Australia, the US, the UK and the European Union are refusing to waive intellectual property rights to Covid-19 vaccines so developing countries can produce the vaccine locally. This refusal, in the face of vaccine hoarding by rich countries, is likely to cause millions more deaths. It is also short sighted because long delays in global vaccination will enable more powerful variants to emerge.
Vaccine nationalism is continuing unabated in Australia and other rich countries. Politicians play to lockdown-fatigued publics, boast of procurement deals and promise herd immunity. Meanwhile many low- and middle-income countries face long delays in accessing vaccines, even for frontline workers and vulnerable groups.
Millions of lives could be saved, and long delays in accessing vaccines eased, if the World Trade Organisation waived certain provisions of its intellectual property agreement that deals with copyright, industrial designs, patents and so on in regard to Covid-19. Such a waiver would enable lower income countries to access the vital technologies to scale up local production of the Covid-19 vaccines.
While more than 100 governments support granting the waiver, Australia, the US, the UK and the European Union continue to oppose it.
Last October, India and South Africa proposed that the WTO agree to waive sections of the TRIPS Agreement that relate to Covid-19 and for the waiver to remain in place until widespread vaccination had occurred globally, and most of the population had developed immunity.
Access to vaccines
On a doses-ordered per capita comparison, the US (10.2 doses per person), the UK (7.6), the EU (6.5), and Australia (5) stand out. These countries are expecting to achieve herd immunity by the end of this year.
In comparison, the African Union (AU) has deals for just 970 million doses for a population of 1.34 billion people, which is well below one dose per person, and for which the funding is still not secured. Zimbabwe (population 14.8 million) has 600,000 doses booked which will cover just 4% of the population.
If low- and middle-income countries have to wait an extra year or two before achieving herd immunity because the West is commandeering the vaccines, there will be about 40-50 million more cases of infections and perhaps 2 to 3 million additional deaths. Many of the deaths will be of health workers.
IP barriers to scaling up production
One issue limiting vaccine production is the use of intellectual property laws to restrict production to licensed manufacturers. Is it possible that restrictions on supply are being imposed to maintain prices and profit flows in the longer term?
It is well to remember the HIV/Aids crisis of 1997-2001 when 39 pharmaceutical companies sued South Africa to try to stop it enacting legislation aimed at reducing the price of medicines for South Africans. This lawsuit effectively was based on maintaining huge profits by denying life-saving treatment to millions of people.
In the case of Covid the refusal of pharmaceutical companies to support open licensing through the Covid Technology Access Pool (C-TAP) and their refusal to participate in head to head comparative trials of candidate vaccines reflects the profit calculations the multinationals are making. This is despite the huge public funding that has gone into the research and development and production support of vaccines.
It is ever more obvious that private enterprise and the ‘free market’ are not well suited to the development and production of global public goods. Without massive grants to rich countries and procurement deals, the rapid development and production of the Covid-19 vaccine would have been impossible.
During the ascendancy of neoliberalism many public sector producers of vaccines were privatised. A strong case is emerging for reversing this trend. However, restoring a strong public sector vaccine industry would face significant barriers that are embedded in contemporary trade agreements.
The Covax facility
Meanwhile, Covax, the global initiative aimed at equitable access to Covid vaccines, remains underfunded, excludes upper middle-income countries from any subsidy, and only aims to facilitate the vaccination of just 20% of the population of participating countries.
The recent announcement that 90 million doses will be delivered to African countries through Covax by mid 2021 will only cover 3% of those countries’ populations. While Covax aims to deliver a further 600 million doses by the end of 2021, enough to immunise 20% of the population, this is optimistic in terms of procurement and delivery is nowhere near close to achieving herd immunity.
The objective of reaching herd immunity thus always depended on countries procuring the vaccines through the open market.
Variants of the virus
The projections regarding vaccine supply are complicated by the emergence of new variants, against which the first generation of vaccines aren’t as effective.
If more virulent, more transmissible strains of the virus develop and circulate in the rest of the world, the risks to the rich world will be heightened.
However, the proposed waiver is not enough on its own. Absolutely critical to production and scaling up vaccines is access to the manufacturing know-how.
However, the waiver on its own will not be sufficient. There will be an associated need for massive investment in the scaling up of research and development and production capacity in low and middle income countries, including through organised technology transfer.
Production critical
Production capacity is critical. Information reported to UNICEF anticipate 3.8 billion doses of licensed vaccines will have been produced by 30 June 2021, although this is believed over-optimistic. Nevertheless, if equitably distributed this would allow for the vaccination of 2 billion people (assuming most required two doses) and could cover WHO’s 20% priority fraction for the whole world.
However, in view of the ambitions of the rich countries for herd immunity and their failure to prioritise the global 20%, this seems very unlikely.
Already, concern about vaccine supply has led to the threats of export controls. Just days ago, Italy imposed a ban on the export of the AstraZeneca vaccine to Australia to accelerate vaccination in Europe. In January, Pfizer’s vaccine delivery schedules for some European countries were cut by 50%.
Legitimation crisis
Transnational globalised capitalism is facing an economic crisis of overproduction. The labour force needed to produce goods and services for the global market is, in relative terms, shrinking, leaving increasing numbers of people on the margins – unemployed, underemployed and low wage employed. Meanwhile, profits which are not going into productive investment, are funding share market speculation creating wealth for those who own shares and leading to widening economic inequality globally.
Neoliberal policies of free trade, marketisation and extreme IP (implemented through TRIPS and other trade agreements and policed through the US’s Super 301) are elements of a policy program directed to preserving capitalist privilege, notwithstanding the widening inequality and alienation they generate and their failure to address the underlying dynamics of the crisis.
