The scientific, medical & societal value that the pharmaceutical industry provides has long been self-evident to pharma industry employees and insiders. However, it was only recently during the pandemic, when therapies and vaccines weren’t yet at hand that many in broader society appreciated the role filled by the pharmaceutical and biotech sectors. At a time of particular crisis in 2020, the then unfulfilled need for effective treatment and prophylaxis for the SARS-CoV-2 virus came as a great shock. This shock was particularly felt in high-net income societies that had become accustomed to reaching to the medicine cabinet for an increasingly sophisticated array of treatments from immuno-oncology, gene therapy to stem-cell therapy. This is a growing medicine cabinet stocked by the pharma industry that has increased in Europe by 266 novel medicines from 2015-2021 alone1 to treat, if not cure many of the diseases that would have limited the lives of previous generations.
However, since the end of the technological golden era of the 1950’s, pharma’s reputation amongst the general population has gradually dwindled both with specific scandals and a pervasive discomfort that pharmaceutical companies are driven not only by clinical endeavour but by a fiduciary requirement to deliver profits to shareholders. Interestingly, the sector’s historic loss of favour can be seen against a broader backdrop of decreasing trust in big business across all industries. This is sharply exemplified by a 12-point rise in the US public stating they had little or no trust in Big Business between 1973-20212 . Yet the trust-benefit dissonance for the pharmaceutical industry exists at a time when the healthcare sector is the most R&D intensive industry globally, in 2020 having invested €189bn3 into research and development to improve human health and wellbeing.
The WHO/ECDC estimates that over 470,000 European aged 60+ were directly saved by COVID-19 vaccines4 with the UN echoing that for every million vaccinated people around the world, global GDP increased by US$8bn5.
From development to administration, the endeavour of getting COVID-19 vaccines into the arms of the public, included drug manufacturers, academia, governments, regulatory bodies, healthcare systems and individual volunteers. From the global to the individual this was a remarkable achievement for humanity. Global research by Ipsos in the latest Ipsos Global Trustworthiness Monitor illustrates that some of this reflected glory has shone positively on the pharmaceutical industry’s reputation and rightly on that of doctors and scientists too. Ipsos research finds that, across 29 countries, a global country average of 31% rate pharmaceutical companies trustworthy, compared to 25% in 2018.
Complete the job
Despite the extraordinary achievements of the vaccine rollout, it is a job only part done. Now is the time to invest this increased public trust in accelerating an end to the pandemic. The pharmaceutical industry has a critical ongoing role to ensure equity of vaccine access by supporting and driving efforts to prioritise vaccine availability in the Global South. While certain developed nations such as Israel have even administered second boosters to vulnerable populations, as of March 2022 data shows only 15% of people in low-income countries have received 1 or more doses compared to 72% of those in high income countries6. As the Omicron variant demonstrates, the global community is only safe when vaccine equity is achieved. The pharmaceutical industry in synchrony with global decision-makers can accelerate realising this goal.
Unfortunately, the current crisis has acutely brought into focus and exacerbated broader global health inequalities. Pharmaceutical players will be pivotal in driving increased equity of access to medicines through local governmental partnership, foundations and institutions like GAVI, PATH etc. while further investing in under-served tropical diseases; HIV, Malaria and TB where lower income countries feel a disproportionate effect due to factors such as medicine affordability, accessibility and equity.
Plan for the future
With pandemics forecast to become increasingly prevalent in the future, so Pharma should identify what role it can play in preparing for threats such as SARS, haemorrhagic fevers and insect-borne disease to name some of the GAVI flagged illnesses identified as having pandemic potential7. Pharma companies can plan with and actively support national regional bodies and the WHO in building pre-negotiated pandemic infrastructure platforms. These frameworks would cover future diagnostic tools, clinical trials, therapeutics and vaccines, ahead of the arrival of the next pandemic as advised by the IPPPR8.
