By Derick Dupuis, expert on sustainable development, ACCSS consultant

No one expects the economic issues behind the issues of the Covid-19 crisis can be resolved simply, on the pretext that money is flowing to keep people safe from the virus. The clumsiness of the CEO of Sanofi, revealing loudly to Bloomberg the negotiations that we imagined taking place behind the scenes between the big state actors and companies, put on the stage a twenty-year-old dilemma that was thought to be settled by the agreements of Marrakech. If it comes back so clearly on the hot seat, it is proof that the priority accorded to health is not yet a consensus in the international community and that global geopolitics is well distributed in « every man for himself » including the big companies that are tempted to use it in their own interest.

As a result, the American contract signed by Sanofi reveals a bitter failure of speeches and so-called societal responsibility approaches, which companies pay great attention to; still the moral of the story is that the CEO of Sanofi was foiled by its president the same day, with public commitments made at the highest level and whose application will be observed with a magnifying glass. If Sanofi’s sincerity has taken a hit, the cause of self-regulation associated with CSR even more, giving reason to those who want compel firms to respect « collective issues » and to put the business in step, in a global economy that we no longer think can bring spontaneously the common good, except to reaffirm the sovereignty of States in this matter.

It will be recalled that the margin of the drug companies in the negotiations has been framed since the Pretoria trial which established the primacy of the right to health on the property of private patents. The situation we live in today thus brings back in 2001 to the time when the South African government made fold the laboratories holding HIV antiretroviral rights and paving the way for provision known as « compulsory licenses », installed in international agreements in Marrakech. Since that time – and this has never ceased to be confirmed in others litigation (cf. India / Glivec …) -, access to health care, in emergencies, takes precedence over the intellectual property in law international.

This principle marked a major turning point in the strategies of laboratories under influence of their American federation essentially, big loser of this disposition, leading them to have to adapt from now on to negotiate with the conditions of States. Even more astonishing is that Sanofi has forgotten this context. What’s more, in his area of excellence, the vaccine, there are international funding mechanisms, through the Gavi (Global Alliance for Vaccines and Immunization) device, which allow firms to have return on their investments through transparent and fair price negotiations. Much more, when of the H1N1 epidemic, attempts to reserve the vaccine for some had ended in final by a takeover by the World Health Organization (WHO) to distribute products according to needs and grant aid to the least solvent. The initiatives of Bill Gates, of the Clinton Foundation, proposing to buy their patents to companies and distribute drugs, have seen humanitarian initiatives to prevail in the public-private war which animates the business of the drug, activated since by the Sino-American competition.

How can this brutal return to haggling to the highest bidders be explained? The answer firstly relates to the general context, which sees one of the consequences of the collapse of the multilateralism and the values of solidarity that it carries. But then, the question arises which follows directly: why, faced with this regression in the multilateral framework, firms with their history and headquarters in Europe and the Europeans themselves, attached above all to the vision of universal access to public health, have not been able to set up the mechanisms making this mercantile regression impossible? We will attempt an answer hypothesis which comes down to considering that firms still have opportunistic strategies depending on the circumstances. Despite all their efforts to think their social and societal responsibility, their reason for being, they fail or not wish to deploy proactive strategies to compensate for the deficiencies of the collective regulation. Become global non-state actors, they do not assume not yet responsibilities.

Without this excusing the lack of commitment from firms, it must be recognized that the absence of leadership on the part of WHO with regard to exit treatment while in particular, from their research to their early availability, has left gaping spaces for manufacturers legitimately anxious to register in frameworks viable for them. But this state of affairs and the weakness of this structure are known to actors, governments and laboratories combined, who are not fooled by influences which weigh here and there on the independence and the efficiency of its decisions.

The risk produced by a lack of international management, faced with attempts by large countries to recover to their advantage the scientific and industrial levers, in logic of cynical market, as we have seen with mask purchases or tests, also refers to the deficiency of « health diplomacy » that Europe, its African allies and others Cooperative states fail to build in a serious way, at the height of the crisis and needs.

From this situation, it must nevertheless be deduced that the large laboratories have taken note of these international shortcomings and preferred to take advantage of them rather than engage in a collective strategy. In fact, one could have naively imagined that the actors private parties would have had an interest in anticipating the situation by seeking to regulate research, evaluations, marketing, prices, dispensation, in a collective framework open and willing, rather than sticking to the logic of competition and market for the smartest or the best to win, in terms of market, results and not only efficiency in public health!

While since Pretoria3, firms have come under pressure from large NGOs, patient coalitions, which themselves profess major approaches to accessing care, one would indeed expect them to take constructive initiatives, at least from the great Europeans. The geopolitics of health is therefore not at this « play space » stage for firms that remain in their commercial economic space, not by lack of know-how, but by inertia of model, if not of way of thinking. The fact that it was the firm’s English General Director who played the deal with the Trump administration rather than the universal framework is not neutral in terms of model battles, cultural and political, which shake the industry today, more than ever.

If « the politically correct » is saved at the end of the general indignation aroused by the Sanofi’s misstep, which is not the comment, but the contract evoked, a conclusion imposes itself: the firms most pressed for ethical issues, most concerned by « the commons « , the most dependent on collective organization strategies, are unripe, whatever they say, to pass from the purely merchant model to one that is aligned with the Objectives of sustainable development (SDG’s), which has become part of the planetary model desired by the civil society, supported by the United Nations and now at the heart of investors’ choices enlightened.

« The Sanofi affair » sheds light on the gap that still exists between firms with a stock market model, now subject to constant scrutiny of opinions and intractable pressure from NGOs, but also pension funds worried about the sustainability of their investment (cf. L&G decision to remove the president of Exxon for refusing to commit to the climate!).

There is indeed a “business geopolitics”, because of the challenges which the major firms are depositaries, because of their power, as is the case for Sanofi, third world laboratory, first in Africa, but there is no desire to assertive and organized regulation of these issues by firms that understand the usage that they could still make of deficits of States and organizations for a long time to perpetuate their economic positions. The fragility of this situation suggests, however, that their interest will quickly switch to more proactive integration of these global contextual situations, the more the decomposition of policies will grow and the rope of civil society actors will no longer to assert themselves, especially with regard to an issue as crucial as public health. The challenge is launched.