Eighteen months after talks began to allow smoother sharing of covid-19 vaccine technologies with developing nations, there’s finally some headway. A draft leaked last month suggests the World Trade Organization (WTO) has brokered a potential waiver from the global patent rules that block such cooperation. But that waiver seems too limited to make a dent, and this experience must push poorer countries to take things in their own hands before the next health emergency strikes, several public health experts told Mint.
Even before covid-19 vaccinations began, the developed world was ready in arms with pharmaceutical giants to corner the vaccines whenever they came. India and South Africa moved the WTO in October 2020 to ensure that patent rules wouldn’t disrupt the global sharing of any future cure or vaccine. But the leak hints at a heavily watered-down version of those demands, several intellectual property (IP) experts and health activists said.
Patent rules exist to promote innovation: if they didn’t, companies would have little incentive to research and develop products such as vaccines. But low-income nations, which cannot afford the know-how, lose out on health security: just 21% of Africa has got its first covid shot, while rich countries give away booster doses. True, striking a balance is an invidious choice for policymakers, but the inability to strike a timely deal even during an emergency offers key lessons—not just for covid-19, but also future pandemics.
While IP sharing is important, lower- and middle-income countries (LMICs) must work towards bolstering local manufacturing capacities and supply chains to achieve self-sufficiency, experts told Mint.
It’s not too late
While the WTO calls the potential deal “a major step forward”, health activists have called for developing countries to reject it. The deal reportedly excludes countries with over 10% share in covid vaccine exports in 2021, doesn’t address barriers other than patents, and also excludes therapeutics and diagnostics from its ambit.
The far more potent waiver that India and South Africa had sought is still as much needed, say experts. Current jabs lose efficacy over time and only prevent severe disease and hospitalization. More efficacious “pan-corona” vaccines are still needed to tackle variants and prevent infection itself, said K.M. Gopakumar, a senior researcher at Third World Network. Better therapeutic options could also enter the market, he added. From a trickle in 2020 to a possible deluge in the covid drug pipeline in 2022, over 85 antivirals and treatments are in late-stage trials, according to data from a tracker maintained by BIO, a US-based trade association of biotechnology companies.
A greater waiver could speed up access as new vaccines and cheaper generic options emerge.
IP waivers are crucial because the charity model the world has depended on so far—in which higher-income countries donate crucial health products to poorer nations—is “unsustainable” for future pandemics, experts said. Take Covax, for instance. The programme was launched with much fanfare in April 2020 to ensure equitable access to covid-19 vaccines irrespective of a country’s ability to pay. Though the facility has managed to ship over 1 billion doses to 145 eligible countries so far, experts point out that the initiative has fallen short of its own initial supply projections of delivering 2 billion doses by the end of 2021. Covax has reportedly managed to raise $11 billion as of 3 March to fund its operations, against its target of $18 billion. “Covax is critical to the global pandemic response,” said Prabhash Ranjan, vice dean at Jindal Global Law School. “But the kind of inequity that we have, it hasn’t achieved the goal it set out to.”
All said, if a whole-hearted patent waiver is not to be, LMICs need to fall back on their own local capacities for the future. If backed by adequate funding and international support, this can reduce external dependence to meet critical healthcare needs, say experts.
Africa fell at the back of the covid vaccine queue because it has limited production capacity for vaccines in general, importing 99% of its needs. Most vaccine firms there don’t produce active ingredients, and research is rare. Even now when covid vaccines are no longer scarce, poor distribution and logistics are keeping vaccinations slow.
A globally distributed model for manufacturing health products could be the way forward. “This will involve better access to finance, efficient models for sharing IP and technology know-how, and training of healthcare workforce to undertake complex manufacturing,” said Krishna Udayakumar, director of US-based Duke Global Health Innovation Center. Greater capacity will also give LMICs an upper hand when they enter complex negotiations.