 For more videos on people's struggles, please subscribe to our YouTube channel. COVID-19 has caused untold grief and suffering to billions across the world. But it has been very good for a handful of big pharma companies which have made massive profits during this time. For instance, in the third quarter of 2021, that's July to September, Pfizer's revenue was USD $24.1 billion, which was a 134% increase from last year. How have these companies managed to earn such massive profits? And what does this say about the way the pharmaceutical sector is organized? Meanwhile, Cuba has emerged as a shining alternative. Technology has been leveraged to benefit the people rather than a few shareholders. Immunologists Dr. Satyajit Rath examines big pharma and the story of Cuba and explains the lessons we can draw from it. So this week, when we talk about COVID-19, it might be interesting and useful to think about the relationship between vaccine production in countries by companies, vaccine used within the country or within the region in the case of Europe, and the vaccine export, and the revenues that have been generated. So from that point of view, it's interesting to note numbers. If you look at the Chinese companies, which have produced between Sinovac and Sinopharm, about, I would say, 2.5 billion doses of vaccines. From 2.5 billion doses of vaccine, the revenue that they show together is about 40, 45 billion US dollars in 2021. On the other hand, if you look at Pfizer, Pfizer's production of vaccine has been just over a billion doses so far, 1.1 billion doses. But Pfizer's revenue matches Sinopharm and Sinophac together. So despite not even having produced half as many vaccines, Pfizer's revenue matches that of Sinophac and Sinopharm. This is one interesting issue to think about. It's even more striking when you look at Moderna because Moderna has made about 400 million doses and yet Moderna's revenue returns are somewhere in the 30 billion dollar range. So despite having made only about a third of the number of doses that Pfizer has made, Moderna has made about 60% of the revenue that Pfizer has generated. And we begin to see how the for-profit pharma sector has been very differently leveraging COVID vaccines for profit. Interestingly, when we begin to look at exports, we run into yet another conundrum and that is which countries are these major productions being exported to? And it turns out because in Europe and in the United States of America, the two major vaccines, Moderna in the US and BioNTech Pfizer in Europe and in the United States together are mRNA platform-based vaccines. Their export, even though formally their exports are quite substantially still to countries of the global North. To countries of the global South, exports have primarily come from Chinese companies and from the AstraZeneca adenovirus platform-based vaccines. And what you then begin to see are the differences in exports, in a commercial setting and exports in the context of global public health. That's one set of issues that I think today's times are useful and important to note. Another context that is important to note, especially because we have been talking about mRNA vaccine platforms and adenovirus vaccine platforms, is the relatively small but instructive example of the Cuban biotechnology enterprise in making COVID vaccines. So Cuba has indigenously designed, tested, manufactured and effectively distributed to the overwhelming majority of its adult population, two vaccines for COVID-19, not one, the one of the Soberana vaccines and the Abdullah vaccine. These are vaccines that are neither based on the mRNA technology, which, as we've all heard repeatedly, is extraordinarily new and so on and so forth, nor is it based on the adenovirus vaccine platform. It is instead based on a somewhat older, recombinant DNA technology-based protein platform. In other words, what that technology does is take the genetic sequence for the spike protein of the COVID-19 virus, get either bacteria or animal cells or yeast cells to make that protein, make sure that it's folded appropriately and take the protein and formulate it as a vaccine. And this is how many of the vaccines in the childhood vaccination campaigns that we are familiar with across the world in public health systems are currently made. So it's a tried and tested technology that generic vaccine manufacturers across the world, not simply in the global north, but also in the global south, are quite familiar. And that's the platform that Cuba has chosen to make these vaccines. It is useful to ask the question, how is it that Cuba could put this entire pipeline of vaccine design, testing, manufacture, and distribution into a public health vaccination campaign seamlessly into place for itself and to the extent that it could for sending overseas as well to neighboring countries. Whereas India, with its wanted vaccine manufacturing technology strength, bench strength, so to say, has not managed to do this. And when you begin to think about this, you realize that the capitalist for-profit company-based framework difference between the two examples is a core issue in determining what the trajectories of vaccine manufacture, vaccine distribution, and vaccine supply and production will be. So India has also done vaccine design in the country. India's indigenous vaccine is designed in public sector institutions. In fact, Indian public sector institutions have also designed the Cuban kind of protein-based vaccines. But a slow withering over recent decades of the Indian public sector vaccine manufacturing enterprises and facilities has meant that even if vaccine design was in the public sector, its manufacture, scale-up, and distribution has remained in the private sector. And the differences between those are there for all of us who are interested in public health to see, appreciate, and learn from this much for this week.