Introduction by Croakey: As vaccinations begin in Britain against the novel coronavirus in a maiden rollout being closely watched across the globe, there are concerns that profiteering and dose-hoarding by wealthy nations will threaten any meaningful progress on the pandemic.
The first doses of Pfizer-BioNTech’s COVID-19 vaccine were delivered to priority populations (doctors, nurses and the elderly) in Britain this week, in a milestone it is hoped may mark a turning point in the accelerating pandemic which has, at latest count, infected more than 67 million people and resulted in more than 1.5 million deaths.
Australia’s acting chief medical officer Paul Kelly has warned that the vaccine, which is expected to begin distribution locally in March 2021, will be no silver bullet, with true elimination only a realistic prospect when safe and effective immunisation attains widespread coverage.
“Only when a sizeable proportion of the Australian population is vaccinated will we see ‘normal’ no longer prefaced with ‘COVID’,” Kelly told the Australasian COVID-19 Virtual Conference this week.
“What lies ahead is no small feat: we are looking at the biggest-ever vaccine rollout in history, to all Australians who choose to be vaccinated, by the end of 2021.”
While advanced economies like Britain, the United States and Australia have poured significant investment into securing vaccine doses, humanitarian organisations and global health advocates say these same countries are threatening meaningful global progress on immunity by blocking a bid to waive intellectual property on COVID-19 treatments and technologies including vaccines.
Oxfam has warned that population-scale vaccination remains out of reach for almost 70 low-income nations, where it will be affordable to immunise just one in 10 citizens. By contrast, the some of the world’s richest countries have bought up enough doses to vaccinate their populations up to five times over, with all of Moderna’s doses and 96 percent of Pfizer’s reserved for wealthy nations.
“No one should be blocked from getting a life-saving vaccine because of the country they live in or the amount of money in their pocket. But unless something changes dramatically, billions of people around the world will not receive a safe and effective vaccine for COVID-19 for years to come,” said Anna Marriott, health policy manager at Oxfam.
Some of these complexities were explored in a vaccines panel at #AustCOVID19Conference this week, which is worth checking out in full.
David Durrheim, who is a member of the World Health Organisation’s Strategic Advisory Group of Experts on COVID-19 and Ebola vaccination told the session equity of access was already shaping up to be a major issue for the COVID-19 vaccine, with prepurchases by the European Union and five other wealthiest nations (including Australia) — a group constituted just 12 percent of the global population — already cornering 50 percent of promised doses from the three leading candidates.
A recent study by the US-based MOBS (Modelling of Biological and Socio-technical Systems) Lab modeled the implications of high-income countries monopolising the first two billion vaccine doses, and contrasted this with a scenario where doses were distributed on a per capita basis globally. The study ran models on a high-efficacy vaccine (80 percent) and low efficacy (65 percent) assumption.
If a high-efficacy vaccine was equitably distributed the study found that 61 percent of potential deaths were averted; this figure in the high-income monopoly scenario was 33 percent. In a lower efficacy model, these figures were 57 percent and 30 percent respectively.
Importantly, the model demonstrated that the margin of benefit was much greater for lower income regions.
For example, in Western Europe the stockpiling model would avert 74 percent of deaths, while equitable access would reduce this to 55 percent; in West Africa, by contrast, wealthy monopolies would see 13 percent of deaths averted, and 93 percent under the equity model. The figures for South East Asia were similarly stark: five percent and 63 percent respectively.
In this piece for Croakey, Jennifer Tierney — executive director of Médecins Sans Frontières Australia — explains that the pandemic will not be over for anyone until it is over for everyone, and profits must be put aside to preserve health.
Jennifer Tierney writes:
Today there are 55 candidate COVID-19 vaccines undergoing human clinical trials in 18 countries, including one in Australia.
With emergency use provisions in place, the UK government is launching a COVID-19 immunisation program as early as this week, while other governments have announced a vaccine will be available in coming months.
These new vaccines and treatments have been funded by huge amounts of public money – but will they be within reach for everyone? If history repeats itself, they might not.
Médecins Sans Frontières/Doctors Without Borders (MSF) has seen firsthand the unnecessary suffering caused by exorbitant drug prices, and other barriers that stop people getting the treatment they need.
MSF has watched the pharmaceutical industry consistently put profit over people. We’ve seen this in the fight to get fair and affordable pricing on drugs for pneumonia, tuberculosis and HIV. We also see it in the lack of drugs for neglected tropical diseases simply because the people most affected cannot afford to pay the price drug companies demand.
If COVID-19 medical tools like vaccines and treatments become a privilege for only the small number of people who can afford them, this will prolong the pandemic. To ensure equitable access, companies must give up their patents and monopolies in order to expand generic production, which in turn lowers the cost and allows for mass production.
Failing that, governments can and should be prepared to suspend and override patents during this pandemic to ensure availability, reduce prices and save more lives. We know if there is one person left with COVID-19, it is a threat to all of us.
That is why we must ensure that medical tools developed to control and treat COVID-19 are accessible and affordable for those who need them most.
