Countries seeking their own COVID-19 vaccine doses are making deals with drug companies that threaten the supply for the global COVAX programme for poor and middle-income countries, the World Health Organization said.
COVAX aims to vaccinate 20% of people in low- and middle-income countries by the end of 2021 – a modest ambition, to UK ears. Late last week, COVAX was boosted by additional donations from the US, UK and European Union. But COVAX and the low-income countries that depend on it are still on the back foot. Despite wealthy countries’ apparent support for COVAX, most have raced to clinch bilateral deals with pharmaceutical companies, “pre-ordering” vaccines even before efficacy trials had been completed – and there is a global shortage of vaccine stock.
The WHO director-general, Dr Tedros Adhanom Ghebreyesus, told the body’s recent executive board that 44 bilateral deals had been done in 2020 and a further 12 this year. Manufacturers, Tedros said, have prioritised regulatory approval in rich countries where the profits are highest
“Even as they speak the language of equitable access, some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue. This is wrong,” said Tedros. Securing private bilateral deals directly with pharmaceutical companies is unaffordable for the least developed countries. Uganda, for example, is paying the Serum Institute of India $7 per dose for the AstraZeneca vaccine – triple the price paid by the European Union ($2.16).
Young people in wealthy countries were being vaccinated before vulnerable groups, including the elderly and health workers, in poorer countries.
Three-quarters of global vaccinations have taken place in only ten countries, while 130 countries don’t have access to a single vaccine,
WHO Director-General Tedros Adhanom Ghebreyesus called for countries to waive intellectual property rules, to allow other countries to make vaccines more quickly.
The WTO's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires countries to give pharmaceutical corporations lengthy monopoly control over the knowledge and technology used to produce medicines. India and South Africa in October 2020 introduced a proposal (pdf) calling on the WTO to exempt member nations from enforcing pandemic-related patent protections. The TRIPS waiver is backed by more than 100 countries, but a small group of powerful states in the Global North—led by the U.S., U.K., and Canada—is actively and successfully impeding the will of a majority of the world.
Biden, despite having had the opportunity to do so at two recent WTO committee meetings, has not yet ended U.S. opposition to India and South Africa's proposal—even though current trends indicate that the world's poorest countries will be forced to wait until 2024 for mass inoculation, causing needless suffering and death, and generating more than $9 trillion in economic losses.
"As an expert in intellectual property law and access to life-saving medicines, I can assure the Biden administration that intellectual property barriers are real, and they're blocking millions of people around the world from accessing life-saving Covid-19 vaccines," Brook Baker, senior policy analyst at Health GAP and professor of law at Northeastern University, said during the press conference. "By obstructing the TRIPS waiver proposal, President Biden is breaking his promise to share Covid-19 vaccine technologies with the world."
The world does not have time to wait for the usual, slow, and unequal distribution of treatments, diagnostics, and vaccines. The new Covid-19 variants, which show more resistance to vaccines, prove that further delay in immunity around the world will lead to faster and stronger mutations. The TRIPS waiver would give countries more ways to tackle the legal barriers to maximizing production and supply of medical products needed for Covid-19 treatment and prevention.
Akshaya Kumar, director of crisis advocacy at Human Rights Watch, pointed out, "Sharing the recipe for vaccines by pooling intellectual property and issuing global, open, and non-exclusive licenses could help scale up manufacturing and expand the number of vaccine doses made."
Abby Maxman, president of Oxfam America, said that "rather than slicing the existing pie of vaccines even more finely, we need to share the recipe so that we have enough for everyone. We need a people's vaccine. A vaccine that is free to everyone around the world, that is fairly distributed based on need and not on nationality or ability to pay." Decrying the "vast chasm of inequality" created by giving "just a handful of giant pharmaceutical corporations... monopoly control over the live-saving technologies we all need," Maxman noted that the U.S., with only 4% of the world's population, has purchased almost half of Pfizer's total expected supply in 2021.
Sister Simone Campbell, executive director of NETWORK Lobby for Catholic Social Justice, emphasized that "rich nations have an obligation to share with the global community. That is the only way to protect the vulnerable here and abroad. The United States must stop blocking the WTO TRIPS waiver in order to share the vaccine with the developing world and to prevent the killing of our vulnerable siblings in the developing world," Campbell added. "If we don't get the waiver, we in the United States, I believe, will have blood on our hands, and we cannot allow that to happen. Let's change this."
Asia Russell, executive director of Health GAP, which has campaigned for equitable access to medicines for over two decades says, “The only solution is for vaccine manufacturers to share their technology so we can start to overcome artificial vaccine supply scarcity through easing monopoly restrictions. Why is gross profiteering being tolerated, while front-line health workers in poor countries are dying waiting in line for access? Aren't their lives worth as much as people in the UK or US? Pharmaceutical companies must wake up. Donation schemes and feel-good initiatives won't fix vaccine apartheid. They must relinquish their patents, share their know-how, and co-operate.”