Syringes containing doses of the AstraZeneca Covid-19 vaccine are shown on a tray at the Bamrasnaradura Infectious Diseases Institute in Nonthaburi, Thailand. File photo: BLOOMBERG/ANDRE MALERBA
Syringes containing doses of the AstraZeneca Covid-19 vaccine are shown on a tray at the Bamrasnaradura Infectious Diseases Institute in Nonthaburi, Thailand. File photo: BLOOMBERG/ANDRE MALERBA

Last week, Western nations blocked proposals from SA and India to waive typical intellectual property rules for Covid-19 shots, treatments and other measures until the world reaches herd immunity.

While we sympathise with the stance taken by wealthy nations such as the US, Switzerland and the UK, home to some of the world’s biggest pharmaceutical companies, SA and India deserve praise for bringing the debate about global equitable access to vaccines to the World Trade Organization (WTO).

It was the eighth time the issue was discussed at the WTO, the consensus-driven pillar of the global economic order, after the two countries brought it up in October 2020, rightly framing it as an opportunity for the world to push back against nationalism and embrace global solidarity.

Indeed, without drastic measures to enable widespread manufacturing of vaccines, developing countries, many of which are on our continent, will not meaningfully participate in the global economic recovery, and millions tossed into extreme poverty will stay there longer.

The IMF expects Sub-Saharan Africa to be the slowest growing region in 2021 as most struggle to get their hands on the scarce vaccines. 

While developing countries have started to receive doses from the World Health Organization’s Covax programme, the amounts available, according to social justice activists such as Oxfam, mean that only about 3% of people in those countries can hope to be inoculated in the next three months, and just one-fifth at best by the end of 2021. 

In the week when SA was making its case before the WTO,  health minister Zweli Mkhize told parliament that the government might miss its target of vaccinating 40-million people by the end of the year because there may not be enough shots available.

The government has ordered 43-million doses of Covid-19 vaccines from Johnson & Johnson (J&J), Pfizer and the international vaccine financing facility Covax, but it has no control over potential manufacturing delays even as the government cannot escape the blame that it let South Africans down by dragging its feet when other countries, including our emerging market peers, pre-ordered the vaccines in 2020. 

The consequences of limited vaccination programme are obvious for SA, as well as for a 100-plus developing countries that have rallied behind its initiative. We face an increased risk of new waves of infections, leading to lockdowns and further depressing an economy that in 2020 slumped to its biggest annual GDP drop since records began.

The big pharmaceutical companies opposed the proposals from SA and India, arguing that it was the promise of IP protections that spurred them to put billions of dollars in investments and roll the dice on developing effective vaccines in record time.  

In any case, they argue, waiving the patents wouldn’t solve access challenges because the vaccines, particularly the first ones, aren’t easy to make. That may be true, but it’s not true that developing countries’ companies do not have the ability to manufacture them.

Aspen Pharmacare, one of the biggest generics medicine companies in the southern hemisphere, and the Serum Institute of India, are already using their factories to make the shots on behalf of J&J and AstraZeneca.

We have been here before. In the late 1990s and early 2000s, during the HIV/AIDS pandemic, Big Pharma came under fire for limiting access to cheaper generic versions of antiretroviral drugs, prompting several countries to issue compulsory licences for the life-saving medications, which meant governments waived the IP rights without the licence owner’s consent. It must be said, however, that in SA the Thabo Mbeki denialism prevented widespread access much more than the IP rules did.     

While it’s hard to dispute the assertion that patent protections were behind the development of the vaccine at a record pace, and that taking that away could potentially stifle innovation, it is clear that manufacturing the vaccine needs to be scaled up. 

As suggested by WTO head Ngozi Okonjo-Iweala, there’s a “third way” to resolve the issue in which Big Pharma can licence manufacturing to other countries to ensure adequate supplies while also making sure IP protections are in place.   

Until everyone agrees that vaccines, especially during a pandemic, are global public goods, Okonjo-Iweala’s idea is sensible and tests world leaders’ commitment to global solidarity.   


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