The Vicuron acquisition auction, won by Pfizer, starkly revealed the fact that the biggest Big Pharmas have now got a striking advantage in their ability to access new products. Not only do they have more cash than anyone else, they can spend it without hurting the "adjusted" profits they highlight to Wall Street. As importantly, investors don't punish them on the basis of the expected returns from these investments. Indeed, the market expects them to spend the money-for now.

Pharma is looking to GAVI to oversee a fair distribution and avoid ‘vaccine nationalism’ – but countries can still sign bilateral deals with companies.