Antibiotic resistance remains an unfolding crisis. Without effective action it is estimated that, by 2020, up to 10 million people may die each year due to antibiotic failure9. This often discussed but under-resourced space needs further champions at a governmental, NGO and commercial level to enact the recommendations of the 2016 Review on Antimicrobial Resistance. Pharmaceutical companies can play a key role not just in identifying novel antimicrobials but also in deepening existing partnership with national healthcare systems in developing innovative ways to drive market access, pricing and appropriate usage.
Grow Scientific Literacy
The WHO-coined ‘infodemic’ entered our common lexicon in 2020 meaning “too much information including false or misleading information in digital and physical environments during a disease outbreak”10. The infodemic around COVID-19 has driven vaccine hesitancy, vaccine refusal and encouraged the misinformed to act against their own best interests and those of the communities around them. Though the impact is difficult to quantify, a recent Johns Hopkins study estimates 5%-30% of voluntary non-vaccination in the US is caused by mis- or disinformation. Further, the report estimates “A public health effort that reduced or effectively countered misinformation and disinformation and was able to reduce related non-vaccination by 10% would be worth between $5 and $30 million per day […] while the pandemic continues”11.
As professional and tenured communicators of scientific value, the Pharmaceutical industry is uniquely positioned to partner with governments and institutions in developing public scientific literacy campaigns. Fostering public engagement with the critical appraisal of data is fundamental for the application of evidence-based medicine and the contract between society and scientists in their service. Such initiatives would have benefits not only in the realm of public health but also in spheres such as climate change and biodiversity loss, where disinformation and contra-scientific thought are heavily propagated.
The final unanswered sentence and call to action in the ‘Trust in Pharma’ chapter of Ipsos’ Global Trustworthiness Monitor reads,
It remains to be seen how the pharmaceutical industry can apply the halo effect of the COVID-19 vaccine success to their companies and wider industry, and whether the industry can uphold this benchmark and continue to build upon the global acceptance of its endeavour and united response.…
This begs the question of the reader:
What next to preserve the valiantly won reputational ground?
It is clear from the commonly suggested actions outlined above there is no time for the pharmaceutical industry to rest on its ‘reputational laurels’ as both the challenges and contributions to be made going forward are significant. The necessary tasks in front of global decision-makers across industries, including Pharma, will determine the course of future crises.
Jeff Bezos’ dictum regarding corporate brands applies well to industry-wide reputation.
A brand for a company is like a reputation for a person. You earn reputation by trying to do hard things well.
Perhaps the best possible deployment of gained trust is using those gains to drive even greater ambition. The pharmaceutical industry has the opportunity to use the accrued capital of public sentiment to ‘double-down’ on its formidable efforts of the last 2 years and invest in doing the ‘hard things’ to markedly increase global health outcomes for the next generation. This comes with the positive biproduct of cementing its improved reputation as being a force for delivering solutions for the greater good.
More information on Trust in the sector can be found in the latest Ipsos Global Trustworthiness Monitor report.
Jennifer Cummins is the founder of Shine Advise, a pharmaceutical advisory company.
- EMA Medicine Evaluation Figures 2015-2020
- Gallup Confidence in Institutions Poll 2021
- The 2021 EU Industrial R&D Investment Scoreboard (pg 30)
- WHO Regional Office for Europe and European Centre for Disease Prevention and Control (ECDC) Eurosurveillance study 2021
- United Nations Development Program, Data Platform 2021
- UNDP Global Dashboard for Vaccine Equity accessed February 2022
- GAVI article 10 infectious diseases that could be the next pandemic May 2020
- COVID-19: Make it the Last Pandemic, the Independent Panel for Pandemic Preparedness and Response May 2021
- O’Neill, J. (2016). Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. Review on Antimicrobial Resistance (page 74)
- WHO Infodemic Website, accessed February 2022
- COVID-19 Vaccine Misinformation and Disinformation Costs an Estimated $50 to $300 Million Each Day The Johns Hopkins Center for Health Security, October 20, 2021