Resistance to the waiver needs to be understood as a refusal by the transnational capitalist class to contemplate any weakening of extreme IP. Notwithstanding the prospect of a huge avoidable disease burden in the low and middle income countries, neoliberalism will not take a backward step in the campaign to defend capitalist privilege.
Big Pharma, and the transnational capitalist elite more generally, are facing a crisis of legitimation arising from popular revulsion (in the developing countries) regarding the selfishness of vaccine hoarding by the rich countries and their defence of extreme IP.
The risk, for the transnational capitalist class, is that the governments of low and middle income countries are being forced to break with the neoliberal project of the West. China and Russia are clearly differentiating themselves from Western vaccine producers by prioritising the export of their vaccines and accepting slower vaccination at home.
WHO is still waiting for China and Russia to provide all of the data required for WHO for pre-qualification purposes.
Now that G7 countries are losing face to China and Russia, but still determined to refuse the waiver, the G7 countries are boosting their funding of the Covax facility to increase supply.
Facing several more years of pandemic and the prospect of higher prices when Covax concludes, the need to expand vaccine production appears self-evident in the global South. The demand for the TRIPS waiver is unlikely to go away.
This article was co-authored by Sun Kim, MS PhD, a Director of the Health Policy Research Centre of the People’s Health Institute in South Korea and Coordinator of the People’s Health Movement for South East Asia and the Pacific.
David Legge is a scholar emeritus in the School of Public Health and Human Biosciences at La Trobe University in Melbourne and a founding member of the People’s Health Movement.
Comments
9 responses to “Vaccine nationalism: Australia votes to deny Covid vaccines to poorer countries”
Something for the WTO look at as part of its reform process? WTO reform has to work for the whole world, not just for the countries with the most IP rights.
There is no doubt that Big Pharma is trying to make a profit. Under nomral circumstances, this is quite acceptable. However, this is a global pandemic and no herd immunity in sight. The rich might feel protected but nature’s cruel trick is that the virus may mutate in poorer nations and come back to re-infect the rich, unless the rich is breathing a different source of air imported from another planet.. Profiteering is immoral under the present circumstances and the consequence are (1) loss of moral leadership in the west as perceived by poorer countries as selfish, uncaring and profiteers; (2) loss of geopolitical influence on subsequent global issues and (3) if China/Russia gives out the vaccine for free, then the world wil realigned with the non- algined nations toward the China-Russia axis – the West is simply pushing the poorer countries into the arms of China/Russia. For India, given the choice of getting the vaccine from China/Russia or to pay more to rthe West, they will re-algin with China/Russia. To the poorer countries, this is life or death matter, and they will not forget any nation who came to the rescue in times of dire need.Vaccino-politics will realign the world. If a family is in possession of the golden pill that can cure this pandemic and his not sharing with the neighbours how long can this family last/ Translate ‘family’ to ‘country’, the consequence will be the same.
Thank you, Anthony. Part of me hopes that the rest of the (impoverished) World will indeed gravitate to the China/Russia axis. Because I so fear that the rulers of our capitalistic wealthy World will not take notice enough to change their international cruelty unless the internationally impoverished do exactly that.
It is good that China and Russia are helping break the stranglehold of the Western capitalist class. Not only in Pharma, but eventually across other industries where huge Western companies continue to suck blood out of the poorest on the planet.
Egalitarianism is coming whether the Western countries like it or not. In our Australian context where we still treasure our egalitarianism (like Medicare…), we say ‘what’s good for the goose is good for the gander’.
Intellectual property is a doomed attempt to establish a monopoly of science. Its proponents are a bunch of sour-faced losers, whose demise will leave the earth a better place.
These vaccines are poisons, like all medicines. That is why Doctors are involved. Look up the legal definition of medicine!
To buy them, governments must agree to indemnify the makers of these experimental poisons. Pharma thus act as a trusted agent of the population. Damage done will be compensated by the population’s government. No dragging the name of the trusted profit maker through the courts, just a semisecret system of restorative justice. Socialism for the capitalists.
This model may not be suitable for poorer countries? They may not wish to provide indemnities. They may not provide compensation. They may trust in a ‘higher’, less accountable, power. But then the kickbacks are attractive…? Bribery is a known factor in 1st world ‘trade’ with poorer countries.
India, China and Russia are all developing their own ‘vaccines’.
We do not need a chorus or claque to destroy national vaccine and pharma developments in poorer countries. Dominating markets is the main intent of this article, bleating about injustice, when poverty is the main killer. Sending cheap foods in good times, to poor countries destroys their ability to establish their own food industries. Yeah!
Until someone can demonstrate that the developers of the vaccines are unreasonably denying use of the IP to additional production facilities, there is no justification for IP waiver. ‘Unreasonable’ in this context means charging for the IP to a third party more than they price the IP into the vaccine they produce themselves – calculated as wholesale price minus production costs. AstraZeneca for example IS being produced by CSL in Australia. Note this needs to be adjusted for scale, the greater the production the less the required margin.
The concept of ‘extreme IP’ doesn’t apply here. That covers circumstances more aking to the continual extension of the duration of copyright after the creator’s death (the real Mickey Mouse clause). The IP on phrmaceuticals is twenty years unless the drug company doesn’t pay maintenance fees.
It is wrong to look at only the profit from successful R&D. Big Pharma also spends a lot on unsuccessful R&D that needs to be funded by revenue from successful R&D.
To increase supply of vaccine to less developed nations, the developed world just has to provide funding.