Info Service on Health Issues (Jan21/06)
Geneva, 19 Jan (D. Ravi Kanth) – The dire warning issued by the WHO director-general on 18 January that the world is on the verge of a “catastrophic moral failure” due to the denial of COVID-19 vaccines to developing and poorest countries has come as a shot in the arm for the proponents of a TRIPS waiver in combating the deadly pandemic and for putting human lives before profits and patents of Big Pharma, sources told the SUNS.
The proponents of the waiver for suspending several provisions in the WTO’s TRIPS Agreement had already cautioned in November last year about the rising wave of “vaccine apartheid” in the distribution of vaccines.
The WTO members will discuss, at an informal meeting of the WTO’s TRIPS Council on 19 January, the waiver proposal from South Africa, India, Kenya, Eswatini (formerly Swaziland), Mozambique, Zimbabwe, Pakistan, Bolivia, Venezuela, and Egypt among others towards arriving at an agreement.
The waiver proposal seeks to suspend temporarily provisions relating to copyrights, industrial designs, patents, and protection of undisclosed information in the TRIPS Agreement in combating the COVID-19 pandemic in order to ramp up manufacturing of specific COVID-19 diagnostics, equipment, therapeutics and vaccines so as to overcome the shortcomings in their distribution.
International civil society organizations, intergovernmental organizations, and many members at the WTO have supported the waiver proposal, according to a document (IP/C/W/674) issued by the proponents and posted on the WTO website.
However, the opponents of the TRIPS waiver proposal led by the United States, the European Union, Japan, Switzerland, and Canada among others have repeatedly maintained that there is no need for a waiver as mechanisms established by the WHO and the Geneva-based GAVI (The Vaccine Alliance) such as COVAX will address the problems of vaccine distribution equitably.
The opponents of the TRIPS waiver will now have to do some “soul-searching” in the wake of the warnings issued by the WHO director-general, Dr Tedros Adhanom Ghebreyesus, at the WHO’s 148th session of its Executive Board on 18 January.
REMARKS BY WHO DIRECTOR-GENERAL
In his remarks at the WHO Executive Board meeting, Dr Tedros praised the development of vaccines to combat COVID-19, saying that vaccines “are the shot in the arm we all need – literally and figuratively.”
The recent emergence of “rapidly-spreading variants makes the rapid and equitable rollout of vaccines all the more important,” Dr Tedros argued.
“But we now face the real danger that even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots,” Dr Tedros said.
While “all governments want to prioritize vaccinating their own health workers and older people first”, “it’s not right that younger, healthier adults in rich countries are vaccinated before health workers and older people in poorer countries,” the DG said pointedly.
He underscored the need to work together as “one global family” to prioritize those most at risk of severe diseases and death, in all countries.
The ACT-Accelerator and COVAX vaccine pillar are laying the groundwork “for the equitable distribution and deployment of vaccines” during the past nine months by overcoming scientific barriers, legal barriers, logistical barriers and regulatory barriers, Dr Tedros said.
Pointing out that the WHO has secured 2 billion doses from five producers, with options on more than 1 billion more doses, he said that the WHO is preparing to start deliveries in February. “COVAX is ready to deliver what it was created for,” he argued.
The COVAX facility was established last year by the WHO with the Geneva-based GAVI and the Coalition for Epidemic Preparedness Innovations for ensuring equitable supply and distribution of the vaccines globally.
Highlighting the nub of the problem, Dr Tedros said that he “heard from several Member States who have questioned whether COVAX will get the vaccines it needs, and whether high-income countries will keep the promises they have made.”
He grimly observed that “as the first vaccines begin to be deployed, the promise of equitable access is at serious risk.”
Dr Tedros offered the most disturbing statistic of vaccine distribution: “More than 39 million doses of vaccine have now been administered in at least 49 higher-income countries. Just 25 doses have been given in one lowest-income country. Not 25 million; not 25 thousand; just 25.”
“I need to be blunt: the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries,” Dr Tedros said.
Worse still, while speaking the language of equitable access, said Dr Tedros, “some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue. This is wrong.”
According to Dr Tedros, “44 bilateral deals were signed last year, and at least 12 have already been signed this year.”
Among others, Pfizer-BioNTech has almost signed deals with the rich countries, while Oxford-AstraZeneca has spread its vaccine distribution among India and a few other developing countries. China’s Sinopharm has distributed its vaccine known as BBIP-corv in the United Arab Emirates, Bahrain, Indonesia, Egypt, and now Brazil, while Russia’s Sputnik vaccine is distributed in Argentina and a few other countries.
