When it became clear the China coronavirus outbreak might lead to a global pandemic, Oxford University’s life scientists convened a crisis meeting. It took place on Thursday 30 January last year, and if the rest of the world hadn’t yet realised the potential consequences of what was unfolding in Wuhan, they had.
Around the table in the Nuffield Department of Medicine were experts from in and around the university, gathered for a moment they had feared would one day come.
It was there that Prof Sarah Gilbert, a vaccine researcher, told her colleagues something remarkable; she had devised a likely vaccine, repurposing technology used by her team to develop vaccines against Ebola and Mers.
But she also said she badly needed to take the next step.
So began the international race to develop, manufacture and deliver drugs to tame a virus that has now killed more than 2 million people, and devastated the lives of many more. A race that this week has become bitter and angry.
Back then, Gilbert’s first suggestion was to start working with an Italian manufacturer, Advent, to produce initial stocks for trials and she wanted £1m of university money to underwrite the work.
“We just told her to go for it and spend what she needed,” said Prof Richard Cornall, the head of the Nuffield Department of Medicine. “Each of us had to do whatever we could. We were not happy about it, but in a way this was the moment we had all been preparing for.”
By the time it became clear to Downing Street that Covid would be the most serious national emergency since the war, the scientists at Oxford and elsewhere were already on their way.
In a country not known for thinking strategically about industrial policy, the UK actually had an advantage. Gilbert’s Jenner Institute, for example, was founded in 1998, when Peter Mandelson was industry secretary, and funded at first by the UK drug company GlaxoSmithKline. It was critical in ensuring the UK got ahead.
The Oxford scientists began meeting weekly, and by late March, Oxford scientists realised they needed a pharmaceutical giant to manufacture the vast quantities of vaccine required. The initial choice of partner was the US company Merck.
However, the prospective deal collapsed. The UK was desperate to secure enough supply for its own citizens – and at the time, ministers including the health secretary, Matt Hancock, were concerned. Not about the EU – but about the behaviour of the then-US president, Donald Trump.
“We were worried about vaccine nationalism – but the person we feared was Trump, that he would be able to pressurise a US company, and perhaps buy up the drug stocks,” said a former adviser at the Department of Health. “We never expected there would be a row with the EU.”
The British government wanted written guarantees of supply from Merck, but the company was only prepared to give verbal one , the adviser said. The deal fell through.
Enter the Anglo-Swedish firm, AstraZeneca, whose French chief executive, Pascal Soriot, was a trusted figure in political circles.
At the time, AstraZeneca was not considered a vaccine specialist, but Soriot was prepared to give written undertakings the UK wanted, and was prepared to sell the vaccine at no profit during the pandemic, at $2-5 a dose globally, which was what Oxford’s scientists wanted to hear.
AstraZeneca was signed as Oxford’s partner on 30 April and signed a deal to supply 100m doses to the UK a fortnight later. Ministers were prepared to pay a few hundred million upfront, allowing the company to build its first virus manufacturing process, and the UK government to demand its citizens be vaccinated first.
“That underpinned all of it,” an industry insider said.
Building on relationships established by the Oxford scientists, the vaccine for the UK market is cultivated at sites in Oxford and at Keele, near Stoke. It is then sent to Wrexham, where it is bottled into vials before being dispatched for final tests by UK regulators and sent on to the NHS.
AstraZeneca says the headstart it had was vital.
The vaccine brewing process – as it described by the company – takes three months and the yield it produces is uncertain. There were yield shortfalls in the UK, but as Soriot said in an interview earlier this week, “we have had an extra three months to fix all the glitches we experienced” before the vaccine was approved at the end of December.
With Brexit looming, the UK drew huge criticism for declining to join EU schemes to purchase PPE and ventilators. There was also growing pressure to join a joint EU procurement plan for vaccines, and to put aside the Brexit rhetoric.
But Brussels’ demands were eye-watering: the UK, unlike EU member states, would not be able to take part in the governance of the scheme, including the steering group or the negotiating team.
Britain would have no say in what vaccines to procure, at what price or in what quantity, and for what delivery schedule. There would be no side-deals possible.
British officials were not convinced. “We had to go it alone,” said a UK source. “There was nothing there for us.” By the time a special UK vaccine taskforce was created in April, the seeds of a successful strategy had been sown.
Run from May by the venture capitalist Kate Bingham, a no-nonsense operator, it directed government money up and down the vaccine supply chain, and helped ensure that two other vaccine candidates were manufactured in the UK – an interventionist policy not seen since before the days of Margaret Thatcher.
Meanwhile, over the Channel, Brussels’ faltering efforts soon convinced Downing Street that it had done the right thing.
There had been concerns from the beginning of the crisis in key EU capitals that others – the US in particular – would steal a march in the hunt for a successful vaccine. But despite the anxiety, the process of organising and purchasing prospective vaccines had been slow.
