Alex Azar, the secretary of health and human services, admitted Wednesday that a vaccine for a new coronavirus might not be affordable for all Americans. “We can’t control that price,” Azar told Rep. Jan Schakowsky, D-Ill., during a congressional hearing about the novel strain, which has been spreading throughout the world and is widely expected to become a serious public health issue in the United States. After a wave of criticism from Democrats, Azar walked the comment back the next day, saying that he would ensure public access to a vaccine for Covid-19, the disease caused by the virus, if one should be developed. But Azar, who served as the top lobbyist for Eli Lilly before becoming president of the drug company’s U.S. operations in 2012 and the secretary of health and human Services in 2018, knows of what he unthinkingly speaks. Exorbitant drug pricing often leaves life-saving treatment out of reach for the poorest Americans. And to the extent that Azar and the other businessmen who make up the majority of the president’s coronavirus task force have any experience with pharmaceuticals, one of the most profitable sectors of the economy, it’s been making money off the system that keeps them out of reach.

In the case of Azar, who earned nearly $2 million during his last year at Lilly, that profit came at the expense of the people who needed the drugs, according to a lawsuit filed in 2017. While Azar was leading the pharmaceutical giant, the cost of its drugs went up significantly. In particular, insulin sold by the company more than doubled in price. According to the suit, which also names Novo Nordisk and Sanofi, Eli Lilly engaged in a scheme to artificially inflate the price of its drug, leaving some diabetic people unable to pay the cost and forced to use expired insulin or none at all. Eli Lilly did not immediately respond to a request for comment, but the company has told other publications that the suit has no merit and that it follows the “highest ethical standards.” For another task force member, the profits could come from the coronavirus itself. Joseph Grogan was a lobbyist for the pharmaceutical giant Gilead Sciences before he joined the Trump administration as director of the Domestic Policy Council and led the Drug Pricing and Innovation Work Group. On Wednesday, after Gilead announced that it would be starting two clinical trials of an antiviral drug that could be used to treat Covid-19, the company’s stock price surged. As a former lobbyist for a company that stands to gain big from a possible treatment for the respiratory disease, Grogan’s participation on the task force poses a host of ethical problems, according to Robert Klitzman, professor of psychiatry and director of the bioethics master’s program at Columbia University. “Does he have a conflict of interest? Yes!” said Klitzman, who points out that the government is likely to spend money on both the research and purchase of treatments for the virus. “Gilead could help shape a government request for proposals so that they could have an unfair advantage.” While Grogan appears to have sold his Gilead stock and, according to the Office of Management and Budget, has severed all financial relationships and taken “the Trump pledge,” the situation is still problematic, according to Klitzman. “When he gets out of office, they could give him a gift for doing a good job or just hire him again. And what about his buddies? I’m sure he is still close to people who work for Gilead who will benefit. These are all major ethical concerns.”