists, epidemiologists and budget experts, each assigned to a different vaccine maker.” And heaven and earth were moved to shove aside any obstacle:
When Moderna discovered this summer that an air handling unit for its factory could not be delivered over a weekend because of Covid-19 limitations on interstate trucking, the major’s team stepped in. Warp Speed officials arranged a law enforcement escort to accompany the massive piece of equipment from the Midwest to its Massachusetts manufacturing plant. The team again sprang into action when Moderna discovered that a specialized pump, needed to make the first batches of vaccine for the clinical trials, was marooned in a rail car and was not going to be delivered on time. Federal workers tracked down the train and rummaged through it until they found the pump.
Then, there’s the military. Liberals and progressives like to see the government adopt a “moral equivalent of war,” but they also prefer to see it administered by bureaucrats, scientific “experts,” and schoolmarms. But who do you call when you need logistics expertise, iron discipline, and a willingness to bulldoze everything in your way to reach an objective? You call the military. The people running the daily business of Operation Warp Speed were a former Moderna board member and a four-star general with a logistics background. From the Times report, you can almost smell the fresh buzzcuts:
Moderna’s team was headed by a Defense Department official whom company executives described only as “the major,” saying they don’t know if his name is supposed to be a secret. . . . The operation, working out of a seventh-floor suite and a second-floor operations center at the Health and Human Services headquarters, had a military flavor. Its leaders discussed the book “Freedom’s Forge,” an account of how American industry armed the military in World War II, and imposed what they called a “battle rhythm” of meetings, including a daily 8 a.m. session on vaccines. Dozens of military officers reported to work in uniform.
This is how government is supposed to work. It’s supposed to be there for emergencies, rather than have a permanent, ongoing presence. The private sector is the reservoir of money and creativity; government drains it in need when the land is parched. The government exists to marshal resources in a crisis; it can never do so as efficiently as private business, but it can do so at a larger scale than any business. Government is wasteful, but when cost is no object, time is of the essence, and it is animated by an urgent, defined goal, its sheer driving force can exceed that of the private sector. We can afford to act as if cost is no object at times; we cannot afford to act that way all of the time, or we will find the reservoir empty when we need it most. This is how the military or NASA works: Give me a goal, and I will move the world. It is not how a perpetual health-care bureaucracy could ever function.
Of course, the American system is not perfect, but its flaws were not the product of too much conservatism. Moderna’s testing was slowed for a critical juncture by demands to include more racial minorities in the trials. For all of Operation Warp Speed’s reductions in regulatory barriers (the FDA has never approved a vaccine in less than four years from its development), the U.K. will likely get the vaccine first because of a more lenient approval process that requires less redundant review of drug-company testing (the EU’s chief regulator has criticized the U.K. for haste, but new, impending post-Brexit rules will allow the U.K. to ignore such EU complaints). Fears of having the vaccines politicized surely contributed to a few weeks’ delay of their announcement until after the election, too, but Republicans were not the ones threatening to conduct a scorched-earth campaign against the credibility of a vaccine if it were publicized before the election.
The pandemic has been good news, in some ways, for liberal and progressive narratives about the need for collective action on health care. But when it comes to ending the crisis, those narratives need to take a back seat to the institutions and capabilities that actually got the job done.