If Bill Gates believes all lives are equal, why is he impeding vaccine distribution?

This struck me as a catastrophic move, turning a vaccine developed by a nonprofit institution into a way to make a company lots of money, with no clear upside. (I think if Oxford stuck to their original plan, they could control the IP and require that their manufacturing partner sell the vaccines at cost). 

Both AstraZeneca and J&J have agreed that they will sell the vaccines at cost during the pandemic; this is mentioned in one of the articles you linked.

Unfortunately, this agreement has had major downsides. By preventing AstraZeneca from making a profit, it has undermined their ability to invest in capacity, and is one of the causes of the numerous production setbacks we have seen. I think it would have been much better if AstraZeneca was allowed to charge higher prices to incentivise them to produce more! If there is a shortage, that suggests that prices are too low, not too high.

Companies that own rights to vaccines developed with enormous public investment and massive guaranteed government contracts are fighting any efforts to share the knowledge that could be used make more vaccines in more parts of the world. 

AstraZeneca signed a voluntary licensing agreement with various Indian manufacturers to allow them to produce its vaccine. This fact was pointed out to you when you wrote about this subject on facebook.

In fact, the novel technology at the heart of the Moderna vaccine, for example, was developed partly by the National Institutes of Health using U.S. federal funds. Moderna then received a total of some $2.5 billion in taxpayer money for research support and as preorders for vaccines; by the company’s own admission, the $1 billion contribution it received for research covered 100 percent of those costs.

Given you highlight Moderna, why did you not mention that they have in fact agreed not to enforce their vaccine IP rights during the pandemic?

As it happens, I doubt this will be that important a move. Manufacturing mRNA vaccines is a very advanced business that requires a lot of expertise; these are not small molecule drugs! Even with the IP waiver I suspect most others would struggle to do what Moderna and Pfizer have achieved. There just is not a huge amount of currently idle capacity in this supply chain. For more detail on the manufacturing details, I recommend reading this article.

In practice, pharma companies are far more focused on boosting their share price than on developing new drugs. For example, in 2018, "the 10 biggest pharmaceutical companies spent nearly 170 percent of their net income (tapping cash reserves and borrowing) on payments to shareholders and executives through stock buybacks and dividends".

Developing new drugs and 'boosting the share price' are not in opposition. If a company develops a promising new drug, the expectation of future profits will cause the share price to increase. This is why biotech companies can see their share prices go up even if they are not doing any cash return at all.

I also think you have misunderstood how accounting works. Net Income is after R&D expense. The more a company spends on R&D, the lower Net Income will be. The fact that Net Income is low compared to cash return doesn't mean that the company isn't doing R&D.

As an example, take a look at Pfizer. In 2020 they spent about $9.4bn on R&D vs Net Income of around $9.6bn. This exceeded their dividends and buybacks, which were around $8.4bn. And we should probably also included M&A, which is basically indirect R&D. This is lumpy but large - e.g. over $10bn for 2019 for example.

I actually think that it is a major problem how low the prices for the vaccines have been. These drug companies have provided us with a way out of the pandemic that many people thought was impossible - and very few expected as quickly as this. For this they should have been richly rewarded - we want to incentivise companies to work on the world's biggest problems for the future! Unfortunately, if you look at the share prices of Pfizer or AstraZeneca and compare them to the broader market, you can see this was not the case. Given the amount these companies have been attacked by politicians, I think it is plausible that AstraZeneca leadership might regard this entire endeavour as a mistake.

I stumbled on a related IGM poll (a survey of many of the top economists from the US) the other day, and they seem to believe that economic incentives through IP rights are important:

Rather than impeding vaccine distribution, could this not ensure profit motive to incentivize further vaccine distribution? A company motivated by profit and distributing vaccines at a loss might not be too excited about doing that very quickly, and try to spend some of their efforts on more profitable things. At a good enough profit, they'll put in 100%.

Did they guarantee lower prices for developing countries, though? Developed countries can pay extra without too much harm, but I'd worry about developing ones.

I think this post unhelpfully mixes general, systemic criticisms around innovation, public goods and IP (which I'm very interested in and sympathetic to) with the "news hook"—COVID vaccines. It strikes me as incredibly unlikely that we'll determine and shift to a better solution in the current crisis. I think the most likely outcome of action here would be to shift us out of the local maximum but not into the global maximum. I think a proposal of an alternative system, an analysis of its cost and benefits relative to the status quo , and a plan for how to get there from here would receive a very different reception.

For quite some time now (even predating Covid), I've suspected that in many situations patents are just an inferior/stopgap market tool, but that a more-nuanced prize system such as you link to would require a trustworthy, competent, and (re)trained bureaucracy. It's outside of my wheelhouse so I haven't really actively pursued it, but I personally would be interested to see more research/discussion on the subject.

That being said, I do take some issue with the title of this post, which appears to beg/load the question: one could make an argument that the decision by Bill Gates could aid vaccine distribution by providing more market incentives for production and fast distribution. I'm definitely not familiar with this, but I do suspect that it's not like the vaccine information is going to be withheld from the world while at the same time pharma companies just price gouge their way through the Global South; I think it's more likely the vaccines will be provided to developing countries via foreign aid and/or other mechanisms at far lower cost relative to what was charged among wealthy countries. In the end, there are going to be unavoidable costs associated with production and distribution; the question is whether that is covered via foreign aid directly or if it will be funded more-indirectly by the profits gained in developing countries.