Activists Demand Rich Countries Suspend Patent Laws and Share Vaccines Freely

By Hadas Thier, In These Times

09 December 20

As rich countries hoard vaccine stocks, activists are calling for a just global distribution.

ar­garet Keenan, 90, became the first per­son in the world to receive a non-tri­al shot of the Pfizer/ BioNTech vac­cine in the Unit­ed King­dom on Decem­ber 8, offi­cial­ly launch­ing the Unit­ed King­dom’s mass inoc­u­la­tion pro­gram. This devel­op­ment fol­lows ini­tial results from Pfiz­er-BioN­Tech, Mod­er­na and Russia’s Sput­nik V vac­cine show­ing over 90% effi­ca­cy rates, pro­vid­ing a wel­come dose of hope. The Unit­ed King­dom had issued an emer­gency approval of the Pfiz­er-BioN­Tech vac­cine. The Unit­ed States, the Euro­pean Union and the World Health Orga­ni­za­tion (WHO) are review­ing the Pfiz­er-BioN­Tech and Mod­er­na vac­cines in the com­ing weeks.

Rev­e­la­tions on Decem­ber 8 that the Trump admin­is­tra­tion had passed on the oppor­tu­ni­ty to lock in addi­tion­al sup­plies from Pfiz­er has many of Trump’s crit­ics up in arms. But the big­ger sto­ry is that the rich­est coun­tries in the world are buy­ing up the world’s sup­plies. Over the past sev­er­al months, before any vac­cine is approved for sale, the wealth­i­est nations have pre-pur­chased mas­sive stock­piles of vac­cines from fron­trun­ner pro­duc­ers. Of the 9.8 bil­lion dos­es already reserved, over half are claimed for the Unit­ed States, Europe and Aus­tralia alone, where just over a tenth of the world’s pop­u­la­tion resides. The Unit­ed States has pur­chased enough dos­es to vac­ci­nate 555 mil­lion peo­ple (though it only has a pop­u­la­tion of 331 mil­lion), and has nego­ti­at­ed the poten­tial to pur­chase an hun­dreds of mil­lions of dos­es beyond that. The Unit­ed King­dom has pur­chased enough dos­es to vac­ci­nate three times its pop­u­la­tion, and Cana­da for five times its pop­u­la­tion. The rest of the world, should it be able to afford the vac­cine, must draw from dimin­ished stocks. This sce­nario threat­ens to unleash a glob­al apartheid of immu­niza­tion and disease.

Activists and human­i­tar­i­an orga­ni­za­tions are in a race against time to secure a more equi­table dis­tri­b­u­tion of Covid vac­cines, as the world pre­pares for the most ambi­tious mass roll­out of immu­niza­tions in his­to­ry. Equi­table dis­tri­b­u­tion requires both fair pric­ing and ramped up man­u­fac­ture of vac­cines, in order to ensure that there is enough sup­ply to go around. But the kind of large-scale pro­duc­tion nec­es­sary to immu­nize the globe is being held back by patent laws and hoard­ing of the tech­no­log­i­cal know-how to pro­duce the vac­cines that we need in the quan­ti­ty that we need them.

Activists from orga­ni­za­tions across the globe are putting for­ward the pol­i­tics of sol­i­dar­i­ty and glob­al coop­er­a­tion, as against vac­cine nation­al­ism and phar­ma­ceu­ti­cal prof­its. From open let­ters aimed at the incom­ing Biden admin­is­tra­tion, to ral­lies that tar­get phar­ma­ceu­ti­cal com­pa­nies, to social media cam­paigns aimed at rais­ing aware­ness, orga­niz­ers are demand­ing that gov­ern­ments, uni­ver­si­ties and cor­po­ra­tions share patents and tech­no­log­i­cal infor­ma­tion in order to ramp up pro­duc­tion of vac­cines and effec­tive­ly treat this glob­al crisis.

Yuan­qiong Hu, senior legal and pol­i­cy advi­sor for the Médecins Sans Fron­tières’ (MSF) Access Cam­paign, which aims to increase access to essen­tial med­i­cines, tells In These Times, “The more inac­tion and excus­es con­tin­ue, the more life is in dan­ger. Gov­ern­ments have a shared respon­si­bil­i­ty to make sure we actu­al­ly end this pandemic.”

