Man Who Fought This Pandemic Discusses the Next One

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Not many Trump appointees have left government with their reputations intact, but Moncef Slaoui is surely one of them. Slaoui, a 30-year veteran of GlaxoSmithKline Plc and the former head of its vaccine division, agreed in May to be the chief scientific adviser to Operation Warp Speed, the administration’s effort to develop a Covid-19 vaccine in record time. In that, the administration — and Slaoui — succeeded. The Food and Drug Administration granted emergency use authorization for Moderna Inc.’s vaccine on Dec. 18. Operation Warp Speed had already arranged to buy 100 million doses of the vaccine developed independently by Pfizer Inc. and BioNTech SE, which received similar authorization a week earlier. More than half a dozen promising vaccines are in the pipeline.

Slaoui didn’t get everything right — early on, he overestimated how many doses would be available by the end of 2020 — but he picked which companies had the best chance of producing viable vaccines and used funds at Operation Warp Speed’s disposal to help pay to develop them, acquire them or both.

In January, President Joe Biden selected David Kessler, a former FDA commissioner, to lead Operation Warp Speed, whose name will be retired. Slaoui stayed on for a month to help with the transition; his last day is Friday. I asked him to reflect on the effort to develop a vaccine to combat Covid-19 — and how we should prepare for the next pandemic. The transcript has been lightly edited and condensed.  

Joe Nocera: How do you think the vaccine rollout is going? Do you think the criticism it’s been getting is justified?

Moncef Slaoui: First, I would say it’s thrilling that we already have two vaccines and a third one coming up for approval. Second, it’s great that we have almost 35 million people vaccinated. Could we have done better? Yes, probably. But it’s critically important, I think, to acknowledge where we are, which is that 13 months after this virus came to the country, we have vaccines combating it.

I do think that there have been issues around communication. When I see that people are frustrated — understandably — because they have to wait to be vaccinated, I think to myself, we have really not communicated appropriately. We never said that there would be enough vaccine to immunize everyone at once. We always said it would likely take until the middle of 2021 to be able to vaccinate the entire U.S. population. That obviously implies there wouldn’t be enough vaccine doses to immunize everyone immediately. Literally every single dose is going to be shipped and used as it becomes available. Yes, there aren’t yet enough vaccine doses, because we can only make them so fast.

JN: What about how the distribution was handled?

MS: I think we misuse the word “distribution.” Distribution means shipping.  As far as shipping the vaccine to the immunization locations, that’s actually what the federal government has done. I’m a little on the sidelines now, so I don’t have the most up-to-date numbers, but the federal government has shipped to at least 14,000 different locations. What the federal government has not done is to organize the immunizations themselves. Our assumption was that if a state health agency tells us to ship 500 doses to a particular location, it has the resources to immunize with those doses.

JN: Operation Warp Speed committed to buying hundreds of millions of vaccine doses well before anyone knew they would work. It obviously worked out, but did you worry about the risk you were taking with taxpayers’ money?

MS: Actually, there was only one company with whom we said we would do a purchase in advance: Pfizer. And in that case, we had de-risked the deal. We said we would only buy the vaccine if it were approved by the FDA. So Pfizer took all the risk. In all the other agreements, the government took the risk on an ongoing basis. We didn’t say, “OK, Johnson & Johnson or Moderna, here’s $2 billion.” Instead, we said, “We’re going to pay you on an ongoing basis, on the basis of vaccine development that we are fully a part of, so we can see the process, and we can control it. As long as the experiments work, we’ll continue paying. If they fail, we’ll stop paying.” Yes, we took a risk. But in exchange for underwriting the development work, we got access to the first 100 million doses, which I think was the right exchange, particularly in a pandemic setting. And without which we probably would not have had vaccines so soon.

JN: Some critics said the federal government should have negotiated a percentage of Moderna’s vaccine profits because of the enormous investment the federal government made in its vaccine development.  Do you agree with that?

