The Trump administration’s bulk purchase of the COVID-19 drug illustrates the stranglehold of monopolies on capitalist governments and global development as a whole, writes Michael Quinn.
On the 1st of July, the US Government struck a deal with Gilead Sciences, to purchase the world’s supply of Remdesivir, an anti-viral drug that has shown some benefits in the treatment of COVID-19. The US administration’s buyout can be used to draw closer attention to the American political system, who it represents and how decisions are made.
Questions have been raised over the effectiveness of the drug, the price set by its patent-holders and the implications of reactionary protectionism amidst global emergency. A Marxist analysis of the situation should seek to ask the questions we are not seeing in the news.
Who benefits from the buyout and how? Who loses out? How does this fit into a wider context of medicine, science and profit under capitalism?
We can then seek to present an alternative based on the humanitarian achievements of the socialist nations, standing in contrast to the disaster unfolding in the wealthiest parts of the capitalist world.
A sellers’ market?
Concern has been voiced across the board with regards to the price set for Remdesivir. Gilead plan to charge $2,340 per course to developed nations, in turn costing the average American citizen with insurance $3,120. [i]
To put the price tag in context – this is a drug with no clearly evidenced benefit on mortality in COVID-19 patients. However, evidence has been established, that Remdesivir has a positive effect on the amount of time critical patients spend in hospital. In this, we see where the focus on the development of the anti-viral aligns with the strategy adopted by the big capitalist nations in the face of the virus. [ii]
The US and UK’s governments have sought a soft approach to tackling the pandemic, seeking to maintain production and keep business afloat – “flattening the curve” in an effort to keep the acceleration rate of infection under the level where healthcare systems become overwhelmed.
Remdesivir can reduce a COVID 19 patient’s hospital stay from fifteen to eleven days, which could provide a degree of respite to healthcare professionals, in a nation facing daily infection rates as high as 42,000. [iii]
According to Texas representative Lloyd Doggett, the drug’s development would have been scrapped if not for a $99 million injection of public funds.[iv]
Anyone under false illusions about the nature of the US state might then ask, why the US public must pay such exorbitant rates for the privilege of well-being. Particularly when confronted with claims from Dr Andrew Hill of the University of Liverpool, that the medicine can be produced as cheaply as $9 a course. [v]
The substance of these claims is echoed by NGO Public Citizen, who campaign for the drug to be sold at $1 a course, based on the public contribution to research.[vi]
Gilead’s price is even ten times higher than the Institute for Clinical and Economic Review’s recommended cost-effectiveness rate of $310 per course, should Remdesivir fail to demonstrate a positive effect on mortality rate.[vii] It is also worth remembering that these rates are already set based on a reasonable level of private profit for shareholders.
With this evidence calling US Government policy into question, we can turn to asking how this situation came to be and who it really benefits.
Who is winning?
We know that in 2016, Gilead was one of many holdings in Donald Trump’s stock portfolio. Even back then, the relationship rose some eyebrows. Two years previous, Gilead had faced scrutiny from the US Congress over its prices for another drug, Sovaldi. Gilead had charged $1,125 per pill ($94,500 per course) for the standard Hepatitis C treatment.[viii]
In turn, Gilead spends a healthy sum on political contributions, including recent payments to local candidates, the Republican Party and $50,000 to the Republican State Leadership Committee – an organisation listed as a “527 group”. [ix]
According to Cornell Law, an organisation can be defined as a 527 if “all the exempt functions of which are solely for the purposes of influencing or attempting to influence the selection, nomination, election, or appointment of any individual to any State or local public office or office in a State or local political organization”. [x]
Here we get an introduction to the workings of capitalist politics and can start to join up dots about the powerful sway money has in its decision making.
The stake President Trump holds in the company pales in comparison still, to some of the other major shareholders in Gilead Science.
The largest of the shareholders is the Vanguard Group, with $7,849,045,059 worth of holdings in the company.[xi] As the name might suggest, the Vanguard Group is not an extremely wealthy individual, but a collective organisation of the extremely wealthy.
While the ideology fed to working people at every level of society focuses on the individual, successful capitalists know that power comes from collaboration and accumulation of resources. Just like workers can use their ability to withdraw labour collectively, the wealthy forge alliances to wield their own collective power through combination and massive build ups of capital.
The Vanguard Group holds $6.2 trillion in assets.[xii] To put the sheer scale of this wealth into perspective, the only two countries in the world to exceed this figure in GDP are the US at $19.485 trillion per year and China at $12.238 trillion. Third on the rankings is Japan with $4.872 trillion. [xiii]
In 2019, the nation sized investment group spent $2,450,000 on political lobbying. Compared to Gilead, Vanguard’s political expenditure is relatively non-partisan with contributions split between the Republicans and the Democrats around the middle. [xiv]
This could be explained by Gilead’s local approach with regards to political contributions, focusing very much on the state of California.