The weight of his­to­ry hangs heav­i­ly as orga­niz­ers at MSF look ahead. “Twen­ty years ago, when HIV/AIDS killed so many peo­ple, it was the monop­oly of the com­pa­nies that hin­dered the dis­tri­b­u­tion of life-sav­ing med­i­cine,” says Hu. “Glob­al soci­ety only came to an agree­ment a few years after the tragedy had already happened.”

Activists from a half dozen orga­ni­za­tions that spoke to In These Times agreed. As Emi­ly Sander­son from Health Gap, an inter­na­tion­al advo­ca­cy orga­ni­za­tion work­ing for access to HIV med­ica­tions, puts it: “It’s our respon­si­bil­i­ty to make sure that in twen­ty years, we’re not fight­ing for a Covid vac­cine for peo­ple in South Africa and Mozam­bique and Kenya. It’s all it’s the same play­book. It’s just a dif­fer­ent year.”

Patents ver­sus pub­lic health

Two glob­al solu­tions are at the cen­ter of orga­niz­ing efforts on the part of human­i­tar­i­an orga­ni­za­tions and activists.

One is the ini­tia­tive put for­ward by South Africa and India with­in the World Trade Orga­ni­za­tion (WTO) to tem­porar­i­ly sus­pend patent laws, which are cur­rent­ly in place through Trade-Relat­ed Aspects of Intel­lec­tu­al Prop­er­ty Rights (TRIPS). The pro­pos­al to waive patent restric­tions for the dura­tion of the pan­dem­ic has been on the table at the WTO for the last cou­ple of months. WTO rep­re­sen­ta­tives will dis­cuss it again at their next meet­ing on Decem­ber 10, and will vote on the pro­pos­al on Decem­ber 17. MSF has been gear­ing up for this vote with a social media cam­paign and Twit­ter storm on Decem­ber 8.

The sec­ond is the WHO-backed Covid-19 Tech­nol­o­gy Access Pool, set up as a repos­i­to­ry for all health-tech­nol­o­gy-relat­ed knowl­edge, intel­lec­tu­al prop­er­ty and data. Orga­ni­za­tions are attempt­ing to put pres­sure on gov­ern­ments, uni­ver­si­ties, and phar­ma­ceu­ti­cal cor­po­ra­tions to par­tic­i­pate. An expan­sion of the tech­nol­o­gy access pool would go even fur­ther than patent waivers, because releas­ing patents does not require com­pa­nies to share the tech­no­log­i­cal know-how nec­es­sary to pro­duce and store the vac­cines, even if it grants them per­mis­sion to do so.

Phar­ma­ceu­ti­cal com­pa­nies have thus far balked at both proposals.

Dr. Albert Bourla, chair­man and CEO of Pfiz­er, told reporters in a not-so-veiled threat in May: “I think it’s non­sense and at this point of time it’s also dan­ger­ous. There’s a giant effort right now hap­pen­ing to find a solu­tion. The risks we are tak­ing [rep­re­sent] bil­lions of dol­lars and the chances of devel­op­ing some­thing are still not very good. So to have a dis­cus­sion, to say keep in mind that if you dis­cov­er [a vac­cine or drug], we are going to take your IP [intel­lec­tu­al prop­er­ty], I think it’s dangerous.”

Phar­ma­ceu­ti­cal philanthropy?

Some phar­ma­ceu­ti­cal com­pa­nies and gov­ern­ments of wealthy nations instead sup­port anoth­er WHO-backed ini­tia­tive, dubbed COV­AX, which aims to raise mon­ey to col­lec­tive­ly buy enough of the vac­cine for 20% of the pop­u­la­tion of devel­op­ing coun­tries. COV­AX is being spear­head­ed by Gavi, a project of the Bill and Melin­da Gates Foundation.

