With turf wars over face masks and other personal protective equipment not yet over, the battle over who will be the first to get a COVID-19 vaccine seems to have begun.
Earlier this week, Paul Hudson, CEO of French pharmaceutical giant Sanofi, told Bloomberg News that if Sanofi develops a vaccine, doses would likely go to Americans first. Hudson said this was understandable, given the U.S. had financially supported its research.
The comments outraged the French government and provoked an uproar in France. "For us, it would be unacceptable for there to be privileged access of any country based on financial reasons," French Deputy Finance Minister Agnès Pannier-Runacher told Radio Sud.
President Emmanuel Macron was said to be shocked by the revelation from a company that is considered a champion of French industry and is given 150 million euros ($162 million) in tax exemptions every year. He will meet with the leaders of Sanofi at the Élysée Palace early next week.
French Health Minister Olivier Véran told France's CNEWS television he was so disturbed he called Sanofi's French division CEO Olivier Bogillot, who he said reassured him about Hudson's comments.
"I believe it was a phrase, as far as I can understand, that was a bit clumsy, and perhaps taken out of context, and I was quite reassured by the conversation I had with the head of Sanofi," said Véran.
Bogillot was soon making the rounds to try to further justify and explain Hudson's comments.
"You understand how shocking this is for us, to hear that one of our top companies would serve Americans first?" asked a commentator on BFMTV.
Yes, said Bogillot, he absolutely did. He tried to explain that the U.S. was very organized and reacting quickly, "more quickly than Europe — with the money and the necessary regulatory structure," he said.
"A vaccine usually takes 10 years and we're trying to do it in 18 or 24 months," he said. "That's something exceptional."
Bogillot emphasized that Sanofi has huge vaccine production facilities in France and Europe and that Europeans would get a vaccine quickly.
France, with nearly 177,000 confirmed cases and more than 27,000 deaths, is among Europe's hardest-hit countries, behind the U.K., Italy and Spain.
Hudson's comments particularly shocked French people because Europe has pledged to fight COVID-19 together with other parts of the world. Earlier this month, the European Union organized a fundraising event at which countries and organizations around the world pledged $8 billion for coronavirus vaccines, diagnostics and therapeutics. The U.S. and Russia were notably absent.
Macron has said vaccine availability should be for all and should not be influenced by the laws of the market.
Stefan De Keersmaecker, a health policy spokesperson at the European Commission in Brussels, says a vaccine should be a global public good. "Its access needs to be equitable and universal," he said at a news conference.
Talk of European solidarity is heartening, says Yannis Natsis, who is on the board of the European Medicines Agency, the equivalent of the U.S. Food and Drug Administration. But the reality has been different, he notes, and he expects there will be fierce competition for access to a vaccine.
"The way there was fierce competition among EU member states when Italy started asking for protective equipment and got nothing," he says. "And the same way EU member states closed their borders and didn't exchange medical supplies. They practically said, 'Everyone for himself.' That's the sad reality."
Natsis also says drugs are almost always released first in the U.S.
"Why? Because there, they get the highest price," he says. "Because the U.S. doesn't have a health care system, it has a market. And the principle is the sky is the limit — as much as the market can bear."
European nations offer universal coverage to their citizens, so they negotiate with drug companies for lower prices. That can translate into much lower prices for drugs in Europe.
But with the U.S. committing so much money to develop a vaccine, Natsis says it would not be surprising if it would be the first market served.
Sanofi board president Serge Weinberg, appearing on the French nightly news, said the U.S. had contributed around $600 million for Sanofi's research.
In a tense interview, Weinberg said he understood why the French felt angry, but he didn't want there to be any ambiguity. He insisted that the French and other Europeans would get a vaccine at the same time as the Americans — made in Sanofi's European factories.
Hudson's comments, he said, had been misconstrued. "We will collaborate and find solutions and make them accessible," he said. "Any vaccine will be a public good."
Natsis says pharmaceutical companies, for the most part, are saying all the right things about accessibility and affordability — but he's not sure what that will mean when this is all over. In the aftermath of COVID-19, he says, European governments are going to be bankrupt and weakened and unable to take on big pharmaceutical companies.
He calls the Sanofi incident a wake-up call for France.
"Sanofi is not a French company," he says. "Even if it instills national pride in France, it stopped being a French company a long time ago. It's a multinational, and it's behaving like one."