One step closer towards achieving global equitable access to vaccines

In the last few days, the United States (US) made two important announcements which have the potential to save millions of  lives in the poorest countries of the world and might contribute towards suppressing a further spread of the Covid-19 virus . 

The first announcement came from the White House on April 26 that the US will share up to 60 million doses of its AstraZeneca vaccines with other countries as they become available in the coming months. Out of these 60 million, 10 million doses are expected to be released soon once the Food and Drug Administration (FDA) of US approves it in the coming weeks, while the other 50 million doses are at different stages of production and would take  more months to be manufactured.

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This initiative by the US is  extremely crucial considering that a set  of rich and developed countries have stockpiled a majority share of the vaccines by placing a pre-order. It was estimated that within merely a month of obtaining regulatory approvals for the first  three Covid-19 vaccines (Pfizer-BioNTech, Moderna and AstraZeneca), the developed countries had placed orders for around 85% of the total estimated production for 2021, although these countries account for only 14% of the world’s population.

The following figures are mind-boggling: Canada and the US had pre-ordered vaccines at a scale which is ten times  and four times of their population, respectively. A direct implication of this unjust hoarding by these rich countries is that a lot of other developing and underdeveloped countries will not have immediate access to these lifesaving vaccines. 

The second announcement was made on May 5 that the US will support the temporary waiver of Intellectual Property Rights (IPR) or patents on Covid-19 vaccines. There was an utmost need for this as the pharmaceutical companies who developed these vaccines and have exclusive IPR on the same, do not have the capacity to produce vaccine doses for the world’s population. This reiterates the earlier point that the other developing and underdeveloped countries would have to wait long  to vaccinate their population.

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The solution to this is that these companies share the knowledge of vaccine production to other manufacturers across countries so that vaccine production could be revamped and become accessible to the poorest countries. This was a critical element of the joint proposal raised by India and South Africa at the World Trade Organisation (WTO) back in October, 2020.

More than 100 countries out of the 160 WTO members were in support of this move but it faced stiff resistance from countries like the US, UK, the European Union (EU), Switzerland, Norway, Australia and Japan. Surprisingly, even Bill Gates, otherwise known for his vast philanthropic work in global health, opposed this waiver of IPR for vaccines.  

This temporary waiver on patents was primarily opposed on two grounds: One, that this would disincentivise medical innovation in the long-term. Two, that the manufacturers in the low- and middle-income countries are not capable of handling such sophisticated technology and that may compromise the safety and quality associated with the vaccines. Let us evaluate these claims.

It is well acknowledged that investment in research and development (R&D), a principal component of vaccine development is both costly and risky, and the companies involved must be awarded with exclusive rights (patents) on the production and marketing of their innovative products (vaccines in this case), so that they get a profitable dividend for their risky investment.

In the present context, the Covid-19 vaccine is a unique case. All the Covid-19 vaccine developments were financed majorly by public money.

The governments, especially in the US, Russia, China, and other European countries subsidised the pharmaceutical companies with millions of funds to help them develop the Covid-19 vaccine. Therefore, this means that these companies will not suffer from any monetary loss by sharing their knowledge of vaccine production. Thus, the argument that relaxing IPR would disincentivise innovation in the future is futile.  

Similarly, the argument that manufacturers of low- and middle-income countries are not sufficiently capable enough to produce safe and quality vaccines reflects the hypocrisy of the rich countries as well as the big pharmaceutical companies.

For years, these same companies have been using the producers of low- and middle-income countries as ‘contract manufacturers’ for their patent protected vaccines and other therapeutic drugs. They did not have reservations about the quality and safety in those scenarios. It is only when they have to surrender their monopoly power and compromise on their profits, that they are concerned about ‘quality and safety’ aspects.  

The Director General of WHO reported on April 9 that, out of 700 million vaccine doses administered, more than 87% have gone to high or middle-income countries and only 0.2% have gone to the low-income countries. These figures reflect the stark disparities in access to vaccines at a global level. 

It is estimated that if IPRs are not waived off to pave the way for mass production of vaccines, some of the poorest countries may have to wait till 2023 or 2024 to get fully vaccinated. We cannot afford to wait that long. No one can really estimate how many lives would be lost by that time. The developed countries must understand that the pandemic will not come to an end until it gets eradicated from all the regions of the world. 

Despite the growing dominance of China at the global level, the US is still considered as the world’s leader and its actions have wider implications on other countries. They should have taken these initiatives much earlier. More recently, they seem to have woken up to the cries and appeals of the low-income countries. These initiatives by the US might positively influence countries like Germany, UK, Switzerland, and other EU countries who earlier opposed the proposal at the WTO. 

Hopefully, when the WTO members meet next month, there will be a constructive discussion on the proposal and these countries do extend their support for this noble initiative of ensuring equitable vaccine access. Similarly, it is expected that once the US fulfills its promise of sharing 60 million vaccines to other countries, other rich countries also follow suit and start sharing the same with other countries on humanitarian grounds.  

There are some apprehensions that patent waiver might not fully solve the problem of vaccine shortages if additional support in the form of sharing ‘manufacturing secrets’ or ‘tech transfer’ are not provided to other vaccine manufacturers.

Also, these processes take time to manifest, and it is not certain if these vaccines will remain effective by then, given the pace at which the virus is mutating. However, despite these uncertainties, the initiative by the US is commendable and it brings us one step closer towards achieving global equitable access to vaccines. 

(Madhurya Deka has a postgraduate degree in Applied Economics from Centre for Development Studies (JNU), Thiruvananthapuram and currently working as a research analyst in CTIER, Pune. The views expressed are the author’s own.)