Pharmaceutical companies in the West and their host governments are very confident today, and some even speak of “post crisis investing”. Certainly, pharma’s scientific credentials have been demonstrated and the public in the UK and the US in particular are seeing the potential end to lockdowns. But what we see depends on where we sit. The world is not doing well from the perspective of many of the millions who have been affected, or who will die unnecessarily, with an unknowable total of deaths due to a lack of accurate documentation or outright suppression in many places. According to the IMF, COVID-19 has cost well in excess of $10trn (€8.2trn).