Photo by Hakan Nural on Unsplash
By K.M. (Gopa) Gopakumar
Third World Network (TWN)
Vaccines are prioritized as one of the most important medical products when it came to the COVID response, as it can drastically reduce the severity of the disease. As of 31st January 2021, there have been around 98.8 million vaccination administered around the world using the 11 various types of vaccines that currently exist. However only 10 countries account for nearly 85% of these 98.8 million administered doses.
One of the main principles of vaccination programs is that no one is safe until everyone is safe. WHO noted that we need to vaccinate at least 70% of the global population in order to get what is often referred to as herd immunity (or maybe even 95% of global population vaccination if we want to entirely break the chain). If we were to calculate the average of two doses per person, then we are talking about around 10.3 billion doses in order to vaccinate 70% of the global population. These vaccinates would all need to demonstrate very high efficacy (percentage reduction of a disease in a clinical trial), and would also need to show that they last over a number of years without a need for re-vaccinations. It is important to note that at this point of time we do not have any clear evidence with regard to the duration of immunity from vaccines.
Yet if we look at who has access to vaccines right now, we see very uneven and unjust distribution. Of the vaccines being “booked” by countries in 2021, a vast number of these vaccines are going to wealthier countries. 16% of the world population (mainly rich countries) have already booked over 60% of the vaccines being developed in 2021. The large and the substantial percentage of the vaccine, in other words, is going to a very small set of the global population while low- and middle-income countries are getting very few doses. This shows a huge access issue.
Given the rate of vaccine development and distribution, this means that poor countries will likely be waiting until 2024 or 2025 before they complete the massive vaccination.
Why is this the case? There are a number of reasons for this, but here are just a few:
Rich countries are placing export restrictions on pharmaceutical companies since the companies are struggling to meet their commitments to vaccine dose development. Many of the companies have not yet been able to produce the does that were originally promised to the EU and US. The European Union has now imposed important restrictions on these companies, meaning that are not allowed to export to other countries without the permission of the EU. Countries like South Africa, Malaysia, etc would now need permission from the EU to get vaccines from these companies.
There are huge cost disparities of the price of vaccines between rich countries and poor countries. In the case of the AstraZeneca vaccine, South Africa was able to obtain vaccines through a settlement in recent months. But the costs of this was around 5 USD per dose. AstraZeneca sold this same vaccine to the EU for a negotiated price of around 1.73 USD per dose. As per reports, Uganda paid 7 USD per dose. Given the need for the vaccine, the African Union has now entered into a bilateral vaccine deals with AstraZeneca to secure around 270 million doses for its member states at a much higher price than that being sold in the EU.
Intellectual property rules are inhibiting the ability to have a diverse enough manufacturing base. There are 11 companies that have now obtained marketing approvals for COVID 19 the vaccines. Since India’s Serum Institute obtained technology form AstraZeneca, out of these 11 vaccines 10 are originator products. There are patents on many of these vaccines (especially the mRNA vaccines), and the companies are not giving up the control on the production and the distribution. Intellectual Property barriers (patents and trade secrets) have allowed the large pharmaceutical companies to maintain a monopoly on the vaccines. All of these intellectual property rules are protected by the global TRIPS agreement (related to intellectual property rights) that has been signed by all member nations of the World Trade Organization (WTO).
What is the solution? What can be done? And how can we have a more just and solidarity-based distribution of the vaccines?
Advocate for the vaccine as a global public good. Humanity is facing a global problem and it needs a global solution. While many political leaders are saying that a vaccine should be a global good, but the actions being done to make this happen is not happening globally. Governments have pumped a HUGE amount of money into this in a short time into developing technologies and a vaccine, and a vast majority of these funds are with public (tax-funded) money. Since these companies have received public money, the vaccines really need to be treated as a public good. Instead, companies are keeping a monopoly on vaccines and placing millions of people’s lives at risk. We need to challenge this on a national and international level.
Scale up production and provide access to efficacious vaccines. Manufacturers must provide access to very efficacious vaccines to all people, and no one should be denied access. This is based on the principle that everyone should have the benefits of scientific progress through the human right of access to science.
Support the proposal of poorer countries to waive the TRIPS agreement on intellectual property during this crisis. South Africa, India and others have brought forward a proposal in the WTO, which would temporarily suspend the intellectual property rights around products that would protect, contain, and treat COVID-19. The proposal would among other things waive protections for patents, copyrights, industrial designs, and trade secrets “until widespread vaccination is in place globally, and the majority of the world’s population has developed immunity.” A vast majority of the WTO member states are now supporting this proposal, along with civil society organizations and the WTO Director General. 10 countries (including European Union and the US) are currently blocking the proposal by stating that the proposal would set a precedent and would jeopardize future medical innovation. But supporting the adoption of this waiver proposal can be a clear way to ensure that everyone has access to vaccines.
The rules of the game have ultimately been rigged in favor of big companies and corporations that is affecting people’s life and health at this point of time. At the end of the day, it is power, it is dominance, it is exploitation, and it is pursuing profit motives at the cost of peoples’ lives. This is unacceptable. In this way, larger social movements can easily connect to these issues. It is an issue of life, death and existence of humanity.
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K.M. (Gopa) Gopakumar is the Legal Advisor and Senior Researcher with the Third World Network (TWN), New Delhi. His area of focus is the global intellectual property regime and its impact on developing countries.