Further, the pharmaceutical companies chose to bypass the WHO regulatory approval and “have prioritized regulatory approval in rich countries where the profits are highest, rather than submitting full dossiers to WHO,” the WHO DG said at the Executive Board meeting.
He warned that opting for regulatory approvals in rich countries where the profits are highest, “could delay COVAX deliveries and create exactly the scenario COVAX was designed to avoid, with hoarding, a chaotic market, an uncoordinated response, and continued social and economic disruption.”
“This me-first approach” adopted by the rich countries will “leave the world’s poorest and most vulnerable people at risk; it’s also self-defeating,” Dr Tedros said.
Ultimately, he said, “these actions will only prolong the pandemic, the restrictions needed to contain it, and human and economic suffering.”
Noting that “vaccine equity is not just a moral imperative,” the WHO DG said that “it is a strategic and economic imperative.”
He cited a recent forecast that “the economic benefits of equitable vaccine allocation for 10 high-income countries would be at least 153 billion US dollars in 2021, rising to 466 billion dollars by 2025,” which is “more than 12 times the total cost of the ACT Accelerator.”
Dr Tedros called on countries to “work together in solidarity to ensure that within the first 100 days of this year, vaccination of health workers and older people is underway in all countries.”
Stating that working in solidarity is “in the best interest of each and every nation on Earth,” Dr Tedros said that “together, we must change the rules of the game, in three ways.”
The three ways include:
First, countries with bilateral contracts – and control of supply – must remain transparent on these contracts with COVAX, including on volumes, pricing and delivery dates. Countries must “give much greater priority to COVAX’s place in the queue, and to share their own doses with COVAX, especially once they have vaccinated their own health workers and older populations, so that other countries can do the same.”
Second, vaccine producers must “provide WHO with full data for regulatory review in real time, to accelerate approvals.” Vaccine producers must “allow countries with bilateral contracts to share doses with COVAX, and to prioritize supplying COVAX rather than new bilateral deals.”
Third, countries introducing vaccines to only use vaccines that “meet rigorous international standards for safety, efficacy and quality, and to accelerate readiness for deployment,” he argued.
Dr Tedros proposed that “the theme for World Health Day this year is health inequality,” arguing that his challenge to “all Member States is to ensure that by the time World Health Day arrives on the 7th of April, COVID-19 vaccines are being administered in every country, as a symbol of hope for overcoming both the pandemic and the inequalities that lie at the root of so many global health challenges.”
PROPONENTS OF TRIPS WAIVER
At the TRIPS Council meetings last year, the proponents of the TRIPS waiver had cautioned about the emerging inequalities in vaccine distribution and the rising wave of “vaccine apartheid”.
To a question from the opponents, particularly the European Union, that voluntary cooperative approaches will solve the COVID-19 crisis through generous support for COVAX facility, the proponents said while they “agree that global cooperation and collaboration is key to addressing the COVID-19 pandemic, initiatives such as the COVAX facility are helpful but insufficient.”
“Our waiver proposal,” the proponents said, “is designed to work synergistically with such initiatives by enabling the rapid scaling of production by multiple producers across many countries, enabling the sharing of knowledge and transfer of technology with the aim of addressing the pandemic.”
Explaining the COVAX facility, the proponents led by South Africa and India said that “COVAX at best provides very short-term, limited access to vaccines. Its approach is not sustainable in the medium and long term.”
Moreover, “the global needs are massive and can only be addressed with global sharing of technology, knowledge and related IP,” the proponents argued, and “not by artificially limiting competition and supply which in turn only results in high prices in the medium and long term.”
The proponents observed that “wealthy nations representing just 13% of the world’s population have already cornered more than half (51%) of the promised doses of leading COVID-19 vaccine candidates” and thereby, creating “significant uncertainty for universal access.”
Further, both “the investment to COVAX and donation commitment cannot solve the issue of the need to diversify, to the maximum level, the global capacity of development, manufacturing and supplying COVID-19 medical tools,” the proponents said.
Lastly, “COVID-19 reveals the deep structural inequality in access to medicines globally, and one of the root causes is that IP sustains dominating industry’s interests at the cost of lives,” the proponents forcefully argued.
The assessment by the proponents is largely reflected in the WHO DG’s dire warning issued on 18 January, said a proponent of the TRIPS waiver, who asked not to be quoted.