On March 23 I spoke at a health forum sponsored by the Wall Street Journal, along with the CEOs of CVS, Moderna, and Pfizer. Pfizer CEO Albert Bourla said his industry should continue to do more to improve goodwill among the public, having led the transformational battle against the coronavirus.
He is right. Big Pharma is the 800-pound gorilla of the health industry. Now is the perfect time for the most powerful sector of the health industry to join the fight against White supremacy—the most powerfully pernicious disease in America.
In the past year, we have seen how much good the pharmaceutical industry can do for a country in crisis. We have pharmaceutical companies to thank for developing and distributing multiple highly effective vaccines—in less than a year after Covid-19 first came to our shores. We have seen giant industry competitors—Merck and Johnson & Johnson—team up to manufacture and distribute vaccines in record time.
As of April 20, more than 132 million shots have been given, and more than 85 million people are fully vaccinated, according to the Centers for Disease Control and Prevention. Meanwhile, President Biden has boldly targeted vaccinations for every adult in the nation by mid-May.
Yet Blacks, Indigenous, and Latino populations (BIPOC)—those hit hardest by the coronavirus disease—are woefully behind in the uptake of this vaccine miracle.
Vaccination Rates and White Structural Supremacy
As of April 13, the CDC reported that it had race and ethnicity information for 55% of those that have received at least one dose. According to the CDC, 11% identify as Hispanic, 9% Black, 5% Asian, and 1% American Indian or Alaskan Native.
In contrast, 65%—nearly two-thirds—of those vaccinated are White. Whites are, in fact, the only population whose vaccination rate exceeds their Sars-CoV2 infection, hospitalization, and death rates. Blacks, Latinos, and Asians, in contrast, face precisely the reverse probabilities.
Stated differently, BIPOC populations have a greater chance of getting the virus, being hospitalized, and dying from Covid-19 than they have of scoring a vaccine shot against the disease. Our response to Covid-19 provides yet another example of the privileging of White lives over non-White lives. This is White structural supremacy at its worst.
The system that connects White supremacy to the disparities associated with the coronavirus pandemic is called “structural racism.” It operates to give Whites better access and transportation to hospitals, clinics, and pharmacies where the vaccine is distributed; better access to transportation to get to vaccine locations; and better access to the internet, so Whites can more easily pre-register widely and check vaccine availability often. It can even result in Whites snagging vaccine appointments ahead of others when vaccines are distributed in BIPOC neighborhoods.
White supremacy also works to supply false narratives that seek to justify these unethical inequalities, including the ready willingness to blame Blacks’ medical distrust and vaccine hesitancy for the disparate vaccination rates.
When the Kaiser Family Foundation reported in February that Blacks are more likely to want to ”wait and see” before getting a Covid-19 vaccine, it was unsurprising, though disappointing, given the usual high caliber of Kaiser’s research, that it declined to report how many Whites shared this attitude. It also made sure to bury the information that showed a majority (65%) of Blacks feel “optimistic” about the vaccination, and combined these findings with totally unrelated surveys that supported the narrative that Blacks do not trust the medical system.
In fact, the Pew Research Foundation recently found that a majority of Blacks (61%) intend to get vaccinated, while the latest NPR/PBS/Marist poll found 73% of Blacks and 70% of Whites have or intend to be vaccinated.
How Big Pharma Should Help
Big Pharma’s fight should begin with making the coronavirus vaccine equitably available to minority populations. West Virginia has done an exemplary job of deploying pharmaceutical networks to achieve wide vaccine distribution; Big Pharma should duplicate these efforts nationwide. But it should not stop there.
We know that community pharmacies can increase health care accessibility to vulnerable and marginalized patient populations. One study showed that Medicare beneficiaries visited their neighborhood pharmacy nearly twice as often as they saw their primary care doctor. However, pharmacies in poor neighborhoods are closing down. Big Pharma could help to open and support community pharmacies in underserved neighborhoods across the nation.
Big Pharma can also introduce need-based policies that regulate prescription drug price mark-ups, broaden availability of generics, and use innovative value-based pricing contracts for drugs that are disproportionately used by minority populations, such as insulin, erythropoietin, anticoagulants, ACE inhibitors, and beta blockers.
Big Pharma can also significantly increase the number of minority researchers and physicians they employ, diversify clinical trial participants, and collaborate with historically Black research centers to develop new, cost effective drugs.
As the U.S. death count from coronavirus climbs to well over a half million, this is the season when Christians are celebrating Easter, Jews are celebrating Passover, and Muslims are observing Ramadan. Thus, we are all mindful of the possibility for transformative good, even if it comes from something as horrific as death.
The millions of lives lost due to Covid-19 should be impetus enough for Big Pharma to now take action and help bend the arc of the universe toward racial justice.
This column does not necessarily reflect the opinion of The Bureau of National Affairs, Inc. or its owner
Dayna Bowen Matthew is the dean and Harold H. Greene Professor of Law at George Washington University Law School. A leader in public health and civil rights law who focuses on racial disparities in health care, she is the author of the book: “Just Medicine: A Cure for Racial Inequality in American Health Care.”