© Unsplash / Steven Cornfield
Although guilty of causing around 2,000 fatalities with a toxic diet drug, none of Servier's bosses went to prison. It's little wonder that Covid-19 vaccine sceptics believe that business, not safety, is big pharma's main concern.

When everyone at the top of one of France's big pharma giants avoids serving prison time, and the company faces a fine of just €2.7 million for producing a drug that led to the death of around 2,000 people over 33 years, you start to understand the mistrust at the heart of French Covid-19 vaccine refuseniks.

The drug at the centre of the scandal, Mediator, was produced by Servier for use by diabetics, but it ended up being prescribed as an appetite suppressant taken by more than five million people until its withdrawal from the market in 2009, a significant number of whom developed fatal heart problems as a result.

First alerted to the toxicity of the drug in the 1990s, Servier "never took the necessary measures," said the president of the Paris Criminal Court, Sylvie Daunis, in her deliberation.

After a trial lasting 18 months, the company was found guilty of "homicide and unintentional injuries" on top of "aggravated deception" in another massive hit not just for Servier, but for a French pharma industry facing an existential crisis.

The conclusion of the trial is the latest in a series of big pharma missteps. Not only has Servier and its top brass been shamed and many fined individually, but elsewhere the highly-regarded Pasteur Institute admitted to humiliating defeat in its bid to find its own Covid-19 vaccine and Sanofi - one of the top 10 companies worldwide in drug sales - announced its coronavirus jab won't be ready until the end of the year at the earliest.

These are not les belles jours for French pharma.

While Servier will clearly take a huge reputational hit for this scandal, any sort of punishment here is really just an abstract idea. No one is being unceremoniously bundled into the back of a police van and whisked off to prison to share a cell and bunk time with a lusty homicidal maniac.

In terms of actual people being punished for their misdeeds, the company's former number two, Jean-Philippe Seta - boss and founder Jacques Servier died in 2014 - was hit hardest and given a four-year suspended sentence, along with a €90,000 fine, and he faces paying out tens of millions of euros in compensation cases. But still, that's not particularly onerous when you consider 2,000 people died as a result of consuming his firm's product. And he did nothing about it.

How would that compare to the treatment expected of those who ran a business that made sausages which led to the deaths of a couple thousand customers? The sausage market would disappear overnight. Big pharma is immune to such effects.

This latest scandal tells us something about the substantial number of vaccine refuseniks in La Republique. The French people just do not trust whatever the government and big pharma is telling them anymore, particularly when it's something new. It's not so much about vaccines in general - after all, French children need 11 immunisations before they can even start school - it's about THIS vaccine.

And that is a massive problem for a government wanting to vaccinate an adult population of 52 million. According to official projections, at the current rate, that goal won't be achieved until April next year, nearly nine months later than initially hoped. Inevitably, that delay will mean further deaths on top of an already grim toll of more than 94,000 lives lost to Covid-19.

As recently as November last year, a report from Imperial College found only 25% of adults said they would willingly take the Covid-19 jab if it was available to them. Since then, that figure has climbed to 40%, still low compared to the 77% in the UK. It also means that 60% of the people don't want the jab. Hesitance might be slowly diminishing, but a study in the Lancet last month found within that 60%, a hardcore of 29% would say a rock-solid 'Non!' to any Covid-19 vaccine.

That figure of nearly one in three helps explain why take-up for the Covid-19 vaccine has been markedly slower in France than many other European countries, with just 11.56% of the population immunised so far. To reach the figure of 60% of the population vaccinated, which might achieve herd immunity, 48.44% of people still need a jab. That is a long way to go.

However, the damage to public trust is not just a result of the failures of big pharma. The National Medicines Safety Agency (ANSM), the French health police responsible for oversight of the industry, was singled out by the criminal court for its failure to ban the sale of Mediator earlier, and fined €303,000 for its role in the scandal.

The people of France are right to ask themselves who they can trust when being asked to take a vaccine. Can scandal-ridden pharmaceutical giants be relied on to put people before profits? Are politicians really on the lookout for what's best for all, and not just for themselves? Is the ANSM fit for purpose?

Unless public health officials and the big pharma companies involved can provide the right answers to a justifiably suspicious population, they will continue to struggle to reach national vaccination targets that, at this point, seem the best way out of this pandemic, but a helluva long way off.

Unfortunately for the French government, there is no jab available to cure public trust when it appears to be terminally ill.
Damian Wilson is a UK journalist, ex-Fleet Street editor, financial industry consultant and political communications special advisor in the UK and EU.