March 11 marked two years since the World Health Organization (WHO) declared a pandemic.
In those two years, the human and economic cost of Covid-19 has been staggering. Estimates, including unreported deaths, show that 19.6 million people have died of Covid-19, with the death toll four times higher in lower-income countries than in high-income nations.
The pandemic has also wreaked havoc on the global economy, with 99% of the world’s population worse off and 160 million people pushed into poverty.Public funds have helped develop and deliver over 10.6 billion doses of incredible life-saving vaccines.
However, their rollout has been very unequal, leaving millions in low-income countries unprotected, while at the same time large pharmaceutical companies are earning millions from prioritising high-incomenations and the subsequent large profits, ahead of vaccine equity. Seventy-three per cent of people in high-income countries are fully vaccinated while just 6% people in low-income countries are.
In October 2020, a proposal was tabled at the World Trade Organization (WTO) by India and South Africa in order to increase supply and local manufacturing of Covid-19 vaccines, tests and treatments. Since then, the waiver has been supported by over 100 countries, 150 Nobel laureates, First Ministers in Scotland and Wales, over 130,000 members of the British public (and millions more globally), and even the Pope.
But the UK remains one of a few countries that is actively blocking the proposal and preventing it from passing. So, what is the waiver, and why should the UK government support it?
The waiver and what it would do
The overriding reason for low vaccination rates across lower-income countries is lack of access. The Trade-Related Aspects of Intellectual Property waiver, otherwise known as the TRIPs waiver, would temporarily waive patents and certain other intellectual property protections associated with vaccines, treatments, and tests.
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This would mean that countries could manufacture or obtain access to lower-cost life-saving medical tools. The waiver will last for the duration of the pandemic and would help increase the supply of vaccines and other technologies, as well as localise the production, so countries would have more reliable access.
Concentrating vaccine manufacturing in just a handful of countries, as is done so now, leaves lower-income countries dependent on charity and solidarity, and ultimately leaves them at the back of the queue. The reliance on donations and handouts has not been effective or reliable so far. Just 48% of doses promised by the G7 have been delivered, and estimates suggest 241 million doses stored in G7 nations will expire and be wasted by March 2022.
COVAX, the global mechanism to ensure equitable access for lower-incomecountries to Covid-19 vaccines, has also been reliant on donations, leaving it under-resourced and not able to deliver. By the end of 2021, COVAX had delivered less than half of the doses it had originally promised.
There are currently over 100 factories that could be producing life-saving Covid-19 vaccines around the world that are not currently being used, and this waiver would help release the technology that would allow countries to utilise this existing space and manufacture their own safe and effective vaccines. Ensuring that everyone had access to vaccines could save 1.5 million lives.
Millions of people would still be alive today if they had been vaccinated. To end the pandemic, we must maximise global manufacturing capacity beyond the means of a handful of pharmaceutical companies, and ensure this capacity is divided equitably between all countries.
Is supply even a problem anymore?
It has been estimated that enough vaccines have been produced for everyone, and all that is needed is to distribute them properly. However, the science suggests that everyone will need a booster shot to fully protect them against Omicron, ideally with mRNA vaccines, and it’s unlikely that current supply will be able to meet demand.
A recent estimate suggested that up to 22 billion doses of mRNA vaccine will be required to control Covid-19. But Pfizer, BioNTech and Moderna are only expected to manufacture 7 billion doses between them in 2022 – a 15 billion dose shortfall. The only way to reach the levels of production needed fast enough is for the mRNA vaccine recipes to be shared and other producers being authorised to make them.
The failure to vaccinate the world quickly also means this pandemic will be prolonged and the virus is predicted to become endemic. That will mean a long-term, ongoing need for vaccines that may require continued adaptation to respond to variants. Giving all countries the rights and the ability to produce vaccines regionally or domestically is the surest way to ensure vaccines for all, now and for the long-term.
What about the new counter proposal from the EU?
Last week, leaked text pertaining to negotiations between the EU, US, India and South Africa, but not yet officially endorsed by any member state, showed that there is now agreement from the EU that intellectual property monopolies have been a significant barrier to accessing Covid-19 tools throughout the pandemic.
However, the text is worrying for a number of reasons, not least because it doesn’t address intellectual property barriers crucial for producing generic vaccines. And far from removing all necessary barriers, the leaked text actually proposes introducing more of them.
The text is also exclusively discussing vaccines, not tests and treatments. As the world continues to open up and we foresee a future of “living with the virus”, access to tests and treatments will be of increasing importance – to exclude them would be highly damaging.
It is also limited by geography, meaning countries like Ethiopia and Brazil might be excluded from purchasing or producing vaccines under the deal. This is only scratching the surface, with other onerous requirements and glaring omissions, that mean this text should be rejected by countries, and a full TRIPS waiver implemented instead.
Is the waiver the only thing that can help?
The waiver is an essential step to ensure more equitable global access to vaccines, tests, and treatments, but there are also several other key things that must be done alongside it.
Before proposals for the waiver were bought forward, WHO set up a facility, known as the Covid Technology Access Pool (CTAP), that would allow drug companies to share their technology with other competent manufacturers. WHO also established technology transfer mRNA hubs to rapidly scale up vaccine manufacturing sites in low- and middle-income countries.
These initiatives have the potential to improve access to medicines in lower-income countries – shifting power away from a handful of corporations and into the hands of the people. The UK must endorse and fund the Covid-19 Technology Access Pooland mRNA hubsto help facilitate the sharing of technology and knowledge, and compel pharmaceutical corporations toshare theirs with the pool for free.
The People’s Vaccine Alliance has put forward a five-step manifesto to ensure the world meetsWHO’s target of vaccinating 70% of humanity by the middle of 2022.