IT is evident that the worldwide roll-out of Covid vaccines is increasingly unequal in its distribution. Five months since the inoculations began, many parts of the developing world still remain unvaccinated.
In the developed world, one in four people are said to be vaccinated. In poorer countries, the ratio of vaccination is only one in 500. At this pace, developed countries will reach the goal of full vaccination by 2024 amid new waves of Covid-19. Richer countries have been able to buy vaccines in bulk to vaccinate their own population, diminishing supplies for poorer countries. The growing vaccine inequity can be also attributed to vaccine nationalism, low bargaining power of poor countries and the failure of the WHO-steered Covax scheme to deliver on its pledged doses which were already inadequate to meet the goal of mass vaccination in the developing world.
Yet one of the major obstacles in the way of faster and equal access to Covid-19 vaccines is the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement.
The TRIPS agreement is holding back equal vaccine access.
The pharma industry has intellectual property (IP) protections provided in the TRIPS agreement to protect monopoly patents that run for 20 years, enabling pharma companies to make exorbitant profits on the original investment. These protections restrict wider availability of new life-saving drugs at affordable prices. The mandatory licensing provisions in the TRIPS agreement, which allow for overriding patents in times of a pandemic, have not been used by weak governments of the developing world for fear of inviting legal challenges from powerful multinationals.
Similarly, voluntary licensing provisions enshrined in the TRIPS have been used by Big Pharma selectively and bilaterally with binding conditions attached to the distribution of cheap licensed versions of vaccines and drugs and their export to other developing countries. Not surprisingly, with Covid-19 infections rising amid profoundly unequal and unjust vaccination access, the focus has returned to suspending TRIPS’ IP protections as a way of ensuring equitable, faster and affordable access.
In October 2020, India and South Africa led the call for lifting patents on Covid technologies, especially vaccines, which would allow vaccine manufactures in the developing world to produce generic cheap versions of the Covid vaccine. The call is being backed up by most of the developing world, including Pakistan. The richer bloc, however, including the UK, EU, Canada and Japan, are blocking the move along with Big Pharma and the ‘philanthropist’ Bill Gates on grounds of preserving innovation and recovering original investment poured into vaccine research and development.
Médecins Sans Frontières, Peoples Vaccine Alliance, a group of INGOS, prominent world leaders and the WHO are also putting their weight behind the waiver initiative. On the other hand, the WHO-supported Covid-19 Technology Access Pool (C-TAP) initiative aimed at voluntarily sharing Covid technologies has been cold-shouldered by Big Pharma.
In another significant move, on April 14, more than 100 former world leaders and Nobel laureates, including Malala Yousafzai and former Pakistani prime minister Shaukat Aziz, wrote to US President Joe Biden urging him to lend his support to the patent waiver call. Now with Joe Biden putting his weight behind the patent waiver call, the naysaying Western countries might drop their opposition too, thus paving the way for the world’s quick exit from the pandemic.
Advocates for IP waiver assert that vaccine research and production has been funded by governments which makes these vaccines global public health goods. Under growing pressure and pushback, the patent-holding companies have pledged to ramp up production.
This will take time, as big vaccine manufactures have failed to deliver on their supply commitments to the developed world at a time when the needs of the latter are enormous. The EU is already planning on suing AstraZeneca for not fulfilling its vaccine supply agreement.
More crucially, there is no guarantee that, even if the current production by patent-holding vaccine producers is ramped up, the developing world will get the required number of doses at affordable prices and in time to achieve mass vaccination. Also, vaccine producers have in some instances charged poorer countries more than the richer countries.
The only realistic and life-saving way forward lies in suspending patents on the Covid vaccine and sharing technology so that producers in the developing world can make cheaper versions to expand faster and cheaper access to Covid vaccines. The urgent concern right now should be to save and protect all lives, not the astronomical profits made from publicly funded vaccine research.
The writer, a public health consultant, is the author of Patient Pakistan: Reforming and Fixing Healthcare for All in the 21st Century.
Published in Dawn, May 8th, 2021