Some further thoughts on the possible long-term significance of the TRIPS waiver for covid vaccines and treatments @pritikrishtel @IMAKglobal @charles_duan @GaryWinslett @ATabarrok 1/

Some critics argue that the waiver is bad because it's a really big deal--i.e., it will undermine future incentives to develop new drugs. I've already explained why these scare stories are bogus: 2/ https://twitter.com/lindsey_brink/status/1389976811870765062

Other critics argue the opposite: the waiver is bad because it's a nothingburger. Lack of know-how and manuf. capacity are the real constraints now, not patents, plus countries already have compulsory licensing authority under TRIPS. 3/

The waiver is thus empty virtue signaling that distracts attention from the real challenge--the need for massive rapid tech transfer and capacity expansion. Plus it feeds leftist bashing of pharma profits when we should be nominating the vaccine producers for Nobel Prizes. 4/

Among others @ATabarrok has argued along these lines. Since Alex has been more right about more things pandemic-related than just about anybody, it is genuinely terrifying to disagree with him. But I think he's selling the waiver short. 5/

I think the waiver sets a vitally important precedent, not just for the remainder of this pandemic for but possible (probable) future pandemics. And that is to establish the principle that INTELLECTUAL PROPERTY HAS ABSOLUTELY NO PLACE IN PANDEMIC RESPONSE POLICY. 6/

IP aims to speed up the creation of new ideas for the long term by slowing down the diffusion of new ideas in the short term: give inventors temporary monopolies (and the power to raise prices and restrict output) and you'll get more inventions over time. 7/

I believe that, in its basic terms, this is good bargain, and that therefore patent law is a useful element in the overall policy framework for encouraging innovation (despite the fact that current patent law is badly flawed in numerous respects). 8/

But in the context of a pandemic, the bargain is a bad one and should be rejected in toto. We want to accelerate the diffusion of effective vaccines and therapies, not give companies the power to slow diffusion by raising prices and blocking competitors. 9/

It's really hard to overstate this point. In general the IP bargain can offer important encouragement to innovation, but when a pandemic hits that bargain is a recipe for mass death. 10/

So if we can't give drug makers the usual patent inducements in a pandemic, how do we incentivize them to save us? Through direct gov't support: public R&D funding, advance purchase commitments, and other direct payouts. 11/

And when we pay drug makers directly, we should pay a big whopping premium--we want them to make huge profits so they're eager to play again when disaster strikes next. 12/

So waiver critics' concern about pharma profit bashing is appropriate--such bashing is incredibly shortsighted. 13/

We definitely shouldn't penny-pinch in payouts to drug makers--whatever we give them will be a drop in the ocean compared to the lives and dollars they save--but we do need to make sure they profit from doing the right things. 14/

We want drug makers to be richly rewarded for vaccinating the world (both on their own and by tech transfer to other firms). We emphatically don't want drug makers to profit because of their ability to interfere with and slow down global vaccination. 15/

The value of the TRIPS waiver is that it cleanly rejects the IP bargain in the context of a pandemic. Now it's time for the US gov't to step up and offer the alternative bargain: pay drug makers generously, even extravagantly, for rapid tech transfer and manuf. expansion. 16/

If the US fails to follow through, then in retrospect the critics' assessment of the TRIPS waiver as empty symbolism will have been correct. 16/

But the Biden admin seems fully aware that the waiver isn't a panacea and that a big push on tech transfer & capacity expansion is needed. And so far they have demonstrated no hesitancy on spending big for pandemic response. 17/

So I'm hopeful that they'll come through and the waiver will be just part of a larger process of changing funding models for pharma innovation in a pandemic. But lots still has to happen--stay tuned. END