Transparent pricing, equitable access, and widespread production
Pharmaceutical companies often claim they need to charge high prices for medical tools and treatments to pay for the high cost of research and development. But MSF knows that is not the case.
The drugs we buy are often underwritten by research and development funded by governments, universities and philanthropists. In the case of COVID-19, these donors have poured in billions of dollars.
The Australian government, as just one example, has contributed more than $2 billion in COVID-19 research and development.
It is critical that any investment of public funding, made available by taxpayer dollars, comes with strings attached. That means guarantees of transparent pricing, equitable access, and widespread production, and needs to result in a public good, distributed based on need.
Last month, India and South Africa proposed the adoption of a temporary intellectual property (IP) waiver to be applied throughout the COVID-19 pandemic.
The proposal, made to the World Trade Organization (WTO), would allow countries to neither grant nor enforce patents and other IP related to COVID-19 drugs, vaccines, diagnostics and other technologies for the duration of the pandemic, until global herd immunity is achieved.
This is ground-breaking. If approved, the proposal could contribute significantly to prevent shortage of vaccines, diagnostics and other tools to treat COVID-19.
A record 100 countries have supported the waiver – but Australia is not one of them.
Lethal consequences
Australia, along with others opposing the waiver (US, UK, Japan, Canada, Brazil, Norway, Switzerland and the European Union) argue that the Trade Related Aspects of Intellectual Property (TRIPS) agreement already contains sufficient flexibilities, one of which is a country’s right to issue compulsory licenses for cheaper generic equivalents in the event of a public health emergency.
But this doesn’t go far enough: compulsory licensing rules apply on a case-by-case and product-by-product basis only. Objecting nations also argue that the TRIPS agreement allows countries to import generics if they don’t have manufacturing capacity.
The reality is negotiating the new treatments and production approaches is complicated and takes time.
All governments are facing challenges ensuring timely, sufficient and affordable access to effective vaccines, treatments and other essential medical tools. But this is especially challenging for many low-income countries that face limitations developing and scaling up manufacturing capacity due to IP barriers.
Another misleading claim is that a temporary removal of patents will contribute to companies losing incentives for innovation. Unfortunately, this argument amounts to nothing more than a giveaway to pharmaceutical corporations.
The fact is the six front-running vaccine candidates have had a total of US$12billion taxpayer funds poured into them. The waiver would transfer power from pharma to elected governments, who would make decisions based on the needs of their populations rather than profits.
By not supporting this proposal, big pharma keeps its power, and history has shown us that this can have lethal consequences.
The Australian government needs to ask itself which side of history they want to be on when the books on this pandemic are written.
This waiver is key to ensuring that all treatments, vaccines and diagnostics for COVID-19 are accessible and affordable, based on needs alone.
Now is the time for the government to demonstrate that it will put people over profits.
Beyond ‘business as usual’
Big pharma typically refuses to grant non-exclusive licences with worldwide coverage, which would enable global access to drugs, vaccines and diagnostics. COVID-19 is no exception.
We have seen a number of promising treatments for COVID-19, already patented in many middle-income countries. With the exception of one company, none of the COVID-19 vaccine developers have committed to treating IP any differently than the status quo.
A global pandemic warrants more than the ‘business as usual’ approach.
It’s not too late for corporations to commit to sharing data and providing technical know-how to generic manufacturers to facilitate production as needed. And governments must adopt binding and enforceable measures to ensure universal equitable access to COVID-19 medical technologies, such as the waiver suggested to the WTO.
They must commit to working in solidarity to meet not only their domestic needs but also supporting other countries to get access to effective medicines, diagnostics and vaccines.
Australia’s contribution to the COVAX Facility, a multilateral initiative coordinated by the World Health Organization and GAVI – the Vaccines Alliance, is encouraging.
COVAX has been set up to ensure that the research, purchase and distribution of vaccines is shared equally with countries across the globe. Equally commendable is Australia’s generous contribution to supporting the Pacific and southeast Asia in their COVID-19 response.
However, we are seeing disturbing instances of vaccine nationalism. High-income countries including the UK, US, Canada, the EU and Australia have struck deals, effectively hoarding billions of doses of potential vaccines. Countries representing only 13 percent of the world’s population have already reserved 50 percent of new vaccines in the pipeline.
Now is the time for Australia to show commitment to the global community by ensuring that any vaccine or treatment developed during this pandemic is available and accessible to all who need it.
This pandemic knows no borders, it knows no nations or ethnicity, it does not recognise power, nor does it distinguish between high-income or low-income countries. But the impact of the disease will not be distributed equally if the tools to combat it are only available to the privileged.
After all, what is the point of having a lifesaving vaccine or treatment if it is inaccessible for most of the world’s population?
Jennifer Tierney is the Executive Director of Médecins Sans Frontières/Doctors Without Borders (MSF) in Australia
MSF is calling on Australians to show their support by signing this petition, appealing to the Australian government to put lives over profit in this pandemic: https://msfa.good.do/covid-petition/covid-vaccine-petition