There was an early initiative by the European commission president, Ursula von der Leyen, to steal away CureVac, a biotech company working on a coronavirus vaccine, from Donald Trump, with whom it was in talks. The EU offered the company €80m in financial backing. “I hope that with this support, we can have a vaccine on the market, perhaps before autumn,” Von der Leyen said at the time. CureVac is still yet to come good.
The governments of Germany, Italy, France and the Netherlands had privately decided they could not wait on Brussels finding common agreement among the 27 on a strategy – and they spotted the potential in AstraZeneca from the start.
The so-called “inclusive alliance” group drafted a one-page set of terms for a deal for between 300m and 400m doses of the Oxford/AstraZeneca jab. But other EU member states were getting restive, concerned that they were being left out.
The four governments passed on the negotiation to the commission “for the common good”, recalled Prof Walter Ricciardi, an adviser to the Italian government on its coronavirus strategy.
“We opened the door for the commission to take over but even then it took time, even when we tried to speed up the process,” Ricciardi said. “There were some countries fully aware of the importance of the vaccine but there were others that were reluctant to put money into this without guarantees of the result. That took time and the best possible energy of the commission. They did recruit the best possible officers to do that but it was a long process”.
It was another three months before the commission finally signed the deal, behind the UK, with some serious ramifications to come.
Authorisation of any vaccines would be done through the European medicines agency, rather than national regulators, to ensure that the rollout was done across the EU in tandem. But that also proved a fateful decision.
The slower authorisation by the EMA ensured that liability for the vaccine – should it prove dangerous – could potentially be pinned on the pharmaceutical companies during contract negotiations.
But if they were maintaining solidarity and perhaps even earning some extra public confidence, they were giving up speed.
The fast-track mechanisms available to national regulators, including the UK’s medicines and healthcare regulatory authority, gave Britain another potential advantage.
Nevertheless, with the announcement in early November that the German startup BioNTech had made a breakthrough in the development of a new type of vaccine to combat Covid-19, hopes remained high that the bloc was on the right path.
“It is Europe’s moment”, Von der Leyen tweeted in mid-December as she announced that between 27 and 29 December, people across the EU’s 27 member states would be vaccinated. “We protect our citizens together,” she said. But her confidence was misplaced. There were hidden frailties.
Rasmus Hansen, the chief executive of Airfinity, a data analytics company working in the life sciences sector, said the EU had failed to invest as it should have in scaling-up production plants.
The EU had spent just €1.78bn in “risk money”, cash handed to pharmaceutical companies without any guarantee of a return, compared to €1.9bn by the UK and €9bn by the US, he said. There were consequences.
The first hit to the EU strategy was the announcement by Pfizer/BioNTech, one of only two vaccine producers authorised for use in the EU at this stage – along with Moderna, with whom only a smaller order has been made – that they needed to slow down production in order to upgrade a facility in Belgium and boost output in late February.
This did not unduly upset officials initially. They had AstraZeneca, and its total of 400m doses, coming down the line. “I am not sure why this debate is there because the numbers are there, the production is ramping up,” Sandra Gallina, the commission’s chief negotiator, told MEPs on 12 January.
But then the hammer blow: last Friday, AstraZeneca, not yet approved by the EMA but expected to get the green light, said it would now be able to deliver only 25% of the intended 100m doses due in the first quarter of this year. A filtering problem at its plant in Seneffe, south of Brussels, had left the company with a lower yield than expected.
“It took a wrecking ball to the national plans,” admitted one diplomat. Just 2% of the EU adult population has so far received a jab, compared with 11% in the UK.
Shortages have been reported across Europe, with programmes suspended in Madrid and Paris, and the loss of the Oxford/AstraZeneca offered little hope of a pick-up in momentum.
Officials angrily pointed to the success of the British end of AstraZeneca’s vaccine production. “If the UK plants are working better, are we expecting the UK plants to deliver doses to us? Yes. Yes. Yes. They are part of our contract,” argued an official.
Gallina, shaken by the move, dived into the customs records to find evidence that AstraZeneca had shipped EU-produced doses to the UK – but without success.
AstraZeneca’s chief executive gave an interview with a group of European newspapers. “The UK agreement was reached in June, three months before the European one,” Soriot said.
“As you could imagine, the UK government said the supply coming out of the UK supply chain would go to the UK first. Basically, that’s how it is.”
The commission has accused AstraZeneca of a breach of contract. It has given its member states the power to block exports of vaccines, raising the spectre of Pfizer doses not being delivered to the UK. But at a meeting of EU ambassadors with commission officials earlier this week, the message was that the capitals were unimpressed.
“The commission was told to change the terms of the debate – we just want vaccines,” said one diplomatic source. “That’s all we want”.