By pool­ing resources from dif­fer­ent coun­tries and work­ing with phar­ma­ceu­ti­cal com­pa­nies, the hope is that COV­AX will be able to pro­vide some relief for coun­tries that have been priced out of the bid­ding wars for vac­cines. Indeed, most mid­dle- and low-resource coun­tries will have no choice but to get their vac­cines through the COV­AX ini­tia­tive. But, apart from pro­vid­ing an addi­tion­al wind­fall for pharmaceutical’s prof­its, thus far COV­AX has col­lect­ed only a small frac­tion of the dos­es needed.

“It’s a step up from vac­cine nation­al­ism,” says Hei­di Chow an orga­niz­er with Glob­al Jus­tice Now, a grass­roots cam­paign in the Unit­ed King­dom which focus­es on jus­tice and devel­op­ment in the Glob­al South. Chow leads Glob­al Jus­tice Now’s phar­ma­ceu­ti­cal cam­paign to fight for access to med­i­cines in the Unit­ed King­dom. “But the prob­lem with COV­AX is that it does­n’t deal with the struc­tur­al issues of patents and guard­ing knowl­edge. There­fore, it has no answer to the ques­tion of where you’re going to buy dos­es from, because it’s already been bought up by the rich countries.”

The prob­lem is ulti­mate­ly one of sup­ply. Accord­ing to Krish­na Udayaku­mar, founder of Duke University’s Glob­al Health Inno­va­tion Cen­ter, “If we look at the over­all pur­chas­es of vac­cines today, we’ve count­ed about sev­en bil­lion dos­es that have already been pur­chased, of which only 10 per­cent — or 700 mil­lion dos­es — are pur­chased through the COV­AX facil­i­ty.” Udayaku­mar esti­mates that it will take three to four years at ear­li­est to achieve glob­al herd immu­ni­ty giv­en the skewed dis­tri­b­u­tion of the vaccine.

Tobi­ta Chow, direc­tor of Jus­tice Is Glob­al, a grass­roots cam­paign focused on equi­ty and sus­tain­abil­i­ty in the glob­al econ­o­my, argues that this inequity is both a moral ques­tion, and a ques­tion of self-inter­est: “On the one hand, this is cru­el to bil­lions of peo­ple,” he tells In These Times. “It’s also racist. This form of glob­al exclu­sion would not be pos­si­ble, were it not for the abil­i­ty of the U.S. gov­ern­ment to write off the lives of bil­lions of peo­ple of col­or around the world.”

“But it’s not just cru­el and racist,” Tobi­ta Chow con­tin­ued. “It’s also real­ly self-destruc­tive. One les­son that we ought to all take from this pan­dem­ic is how deeply our lives are inter­twined around the world and how the des­tiny of peo­ple across the Unit­ed States is linked togeth­er with the des­tiny of peo­ple in every oth­er coun­try. This virus does­n’t real­ly care about these bor­ders that we’ve invent­ed. And the only way that we’re real­ly going to over­come this glob­al cri­sis is by deal­ing with it everywhere.”

Indeed, with large parts of the world unvac­ci­nat­ed, the virus will be able to spread and mutate, even­tu­al­ly ren­der­ing the hoard­ed stock­piles of vac­cines use­less. “So the say­ing,” explains Hei­di Chow, “that no one is safe until every­one is safe, is not just a glib expres­sion. That’s what real­i­ty actu­al­ly means.”

Pub­lic health as a pub­lic good

Activists around the world are set­ting their sights high­er. Glob­al Jus­tice Now in the Unit­ed King­dom has orga­nized an aggres­sive grass­roots cam­paign to build aware­ness and to pres­sure the gov­ern­ment to sup­port the patents waiv­er at the WTO. The British rep­re­sen­ta­tive to the WTO has been del­uged by a recent email cam­paign by activists, and over a hun­dred mem­bers of par­lia­ment have signed on to an open let­ter sup­port­ing the waiver.

In the Unit­ed States, the incom­ing Biden pres­i­den­cy has made at least ver­bal com­mit­ments to the idea that vac­cines and med­ica­tions should be shared more freely across the globe. Activists hope that this will cre­ate an open­ing to push for poli­cies that sup­port these prin­ci­ples on the ground. A Biden pres­i­den­cy could make some deci­sions by exec­u­tive action — for instance, sup­port­ing efforts to sus­pend patent require­ments at the WTO — which could have an imme­di­ate impact.