MS: Under normal conditions, I would say yes. On the other hand, here is the calculation I was making. The vaccine doses we acquired cost between $10 and $20 each. But the cost of a typical vaccine is anywhere between $50 and $200 per dose. So the government got a significant discount in exchange for supporting the vaccine’s development.

JN:  I’ve read where you said that manufacturing vaccines was perhaps the most difficult task of all. Can you expand on that?

MS: Manufacturing is a very complex process for vaccines and biological products. And in my previous life, for 30 years, I have experienced how difficult, how lengthy, how technically complex vaccine manufacturing is, how regulated it is — appropriately — to make sure that you’re going to be making something out of living cells in a way where the first dose you make, and the one billionth dose, are identical. It’s not only about engineering, it’s about controlling living things that are producing the vaccine. And doing it under sterile conditions.

JN: What were your expectations when you came into the federal government? Quite often, businessmen have very low expectations of government employees. I’m guessing that your experience did not bear that out.

MS: I was expecting enormous bureaucracy and complexity. And I made it a condition to take the role that the operation would be fully empowered, which was really another way to say, we’ll just plow through the bureaucracy. Aside from that, I’ve been impressed by the quality of the government scientists, whether in the NIH or the FDA or the CDC. The same is true of the Army leaders, who have committed 24 hours a day, seven days a week for the past nine months. And the companies, too. I was amazed by the alignment and teamwork that took place between the companies, the government agencies and the Army. This crisis has shown, in my view, that the science ecosystem between biotechnology companies, pharmaceutical companies, academia and the government can work together and make possible what might appear to be impossible.

JN: In September, you said publicly if you felt any political interference, you would quit. Do you feel that your statement made a difference in terms of keeping the Trump administration from pressuring government scientists into approving the vaccine too soon? Were you worried that President Trump might fire you?

MS: I have no political ambition. I was there to help make vaccines for our country and the world. And everything else didn’t matter. And therefore, I didn’t see my statement as taking a risk. To me, it was what I had to say.  If there had been pressure to approve the vaccine too fast, yes, I would have resigned. Did it have an impact? I don’t know because, honestly, we decided within the operation we wouldn’t care about what was said in the political arena. During the election, people could say whatever they wanted. We were going to rely on data and on facts. And that’s it. Whenever the president would ask me, “Are we going to have the vaccine before the election?” I always gave him the same answer, which was, “Mr. President, I cannot tell you, it’s impossible to predict.” And each time that was the end of the conversation. I personally never felt any pressure.

JN: Officials both in and out of government have been giving a lot of thought to how we can better prepare for the next pandemic. What are your views about that?

MS:  When I was at GlaxoSmithKline, I wanted to establish a dedicated organization to research, develop and, critically, to manufacture vaccines, because the hardest thing is to either build a new manufacturing site or redesign a manufacturing site to adapt it to vaccine manufacturing. That takes time, it takes money, and it carries a lot of risk. I still think that’s the right approach. We should create a small network of three or four entities with the capacity to discover, develop and manufacture vaccines at industrial scale, maybe have two in North America and two in Europe, have them connected, so they synergize rather than compete and ask them to produce vaccines for known potential pandemic agents. That would do two things: It would allow millions of doses to be stockpiled, and if there is a pandemic, we will be ready to use them instantly. Secondly, the scientists and engineers at these entities would become the best teams on earth, able to discover, develop and manufacture vaccines quickly.

JN: Are you disappointed you’re leaving the federal government before the pandemic ends?

MS: Honestly, no. I was incredibly fortunate and happy to have done it. And I also am happy that it’s coming to an end. I delayed my departure to make sure I can help the new administration take over as efficiently as possible. But that’s done. My last day is Friday. I will remain available to help as needed, but I need to go back to my private life and private business. Yeah, no regrets. Very happy, and very proud.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Joe Nocera is a Bloomberg Opinion columnist covering business. He has written business columns for Esquire, GQ and the New York Times, and is the former editorial director of Fortune. His latest project is the Bloomberg-Wondery podcast "The Shrink Next Door."

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