Vanguard on the other hand, funds candidates across the nation on a case by case basis. The amount of money Vanguard contributes to the Democrats is increasing, as sections of financial capital seek a safe alternative to Donald Trump.
This could have been a key incentive in the Democrat Party’s anti-democratic super-delegates decision to overturn the popular momentum gathered by the Bernie Sanders campaign in candidate selection for the 2020 presidential election. [xv]
In the US, political candidates and elected representatives from both parties compete for big business backing at local and national level. In the words of African leader Julius Nyerere “The United States is also a one-party state but, with typical American extravagance, they have two of them.”
In turn, companies like Gilead are happy to give money to the Christian right in one hand and LGBT charities in the other. Juggernauts like Vanguard are happy to spread their wealth, setting their own terms with stockpiles of accumulated capital. Government officials can end up working for them as political lobbyists – in fact 17 of Vanguard’s 27 lobbyists formerly held government jobs. [xvi]
All this paints a picture of an interdependent relationship between the US state and US capital. We see who benefits from real people thrown into financial hardship out of illness and we can see why those who run the state might owe their real loyalty to firms like Gilead and Vanguard.
Capital takes on a global character and closer to home, a recent big investor in Gilead is the Scottish Investment Trust[xvii], meaning that capital from the US government buying 100% of the worlds Remdesivir supply for July (and 90% the two months after that) will flow into Scotland and the UK – despite no available access to the drug until October.[xviii] [xix]
While profits flow freely between capitalist nations, scientific and medical progress is blocked off behind privately held patents, production is monopolised, and prices are set to maximise profit.
As the programme of the Communist Party, Britain’s Road To Socialism, puts it “Capitalism’s drive to maximise profit leads it to turn every area of human need : food, clothing, shelter, education, sex, leisure into a market for the production and sale of commodities for profit, it will not produce even the most vital goods and services to meet society’s needs“.
In this we see a cynical form of international solidarity, where the size of dividends has more of an influence on the distribution of necessities, than need.
The socialist alternative
Compare it to the humanitarian endeavour of a small island nation in the Caribbean with a GDP that makes up 1.56% ($96.85 billion) of the total assets held by the Vanguard Group. That nation is Cuba, a socialist nation under an oppressive economic blockade led by the US and upheld by its allies. [xx]
Campaigners are calling for Cuban doctors to be awarded the Nobel Peace Prize in recognition of the international effort mounted by the medical brigades. Cuba has dispatched over 2,000 doctors to 27 countries in a huge effort to combat the pandemic. [xxi]
Cuban doctors previously played a leading role in combatting the Ebola epidemic and work constantly in underdeveloped nations to save lives.[xxii]
Cuba’s economy is structured very differently than capitalist counterparts. Most Cuban industry is state owned, and its proceeds go directly into increasing literacy, free quality education at all levels and some of the best healthcare in the world. Cuba has 8.22 Doctors per 1000 people. The UK has 2.81 and the US 2.6. [xxiii]
Think of Cuban exports and you might think of cigars, rum or sugar but in 2018 Cuban doctors brought in $6.8 billion, more than all three combined. So where does this money come from, where is it spent and who benefits?
Cuban doctors are dispatched all over the world, with revenue from their missions in wealthy nations going towards solidarity missions in underdeveloped nations and former colonies. Cuba has also never charged for international efforts combatting pandemics, earthquakes, hurricanes and other crises. [xxiv]
Revenue also goes towards the Latin American School of Medicine, which trains doctors from areas with low access to medical care on the basis that they return to their communities in service. Over 29,000 doctors from over 100 countries have been trained by the school over the past 20 years. [xxv]
Some of these doctors are engaged in humanitarian aid in the US, despite decades of economic blockade imposing a heavy toll on the small nation. [xxvi]
The contrast between this model and the model described using Remdesivir as an example tells a truth. It demonstrates the possibility of an economic system beyond capitalism and provokes the imagination with a picture of the possibilities of a world where advanced economies are structured for human need.
As one example of many, in a world shellshocked by capitalism’s inaction in crisis, of socialist success and capability.
This success poses a threat to American and indeed, capitalist, global leadership and the example of Cuban doctors can be invoked again to demonstrate how imperialism defends its international interest.
According to the New York Times, 37,000 Brazilian children are at risk of death after Jair Bolsonaro took power in Brazil and expelled Cuban doctors stationed in the nation[xxvii]. President Lenin Moreno of Ecuador realigned his country’s foreign policy toward the US and expelled a delegation of 400 Cuban doctors[xxviii]. Bolivian socialist President Evo Morales was deposed in a coup several months ago, US diplomatic plates were spotted on a car outside of a site where 725 Cuban medical staff were interrogated before expulsion. [xxix]
Not content with medical and scientific isolationism, private capital uses state power to undermine humanitarian effort – should that effort belong to the new socialist world.
In the interest of human progress, the advances of the socialist nations must be defended, and the barbarism of the capitalist nations must be exposed. An economy run on human need must become the standard, rather than the exception.