Every country should have the right to make its own vaccines during a pandemic, however, it is not that simple when not every country has the infrastructure and wealth to do it. The United Nations has warned one of the reasons COVID-19 continues to spread is due to vaccine inequality between nations. Even though 3 billion COVID-19 vaccine doses have been administered worldwide, the vast majority have been administered within developed nations. Still, this is not the case everywhere, and the reality is different in Low-and-middle-income countries (LMICs). Africa, for example, have received less than two percent of the administered doses. Wealthy nations, such as the US have produced over 333 million vaccine doses, exporting close to three million. Luckily, this will change as domestic vaccination rates increase within developed nations, reducing demand as life return to normal.
Three agencies: Gavi, the Vaccine Alliance; WHO; and the Coalition for Epidermic Preparedness Innovations (CEPI) came together to establish an initiative called Covax aiming to create an equitable distribution of vaccines globally. Securing vaccines for all high-risk populations around the world, regardless of social class is the top priority goal of this initiative by the end of 2021. However, wealthy nations circumvented Covax by securing their own supply and prioritizing their own low-risk populations over the Covax initiative. This has left low-income nations struggling to obtain vaccines for even their health workers and at-risk populations.
What do LMICs need?
One major lesson from the COVID-19 pandemic is that intellectual property and pandemics do not mix. LMICs have greatly relied on donations for their vaccine supply as they are unable to buy them in such scale as developed nations whose supply exceeds their demands. One potential solution would be for LMICs to develop their own infrastructure, which unluckily takes time and money, to sustainably create their own vaccines in the future. However, for the current pandemic, that is not possible and instead they have relied in an amendment for a temporary waiver of Intellectual property (IP) protections on COVID-19 vaccines, the transfer of technical knowledge from vaccine makers to the manufacturers in LMICs, and their subsidisation for manufacturing them.
What are IP waivers and what needs to be done?
An IP waiver would allow other companies to make raw materials for export for all the current vaccines, industrial parts, and components. It would also simplify agreements for eventual production of more doses. Still, an IP waiver alone will not solve the COVID-19 vaccine access challenge. Last October, India and South Africa put forward an initiative at the World Trade Organization (WTO) to temporarily suspend rules on intellectual property rights for COVID-19 vaccines. In June 2021, members of the European Parliament resolved to start a temporary IP waiver. However, this means potential manufacturers would also require access to potential trade secrets, knowledge, and technology to produce the vaccines, especially for novel technologies like Pfizer and Moderna that use messenger RNA (mRNA) vaccines. As a result, the lack of global health policies resulted in an unpreparedness to deal with pandemics as many of the companies prioritize their profit over a fair distribution and could explain why new variants continue to emerge globally.
Who opposes IP waivers and why?
At present, manufacturers in Bangladesh, Canada, Denmark, and India have said they have the capability to produce vaccines, but they are unable to secure the licenses to achieve it. However, other high-income nations as Japan, the UK and Australia, and organizations, as the World Bank and European Union, and the pharmaceutical industry, who are mainly located in wealthy nations, do not support IP waivers. Instead, these countries are pledging to share more of their own vaccines with low-income nations and to provide more funding to charitable vaccine-provision schemes such as Covax. Also, they claim IP relief will not accelerate vaccine manufacturing, because materials are in short supply, and it can take several years to build up capacity from scratch.
What is next?
Experts feel that relying so heavily on a single country for vaccine distribution is not wise. Especially with emerging variants which can set back vaccine distribution as local vaccine demand increases. Still, with the US and other countries, as Russia and China, showing their support behind the IP waiver and even the support of organizations like the Bill and Melinda Gates Foundation the domino effect continues and may allow a better distribution of COVID-19 vaccines worldwide. Still, even if an IP waiver could be the right thing to do from a global health perspective, these processes take time, which is lacking right now, emphasizing the need of support and initiative for global health in future pandemics.
References
- (2021). A patent waiver on COVID vaccines is right and fair. Nature, 593 (7860), 478-478. Retrieved on July 20, 2021, from https://www.nature.com/articles/d41586-021-01242-1
- Melimopoulos, E. (2021). Explainer: What are patent waivers for COVID vaccines? Aljazeera. Retrieved on July 20, 2021, from https://www.aljazeera.com/news/2021/6/29/explainer-what-are-covid-vaccine-patent-waivers
- Gonsalves, G., & Yamey, G. (2021). The covid-19 vaccine patent waiver: a crucial step towards a “people’s vaccine”. BMJ, n1249. Retrieved on July 20, 2021 from https://www.bmj.com/content/373/bmj.n1249
- (2021). WTO Chief Hopeful for Deal to Get More COVID-19 Jabs to Developing Nations, IISD. Retrieved on July 20, 2021, from: https://sdg.iisd.org/commentary/policy-briefs/wto-chief-hopeful-for-deal-to-get-more-covid-19-jabs-to-developing-nations/
Juan Diego Sanchez Vasquez
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