Peter May­bar­duk, direc­tor of the Med­i­cines and Knowl­edge Econ­o­my Group of Pub­lic Cit­i­zen, a con­sumer advo­ca­cy orga­ni­za­tion, explains that a Biden admin­is­tra­tion could also license the patents that the gov­ern­ment already owns, such as sta­bi­lized spike pro­teins, to the WHO. It could fur­ther insist that Mod­er­na share its vac­cine stor­age tech­nol­o­gy with Pfiz­er, in return for compensation.

“There is pop­u­lar sup­port for these mea­sures,” May­bar­duk argues. “The phar­ma­ceu­ti­cal indus­try is not very pop­u­lar in this coun­try. So it’s real­ly a mat­ter of orga­niz­ing the mass­es of peo­ple who are out there, that agree with us, and do not have any inter­est in exclud­ing bil­lions of peo­ple from vac­cines for the sake of Pfiz­er’s prof­its. And if we can mobi­lize enough of those peo­ple, we can exert enough pow­er to get some real wins from the administration.”

To do so, activists will need to counter the pres­sure exert­ed by phar­ma­ceu­ti­cal com­pa­nies, which have show­ered both Repub­li­cans and Democ­rats with cam­paign con­tri­bu­tions for years. In this past elec­tion, the phar­ma­ceu­ti­cal indus­try large­ly put its weight behind the Biden cam­paign, despite a long­stand­ing his­to­ry of favor­ing Repub­li­can candidates.

Tobi­ta Chow notes, “The big ques­tion is going to be, ‘Once they are in office, are they going to be able to sum­mon the polit­i­cal will to take on the phar­ma­ceu­ti­cal indus­try and their lob­bies, and the enor­mous invest­ments that these cor­po­rate lob­bies have in pro­tect­ing the intel­lec­tu­al prop­er­ty rights régime, in order to con­tin­ue to hoard profits?’”

A focal point will be an inter­na­tion­al day of action on Decem­ber 14, to bom­bard Pfiz­er, Mod­er­na and AstraZeneca with demands that these com­pa­nies join the WHO’s Covid-19 Tech­nol­o­gy Access Pool (C‑TAP). In the Unit­ed States, the day of action is being coor­di­nat­ed by a People’s Vac­cine Alliance, made up of human­i­tar­i­an organizations.

Among the orga­ni­za­tions affil­i­at­ed with the People’s Vac­cine Alliance is the Free the Vac­cine Cam­paign. Free the Vac­cine is a cam­paign that was launched by Uni­ver­si­ties Allied for Essen­tial Med­i­cine (UAEM), a net­work of stu­dents work­ing to pres­sure their uni­ver­si­ties to allow glob­al access to the health research and patents that come out of their facil­i­ties. Free the Vac­cine, accord­ing to UAEM North Amer­i­ca Direc­tor Merith Basey, was tai­lored to the needs of social­ly dis­tanced activism. It has orga­nized 300 activists from 29 coun­tries, rang­ing in age from their teens to their sev­en­ties, to devel­op cre­ative, week­ly actions that “lead with joy,” as Basey put it.

It’s aim­ing pres­sure pri­mar­i­ly at the uni­ver­si­ties, which receive bil­lions of dol­lars from the Nation­al Insti­tutes of Health (NIH) in the form of grants, to par­tic­i­pate in C‑TAP. Basey explained: “It’s an upstream solu­tion to this down­stream issue of high priced drugs and a lack of access. We’re try­ing to change the way that these uni­ver­si­ties that behave like cor­po­ra­tions, espe­cial­ly in the Unit­ed States, think about access.”

Among its week­ly actions, Free the Vac­cine orga­nized a protest at Moderna’s head­quar­ters in August, a “Funk Ral­ly” in Octo­ber out­side of Health and Human Ser­vices, and was respon­si­ble for a pop­u­lar riff on Dol­ly Parton’s Jolene.

