The vaccination gap between rich and poor countries has widened to a chasm. As science writer Stephen Buranyi noted this week in the Guardian: “Of the doses already given, about half have gone to the richest 16% of the world’s population. . . . According to analysis by the Center for Global Development and the Economist, nations in the global south may not reach widespread vaccination until 2023.”
That’s not a problem according to people like Bill Gates, whose claim to public health czardom is simply that he’s a multibillionaire. In an interview with Sky News, he assured us: “The actual death rate in the poorest countries has been quite low. So the places where you want to get everyone over sixty vaccinated, South Africa, Brazil, that will become a priority, just in the next three to four months when the US will move into that excess position.”
Translation: poor countries should be grateful to wait for the leftovers.
But every day in India, for instance, hundreds of thousands of new cases are being reported. On Monday, India’s 352,991 new cases broke the single-day record for any country. Hospitals have run out of oxygen, ICU beds, and supplies.
The fire is raging everywhere. And the reality — which Bill Gates and pharmaceutical CEOs want us to accept — is that it may take years for vaccine supply to reach most of the world. In the meantime, global vaccine inequality will become global vaccine apartheid, and the virus will be allowed to mutate and spread.
What Part of “Global Health Emergency” Do You Not Understand?
Gates is a key driver behind the global COVAX initiative, a voluntary project to buy vaccines for developing countries. Spearheaded by Gavi, a project of the Bill & Melinda Gates Foundation, COVAX has been lauded as a humanitarian mission. But although the initiative may be a step up from vaccine nationalism, it purposefully leaves in place the market mechanisms and patent protections that the pharmaceutical companies depend on. It has delivered just thirty-eight million doses so far.
The real problem is one of supply. And the way to boost supply is to release the patents and technological know-how that are needed to actually ramp up production around the world.
Neither pharmaceutical companies, who stand to lose billions if they forfeit monopoly control over vaccine production, nor self-appointed billionaire philanthropists, who themselves made their fortunes off of intellectual property laws, will make this right. It is against their interests to do so. But the fact that they have been left in the driver’s seat in the first place is the fault of the US and other wealthy governments.
In an interview with Sky News, Gates scoffed, “we don’t have a world government” that could ignore or override the United States or United Kingdom. And he’s right: we don’t have a world government. But what we do have are international institutions where wealthy nations, led by the United States, are actively sabotaging any efforts to push for equity in the production and distribution of vaccines. South Africa and India have proposed waiving patents and other intellectual property (IP) restrictions through the World Trade Organization (WTO) for the duration of the pandemic.
Despite the support of over one hundred countries, this effort has so far been stonewalled. And meanwhile, according to the New York Times, pharmaceutical companies like Pfizer are “ask[ing] governments to put up sovereign assets, including their bank reserves, embassy buildings and military bases” to protect companies from civil lawsuits that arise from their own negligence.
Release the Patents, Share the Technology
For months, activists and civil organizations have been calling on President Joe Biden to support a temporary patent waiver at the World Trade Organization, a demand that has been on the table since last October and will come up for discussion again on May 5. The same wealthy nations that are hoarding supplies are also blocking the waiver.
Now pressure is mounting on Biden from mainstream quarters as well. The New York Times editorial board is arguing for sharing patents and technological know-how, and even the Economist is urging Biden to disavow “vaccine selfishness.” Adar Poonawalla, the head of the world’s biggest vaccine-maker, the Serum Institute of India, is beseeching the Biden administration to lift the embargo of raw material exports out of the United States in order to allow for greater vaccine production in India.
Biden has begun to budge on certain issues, including committing to shipping oxygen generators and materials for AstraZeneca’s vaccine to India. The administration has promised to divert some excess (and not-approved-for-use-in-the-United-States) doses overseas, either via COVAX or bilateral arrangements. These are fine first steps, but they clear a very low bar and are not nearly enough to address the crisis.
To boost vaccine production to the levels necessary to inoculate the majority of the world’s population, pharmaceutical companies must be forced to release the patents and technological know-how to make them. This will allow generic and other drug manufacturers to scale up vaccine production.
Joe Biden Could End this Pandemic If He Wanted To
The United States government has both the power and the legal right to do so. The first step would be to stop stonewalling the patent waiver at the WTO. The Biden administration could also provide compulsory licenses of publicly funded vaccines to drug manufacturers that have the capacity to produce the vaccine. Most COVID-19 vaccines, for instance, use stabilized spike protein technology, which was developed by the National Institutes of Health (NIH) using public funding. The NIH has in fact claimed joint ownership of the Moderna vaccine.
The US government can help facilitate technology transfer between drug manufacturers and share knowledge and intellectual property with the World Health Organization’s Technology Access Pool. Much greater resources should also be invested to scale up production capacities around the world. Operation Warp Speed, for example, had already “augmented and scaled-up 23 manufacturing facilities within six months,” according to a Public Citizen report. Given the economic and political weight of the United States, a combination of these measures could be implemented to turn COVID-19 vaccines into a global public good.
This kind of action is extremely popular. What stands in the way is the Biden administration’s commitment to the pharmaceutical industry, their lobbies, and their profits.
The industry benefits tremendously from strict patent rights and no-strings-attached government funding of research. We’re often told that this is a necessary arrangement — otherwise, companies wouldn’t have the incentive to collaborate and undertake risky research. But pharmaceutical companies typically spend a very small portion of their revenue on research and development. When they do, it’s rarely for vaccine development, which is a less profitable venture and requires long-term research and sustained investment.
We can’t rely on the goodwill of the pharmaceutical companies or the market’s “invisible hand.” Any further delays will deepen an already catastrophic health and economic crisis — one that has taken over three million lives and plunged approximately 150 million people into poverty.
The skies of Delhi today are streaked in smoke from dozens of makeshift crematoriums. “People are just dying, dying and dying,” Jitender Singh Shanty, who is coordinating more than 100 cremations per day, told the Guardian. This is not a moment to tinker around the edges. Release the vaccines.