Alex Azar, the secretary of health and human services, admitted Wednesday that a vaccine for a new coronavirus might not be affordable for all Americans. “We can’t control that price,” Azar told Rep. Jan Schakowsky, D-Ill., during a congressional hearing about the novel strain, which has been spreading throughout the world and is widely expected to become a serious public health issue in the United States.
After a wave of criticism from Democrats, Azar walked the comment back the next day, saying that he would ensure public access to a vaccine for Covid-19, the disease caused by the virus, if one should be developed. But Azar, who served as the top lobbyist for Eli Lilly before becoming president of the drug company’s U.S. operations in 2012 and the secretary of health and human Services in 2018, knows of what he unthinkingly speaks. Exorbitant drug pricing often leaves life-saving treatment out of reach for the poorest Americans. And to the extent that Azar and the other businessmen who make up the majority of the president’s coronavirus task force have any experience with pharmaceuticals, one of the most profitable sectors of the economy, it’s been making money off the system that keeps them out of reach.
In the case of Azar, who earned nearly $2 million during his last year at Lilly, that profit came at the expense of the people who needed the drugs, according to a lawsuit filed in 2017. While Azar was leading the pharmaceutical giant, the cost of its drugs went up significantly. In particular, insulin sold by the company more than doubled in price. According to the suit, which also names Novo Nordisk and Sanofi, Eli Lilly engaged in a scheme to artificially inflate the price of its drug, leaving some diabetic people unable to pay the cost and forced to use expired insulin or none at all. Eli Lilly did not immediately respond to a request for comment, but the company has told other publications that the suit has no merit and that it follows the “highest ethical standards.”
For another task force member, the profits could come from the coronavirus itself. Joseph Grogan was a lobbyist for the pharmaceutical giant Gilead Sciences before he joined the Trump administration as director of the Domestic Policy Council and led the Drug Pricing and Innovation Work Group. On Wednesday, after Gilead announced that it would be starting two clinical trials of an antiviral drug that could be used to treat Covid-19, the company’s stock price surged.
As a former lobbyist for a company that stands to gain big from a possible treatment for the respiratory disease, Grogan’s participation on the task force poses a host of ethical problems, according to Robert Klitzman, professor of psychiatry and director of the bioethics master’s program at Columbia University. “Does he have a conflict of interest? Yes!” said Klitzman, who points out that the government is likely to spend money on both the research and purchase of treatments for the virus. “Gilead could help shape a government request for proposals so that they could have an unfair advantage.”
While Grogan appears to have sold his Gilead stock and, according to the Office of Management and Budget, has severed all financial relationships and taken “the Trump pledge,” the situation is still problematic, according to Klitzman. “When he gets out of office, they could give him a gift for doing a good job or just hire him again. And what about his buddies? I’m sure he is still close to people who work for Gilead who will benefit. These are all major ethical concerns.”
Although Grogan and his friends may have a lot to gain from his participation on the task force, it is not clear what expertise he and most of the others serving on the group bring to it. Of the task force’s 16 members — 17, if you include Vice President Mike Pence, who is heading the effort — only four have any training in science or medicine. The others mostly hail from the business world, including Treasury Secretary Steven Mnuchin, an investment banker who was sued for asset stripping; Ken Cuccinelli, a lawyer and self-described “opponent of homosexuality” now serving as acting deputy secretary of homeland security; and Christopher Liddell, a former executive at Microsoft and General Motors, who worked with Trump’s son-in-law Jared Kushner on the modernization of federal IT systems before directing the country’s response to what may be the biggest public health crisis in over a century.
Pence also named Larry Kudlow to the task force on Thursday. Kudlow, a top economic adviser to Trump who used to work for Bear Stearns, went on Fox Business to reassure the American public that reports of increasing coronavirus infections around the world don’t necessarily mean “that this thing is going to skyrocket in North America.” Kudlow then encouraged everyone to keep investing, saying, “Stocks look pretty cheap to me.”
Trump has fired many of the people who actually know how to coordinate government responses to epidemics. As Laurie Garrett reported in January, the president shut down the National Security Council’s global health security unit and cut $15 billion in national health spending, including funding for the management of infectious global diseases at the Centers for Disease Control and Prevention, Department of Homeland Security, and HHS. At the CDC, the funding cuts to the global health section were so severe, Garrett wrote, that “the number of countries it was working in was reduced from 49 to merely 10.”
While four doctors are on the task force, it’s not clear how much they will be allowed to direct the response to the virus. The White House reportedly told Anthony Fauci, an immunologist who directs the National Institute of Allergy and Infectious Disease and has extensive experience combating infectious diseases, not to speak publicly without clearance after he said at a meeting that the virus “has adapted extremely well to human species.”
On Thursday, Deborah Birx, a physician who has served as the U.S. Global AIDS Coordinator since 2014, was named as the White House coronavirus response coordinator, and Surgeon General Jerome Adams was added to the task force. Their appointments came after Sen. Bernie Sanders slammed Trump for putting “political cronies, not scientists” in charge of the government response to the virus.