Waiver of intellectual property rights is an imperfect solution to achieving vaccine equity
OWhen the history of the Covid-19 pandemic is written, readers will be as stunned by the glaring collective failure to immunize everyone who needed it as by the remarkable successes in vaccine and drug development.
A huge failure has been the failure of the global healthcare community to fulfill its moral obligation to older people, people living with chronic conditions and others in low- and middle-income countries who are the most likely to develop severe cases of Covid-19 or die. From this. The inequitable distribution of Covid-19 vaccines is not the fault of any particular entity. The global health care community as a whole – governments, international organizations, non-governmental organizations, the biopharmaceutical industry and others – has broken its promise to leave no one behind.
Also, we are not off the hook for this pandemic as the disease continues to spread in parts of the world.
Today, 2 billion vaccines are stuck in refrigerators around the world, while in some countries the elderly and others vulnerable to severe Covid-19 have still not received their full course of vaccines. By December 2021, global production of Covid-19 had reached almost 11 billion doses, but vaccine manufacturing capacities are now reduced. The Serum Institute of India is halting production of the AstraZeneca vaccine, and Aspen Pharmacare in South Africa fears it may have to shut down its two Covid-19 vaccine production lines permanently unless a new order arrives soon. Aspen leader Stavros Nicolaou told the media: “If Aspen can’t produce Covid vaccines, what hope is there for others.”
Getting Covid-19 vaccines to everyone who needs them remains a huge challenge. Vaccines sit in storage as immunization efforts fail because many health care systems are underfunded and lack trained personnel in both urban and rural settings; there is a lack of coordination and political commitment; the complexity of vaccine handling; and vaccine hesitancy.
Because lack of demand, not lack of supply, is driving the current challenges, it is surprising that discussions are still progressing on a proposal originally submitted by India and South Africa to the World Trade Organization in October 2020 which would waive intellectual property rights to Covid-19 vaccines to help increase vaccine production. The talks on lifting aspects of trade-related intellectual property rights (TRIPS) are all the more confusing as, according to health intelligence analyst Airfinity, there are more than 380 Covid-19 vaccine partnerships and 150 for Covid-19 therapies. India and South Africa are two countries that have benefited from technology transfer as, in 2021, India was the third largest producer of Covid-19 vaccines, ahead of the United States.
The premise of an intellectual property waiver for Covid-19 vaccines was wrong from the start. Such a waiver is not sufficient to allow a manufacturer to consistently produce high quality vaccines. Vaccine makers in low-income countries are the first to recognize that voluntary technology partnerships should be just that – voluntary – and achieved by sitting down together to find solutions to production, labor, supplies, quality and regulatory approvals.
It is difficult to understand why the United States lent its support to the proposed waiver in May 2021, the early days of the Biden administration. At the time, the United States had enough vaccine on its books to vaccinate its population six times, global manufacturing scale-up was well underway, and if shared fairly, there would have been enough vaccines to vaccinate the world. The proposed TRIPS waiver makes even less sense when no one can point to intellectual property as a barrier to expanding global manufacturing. It is also unclear how US interests would be served by undermining intellectual property, since more than 40% of US gross domestic product comes from IP-intensive industries. This sends a chilling message to a third of the total workforce working in these industries.
The biggest factor affecting vaccine scarcity last year was not intellectual property but trade. The US Defense Protection Act has slowed manufacturing scale-up by hampering the vaccine supply chain, and India’s export ban on COVAX vaccine supplies has severely affected the fair distribution of vaccines. vaccines in most countries in Africa for much of 2021. Africans have been severely disappointed. by not receiving secure COVAX orders from the Serum Institute. The shortfall was made up within months by other vaccine manufacturers.
And looking ahead, the biopharmaceutical industry (Johnson & Johnson, Moderna, Pfizer and BioNTech) is supporting initiatives to build vaccine manufacturing capacity on the African continent. Moreover, the infrastructure needed for local production in any country will itself be fostered by strong intellectual property protection that rewards successful innovations.
Ahead of the World Trade Organization ministerial conference, which begins on Sunday, negotiators are mulling over language in the latest TRIPS waiver document, which aims to simplify procedures and address the challenges of increased production. But they should keep in mind that rather than solving a theoretical problem, the waiver proposal is more likely to undermine innovation by creating uncertainty and hindering future research and partnerships by changing the very framework that facilitated an unprecedented number of partnerships, voluntary licenses and knowledge sharing. that emerged as a result of Covid-19. The biggest loser will be global health security, the exact opposite of what to do for future pandemics.
Proposed waivers from the TRIPS Agreement are political diversion for industrial policy purposes for some countries and political grandstanding for others. The potential casualty of this heated and dishonest debate on waiver is finding solutions to equitable access, without which global health security cannot be achieved. Whatever the next unknown disease, this pandemic has demonstrated that science and scientific effort combined with collaboration and solidarity will be at the heart of the capacity, speed and equity of the world’s response.
Only by being brutally honest about what worked and what didn’t do we have a chance to better respond to a future pandemic, even if we continue to fight this one.
Thomas B. Cueni is Director General of the International Federation of Pharmaceutical Manufacturers and Associations. The opinions expressed here are his own.