Can the waiver of the patent for the Covid-19 treatment bring vaccine equity?
Inequalities in access to vaccines to fight the Covid-19 pandemic are widening. Since the invention of vaccines, there has been apprehension about the accessibility of vaccines to citizens of the poorest countries. The supply of vaccines is also well below demand. And whatever is manufactured is bought by developed countries in advance and in abundance, leaving low and lower middle income countries far behind in the vaccination campaign. Many high-income countries have already successfully immunized a large part of their population. While most people in Least Developed Countries (LDCs) are still waiting for their injections and struggling to recover from the pandemic, both health and economically.
The world needs 11 billion doses of Covid-19 vaccine, given that 70% of the world’s population must be vaccinated, at the rate of two doses per person. The Duke Global Health Innovation Center reports that as of March 19, 2021, high- and upper-middle-income countries have obtained about 6 billion out of 8.6 billion doses of vaccine. These countries only have a fifth of the world’s total population. Low- and lower-middle-income countries could only get 2.6 billion doses, even though four-fifths of the world’s population live in these countries.
Since the vaccine rollout in December 2020, the number of people vaccinated has varied by country. As of July 8, 2021, only 0.2% of people in low-income countries and 4.1% of people in lower-middle-income countries had been fully immunized. Bangladesh has been able to fully immunize 2.6 percent of its population while India has fully immunized 5.1 percent of its population during the same period. The United States has vaccinated 47% and the United Kingdom has vaccinated 51% of their respective populations until July 8, 2021. As a result, the global average of fully vaccinated people now stands at 12%. However, with such uneven access to Covid-19 vaccines, the world cannot fully recover from the pandemic, even though some countries are fully vaccinated, as we do not live in isolation these days. Therefore, the rapid scale-up of vaccine manufacture and distribution is crucial.
In order to increase the supply of Covid-19 vaccines and reduce the inequality of vaccines, proposals have been made to offer developing countries and least developed countries the possibility of manufacturing generic versions of Covid-19 vaccines. . Several countries have expressed their desire to manufacture vaccines to meet national needs and to supply them to other countries. But the trade-related intellectual property rights (TRIPS) aspects of the World Trade Organization (WTO) have been an obstacle to this. The TRIPS Agreement, negotiated during the Uruguay Round negotiations of the WTO and entered into force in 1995, protects creations and innovations using patents, copyrights and trademarks. Pharmaceutical companies benefit from these patents by investing in innovation and producing drugs. This has given some companies a monopoly on the production of certain drugs, which also allows them to charge high prices.
To overcome the vaccine crisis, India and South Africa presented a submission to the TRIPS Council on October 2, 2020 requesting a “temporary waiver of certain provisions of the TRIPS Agreement for the prevention, containment and the treatment of Covid-19 ”. In their communication, the two countries urged WTO members “to work together to ensure that intellectual property rights such as patents, industrial designs, copyright and the protection of undisclosed information do not create barriers to timely access to affordable medical products, including vaccines and drugs. or the intensification of research, development, manufacture and supply of essential medical products to fight Covid-19. “
On May 25, 2021, a revised proposal was submitted by 62 co-sponsors, including India, South Africa and Indonesia, requesting a three-year waiver “with respect to health products and technologies. , including diagnostics, therapies, vaccines, medical devices, protective equipment, their materials or components, and their methods and means of manufacture for the prevention, treatment or containment of Covid-19. “
Naturally, pharmaceutical companies are not happy with the idea of transferring intellectual property to countries to make Covid-19 vaccines. They believe that renouncing the patenting of pharmaceuticals will take away their freedom to decide on drug prices. According to them, since they invest in research and development of vaccines, it is their exclusive right to put a price on pharmaceutical products. Many opponents have also raised the issue of the quality and safety of vaccines that will be manufactured in other countries. But proponents of making generic versions disagree, saying manufacturers have adequate experience in delivering high-quality drugs and vaccines. The proposal from India and South Africa has received support from around 120 countries. However, the United States agrees to waive patent rights only for Covid-19 vaccines. Several countries, including Australia, Japan, EU, UK, Singapore, Brazil and South Korea, do not wish to discuss the revised proposal. But on June 9, 2021, WTO members agreed to start text-based negotiations on the proposal. By the end of July 2021, WTO members are expected to reach an agreed text for negotiation.
If a temporary patent waiver is negotiated and accepted by WTO members, it will be an unprecedented decision during this unprecedented period. However, the waiver is not sufficient to increase vaccine supply and reduce vaccine inequalities between rich and poor countries. We are aware that there is already some flexibility in the WTO when it comes to TRIPS. As such, the decision is expected to speed up the production and export of affordable generic versions, more than what is allowed under existing WTO rules. Recall that the 2001 Doha Declaration of the WTO on TRIPS and public health reaffirmed the flexibility of TRIPS member countries to circumvent patent rights for better access to essential drugs. In accordance with the Doha Declaration, WTO member states can grant compulsory licenses for patented medicines, allowing faster and more affordable production of generic versions. The 2005 TRIPS decision provided that countries with no manufacturing capacity or insufficient demand for pharmaceuticals could import generic equivalents with the help of producing or exporting countries.
Therefore, although the patent waiver under the TRIPS Agreement is a crucial step towards the generic manufacture of vaccines, it is only the first step. Most important is the transfer of know-how and technology to the generic manufacturer. Article 66.2 of the TRIPS Agreement refers to the promotion and encouragement of transfer of technology from developed countries to LDC members. The 2003 and 2005 decisions on TRIPS and public health also focused on the implementation of Article 66.2. However, developed countries and pharmaceutical companies are clearly reluctant to share technology with LDCs.
Bangladesh, which is a lower middle-income country as well as an LDC, has an active interest in the proposed patent waiver for Covid-19 vaccines and drugs. With only 2.6% of our population fully vaccinated so far, we still don’t know how and when 120 million people eligible for the vaccine will be fully vaccinated. However, Bangladesh has better pharmaceutical manufacturing capacity than other LDCs. It has a few world-class pharmaceutical factories that provide cheap drugs to other countries, especially poorer ones. As an LDC, Bangladesh can export its pharmaceutical products under compulsory license. And with improved technological capacity, Bangladesh can improve its production capacity and manufacture Covid-19 vaccines to meet domestic and international demand.
Therefore, Bangladesh should actively work alongside other struggling countries to complete patent waiver negotiations to deal with the current Covid-19 crisis.
Dr Fahmida Khatun is the Executive Director of the Center for Policy Dialogue.
The opinions expressed in this article are personal.