Social­ized invest­ment, pri­va­tized ownership

These activists face big chal­lenges. Hei­di Chow explains, “Rich coun­tries have been hoard­ing vac­cines for the last six months at an astro­nom­i­cal rate. They’ve got the mon­ey and the pow­er and the resources to stock­pile poten­tial vac­cines. The rea­son that they’re hoard­ing is because they know there’s a scarci­ty of dos­es. And the rea­son there’s a scarci­ty of dos­es is because of the patent sys­tem. A patent sys­tem that will mean, for exam­ple, that the Pfiz­er vac­cine can only be made by Pfizer.”

“No one com­pa­ny is going to be able to sup­ply the world on its own,” Chow con­tin­ues. “And if they could, they could­n’t do it quick­ly. So the answer real­ly needs to be lift­ing the bar­ri­ers that are pre­vent­ing oth­er sup­pli­ers from mak­ing it.”

An addi­tion­al chal­lenge, accord­ing to Hu, is get­ting the vac­cine to large swaths of the glob­al pop­u­la­tion that have no access to health care at all: “For many peo­ple, refugees and inter­nal­ly dis­placed peo­ple, for instance, it’s unclear how they are being account­ed for when it comes to dis­tri­b­u­tion and allo­ca­tion. They are not part of the offi­cial health­care sys­tem. How are they going to get vac­ci­na­tion? We don’t know.”

Phar­ma­ceu­ti­cal indus­tries that are now pro­duc­ing vac­cines have all ben­e­fit­ed tremen­dous­ly from gov­ern­ment fund­ing of research. In the Unit­ed States, this has tak­en the form of tax­pay­er mon­ey to the NIH, which is then dis­persed in the form of grants to uni­ver­si­ties, com­pa­nies and organizations.

As research by Pub­lic Cit­i­zen has high­light­ed, most of the lead­ing Covid-19 vac­cine can­di­dates are “using a spike pro­tein tech­nol­o­gy devel­oped by the U.S. gov­ern­ment” via NIH grants. This applies whether or not com­pa­nies have par­tic­i­pat­ed in Don­ald Trump’s “Oper­a­tion Warp Speed,” which has poured bil­lions of dol­lars into the devel­op­ment, man­u­fac­ture and dis­tri­b­u­tion of vaccines.

May­bar­duk explains, “These vac­cines, like most med­ical inno­va­tions, have been devel­oped through pub­lic-pri­vate col­lab­o­ra­tions fund­ed by tax­pay­ers. And the gov­ern­ment has con­sid­er­able rights in the tech­nolo­gies as a mat­ter of law, and con­sid­er­able rights in the tech­nolo­gies as a mat­ter of moral­i­ty. But the stan­dard polit­i­cal econ­o­my today is we give very large grants to these com­pa­nies to accel­er­ate the devel­op­ment of the clin­i­cal tri­als. And we’re not ask­ing a lot in return.”

The U.S. gov­ern­ment will take on the respon­si­bil­i­ty of vac­cine dis­tri­b­u­tion, but will put few con­di­tions in place on whether com­pa­nies must share tech­no­log­i­cal know-how or expand man­u­fac­tur­ing capac­i­ty in order to reach more peo­ple, more quickly.

In light of these real­i­ties, strug­gles for an equi­table glob­al dis­tri­b­u­tion will be an uphill bat­tle. And their con­se­quences will not only be felt by peo­ple liv­ing in coun­tries of the Glob­al South. In the rich­est nations, too, the vac­cines will only be as strong as the vac­ci­na­tion pro­grams dis­sem­i­nat­ing them. In the Unit­ed States, there is no nation­al health care sys­tem cur­rent­ly capa­ble of effec­tive­ly immu­niz­ing the whole of the pop­u­la­tion. Nor is there a pop­u­la­tion suf­fi­cient­ly edu­cat­ed and sup­port­ive of a vac­ci­na­tion program.

The depth of cur­rent cri­sis, and the wide­spread yearn­ing for a just solu­tion, might pro­vide an oppor­tu­ni­ty to shift course. “I think that we have to find a way to pop­u­late the col­lec­tive imag­i­na­tion with this con­cept of a moon­shot of a peo­ple’s vac­cine,” May­bar­duk says, “and not miss our chance to make such a dif­fer­ence in this moment of human­i­ty’s great need.”