Vaccine export barriers during a pandemic are wrong. So are intellectual property barriers and vaccine nationalism.
In the last few weeks, a global trade war has erupted over equitable access to COVID-19 vaccines. Yet it is the wrong one. High-income countries are fighting over who gets to be first in line for access to COVID-19 vaccines, even after having hoarded most of the world’s supply. In doing so, they are letting pharmaceutical corporations off the hook, and leaving the poorest countries out in the cold.
The European Union’s decision to pull up the drawbridge and potentially restrict exports of COVID-19 vaccines has been met with equal parts consternation and indignation by other wealthy countries. Protesting countries, such as Canada and Japan, have benefited handsomely from the current ‘free for all’ that is a defining feature of the pandemic — Canada ‘leads the world’ — having secured ten doses for every Canadian, with Japan having ‘only’ secured 4 doses per person. If politics, as they say, stops at the water’s edge, so does concern for a fair and equitable trading system.
In October 2020, faced with a likely reality that their own countries and their neighbours would be left with little to no access to COVID-19 vaccines, the governments of India and South Africa, now supported by nearly all low- and middle-income countries, petitioned the World Trade Organization to temporarily suspend all intellectual property rules for COVID-19 medical technologies for the duration of the pandemic. Their concerns about insufficient supplies have been borne out — only 55 doses of COVID-19 vaccines have been administered in low-income countries out of a total of more than 138 million doses administered worldwide.
This situation is not likely to improve. Rich countries with 14% of the global population had secured 4.2 billion vaccine doses, versus only 2.4 billion by low- and middle-income countries. These countries are also at the front of the line with options for over 4 billion additional doses still being negotiated. The COVAX facility, which is supposed to facilitate equitable vaccine access, has secured 1.1 billion doses with plans for an additional 1.2 billion, but some of those doses are reserved for upper-income countries, and most will arrive later this year, when many rich countries will have already reached herd immunity.
Intellectual property rights undermine supply, affordability, and equitable distribution to new COVID-19 vaccines by leaving total control of the knowledge and technology required for each vaccine in the hands of a small group of drug corporations that exclude other producers. We already know that no one company can supply all the vaccines needed to tackle the coronavirus and emerging variants, and we also know that given the choice, companies with limited supply will always sell to the highest bidder, whether that is wealthy countries, big companies, or individuals who want to cut the queue.
The proposed WTO IP waiver would remove an unnecessary barrier to the sharing of knowledge that is required to scale-up production of vaccines. It would allow any manufacturer willing to invest to make the vaccines for underserved markets. It is not as if intellectual property has played a major role in getting vaccines to market. Prior to the pandemic, coronavirus vaccine research programs were limited to a few academic consortiums, and in the midst of the pandemic, governments have spent over 90 billion Euros to pay for research and development, manufacturing and advanced purchases of new vaccines.
Yet even though intellectual property rights did not contribute to the rapid development of new COVID vaccines, IP rights are critical for those pharmaceutical corporations that now have exclusive rights and want to maximize profits this year and beyond. Pfizer is projecting US$ 15 billion in revenues in 2021, and expects to have a ‘durable’ revenue stream in the long-term due to the need for boosters against variants. In other words, our collective failure to control the pandemic and have enough supply is directly tied to the industry’s intent to retain its crown-jewel monopolies.
The European Union was right to criticize AstraZeneca, which signed an exclusive agreement with Oxford to manufacture a vaccine it had no hand in inventing, for not honoring its commitments. Yet instead of training its power upon rectifying the exclusive control of vaccines with a few multinational companies, they have decided to divide governments against one another, not to mention continuing to ignore the needs of the most vulnerable countries. Even now, the European Union has been antagonistic to India’s and South Africa’s request at the WTO, apparently willing to grant drug companies unfettered power to control these vaccines, if they can obtain enough doses for their own population.
It is not as if other high-income countries are any more virtuous. The same governments that are speaking out against EU export restrictions for depriving them of vaccines for their domestic populations have also been unwilling to support suspending IP rights on COVID-19 medical technologies. Some have been outright antagonistic — such as the case with Japan and the United Kingdom, while others such as Canada have been unable to commit to supporting the waiver. Of course, this stance reeks of a double standard.
Export restrictions had an immediate bite on the supplies provided to rich countries, and so they responded quickly. Yet these countries are happy to run out the clock on addressing intellectual property rights since they may believe their immunization programs can ‘outrun’ variants while avoiding supply disruptions in the future. These countries still have the chance to make the right choice, including at a meeting at the WTO in early March. Allowing the free movement of vaccines may allow the wealthiest countries to temporarily exit the pandemic this year, but only by allowing the free movement of knowledge will these countries rectify the inequity of access for which they are responsible, while also encouraging all countries to work with one another to end this pandemic.
Rohit Malpani is a public health consultant and advocate and represents non-governmental organizations on the Board of Unitaid.
Brook Baker is a professor at Northeastern University School of Law, USA; an honorary research fellow at the University of KwaZulu Natal; and a senior policy analyst with Health GAP (Global Access Project).
