Biomed Europa: after the coronavirus, a public infrastructure to overcome the pharmaceutical oligopoly

As of June 30th, 2020, the global outbreak of Severe Acute Respiratory Syndrome (SARS)—associated coronavirus 2 (SARS-CoV-2) has claimed about 500,000 lives, with over 10 million confirmed cases and nearly 3 billion people around the world under some form of lockdown. The COVID-19 pandemic has exposed profound weaknesses in a global health system that in the last decades relied in most countries too heavily on the pro-profit private sector for the discovery, development and distribution of new drugs. Pharmaceutical research is slow, risky, and costly. Governments allocate public funds to health-related research – grants for the most part aimed at supporting research upstream of drug development. Rather, late-stage drug development is largely funded by private pharmaceutical companies, drug corporations and venture capitals, which are incentivized to invest by a system of patent monopolies. To maximize their financial returns, private agents invest almost exclusively on the most marketable and profitable biomedical sectors, where drugs command the highest profits even if sometimes offer marginal therapeutic improvements and have little impact on social welfare. Critically important biomedical research sectors remain thus underfunded, and urgent public health needs are left unmet by the investment plans of the industry. Such was the case of drug development to prevent and fight coronavirus infections – neglected by “Big-Pharma†companies despite the alarming concerns raised by the scientific community for almost 20 years, the predicted economic burden of a pandemic on the public sanitary system, and the undisputable societal benefits represented by the discovery of an affordable cure. This pandemic provides a fundamental lesson — one ignored after the outbreak of SARS in 2003, the epidemic of MERS in 2006, and other past pandemics — a lesson about infectious threats that we face globally and that exacerbate vulnerabilities associated with income inequality and health disparities. It is now imperative to rethink the present public health funding strategy, and the roles and goals of all players involved. Here, after a brief analysis of the causes underlying the failure of the private sector to prevent and address the present COVID-19 pandemic, we propose a structural intervention aimed at creating the conditions for a new model of public health research. We detail a plan for an international, interconnected, transparent, science-informed, and publicly funded research infrastructure for pharmaceutical and biomedical research – BIOMED EUROPA. The proposed platform aims at identifying research priorities in the public health sector, 5 focusing efforts on the development of preventive and therapeutic strategies against those diseases that pose the greatest threats to human and social welfare. We suggest that BIOMED EUROPA should be managed as both a research infrastructure, along the model of CERN (the European Organization for Nuclear Research, Geneva) or the EMBL (European Molecular Biology Laboratory, Heidelberg) and as a knowledge-intensive public enterprise with an industrial policy mission, such as the ESA (European Space Agency).