Wellcome Trust and the Bill & Melinda Gates Foundation stand to profit handsomely from their investments in drug companies researching solutions for the pandemic. Some say that raises critical questions around conflicts of interest, transparency and accountability.
An increasingly clear feature of the COVID-19 pandemic is that the public health response is being driven not only by governments and multilateral institutions, such as the World Health Organisation, but also by a welter of public-private partnerships involving drug companies and private foundations.
One leading voice to emerge is the Wellcome Trust, one of the world’s top funders of health research, whose sprawling charitable activities in the pandemic include co-leading a WHO programme to support new COVID-19 therapeutics. The Access to COVID-19 Tools (ACT) Accelerator project hopes to raise billions of dollars and deliver hundreds of millions of treatment courses in the year ahead, including dexamethasone and a number of monoclonal antibodies.
At the same time, The BMJ finds, Wellcome itself holds investments in companies producing these same treatments. Financial disclosures from late 2020 show that Wellcome has a £275m (€318m; $389m) stake in Novartis, which manufactures dexamethasone and is investigating additional therapeutics. And Roche, in which Wellcome holds a £252m stake, is helping to manufacture monoclonal antibodies with Regeneron. Both Roche and Novartis report having had conversations with WHO’s ACT Accelerator about their therapeutic drugs.
Wellcome’s financial interests have been published on the trust’s website and through financial regulatory filings but do not seem to have been disclosed as financial conflicts of interest in the context of Wellcome’s work on COVID-19, even as they show that the trust is positioned to potentially gain from the pandemic financially.
Revelations of the Wellcome Trust’s financial conflicts of interest follow news reports that another charity, the Gates Foundation, is also positioned to potentially benefit financially from its leading role in the pandemic response. An investigation by the Nation revealed that Gates had more than $250m (£179m; €206m) invested in companies working on COVID-19 and cited civil society groups expressing alarm with the outsize influence the billionaire charity wields in the pandemic response, which they see as elevating the role of the drug industry.
Yet charities such as Gates and Wellcome — and even drug companies — have generally been praised in the news media during the pandemic for their efforts to solve the public health crisis, with relatively little attention paid to their financial interests and with few checks and balances put on their work.
“What the pandemic is doing is buffing the reputation of organisations like Gates and Wellcome and the drug companies, when I don’t think they really deserve that buffing up,” says Joel Lexchin, professor emeritus of York University’s school of health policy and management in Toronto. “I think they’re acting the way they always have, which is, from the drug companies’ point of view, looking after their own financial interests, and from the point of view of the foundations is pursuing their own privately developed objectives without being responsible to anybody but their own boards of directors.”
Conflict of interest?
Mohga Kamal-Yanni, a policy adviser to UNAIDS and other organisations who recently co-wrote a paper citing problems with the Gates Foundation’s influence in the pandemic, says that Wellcome’s investments raise critical questions around transparency and accountability.
“In COVID, these two words have such a huge meaning because we need to know that decisions are being made based on evidence and science,” she tells The BMJ. “Do we know which companies they are talking to? How they make the decisions about funding a particular company — or this product or that one?”…