The race for a vaccine has highlighted the divide between the world’s richest and poorest nations. Finbar Lynch argues for a not-for-profit People’s Vaccine through a suspension of intellectual property rights in order to tackle the pandemic at a global level.
“The doctrine that in time of famine the poor are entitled to demand relief … would probably lead to the doctrine that they are entitled to such relief at all times, and thus the foundation would be laid of a system of general poor relief, which we cannot contemplate without serious apprehension …”
The above quote is from the Famine Commission produced after 1876-78 Famine in India.
India was still under crown rule and the British continued to export food from India while its people starved, much like they did here in Ireland in the 1840s. For the crown, it was better to let people starve than allow those, who never asked to be under British rule in the first place, ‘leech’ off the British state.
Today, many have been desensitized to poverty, starvation, and violence in the poorest countries in the world. We are conditioned to think of these things as inevitable, encouraged to donate to charities who send volunteers to these countries to help mitigate their suffering and develop their infrastructure.
Global inequality did not emerge in a vacuum, and it is not inevitable. It is the legacy of colonialism and the plunder of natural resources from the Global South over centuries and perpetuated by global capitalism that puts profits ahead of human need.
It is no surprise that despite the flurry of announcements of effective vaccines over the past few months, that those living in the developing world have little cause to celebrate for the moment. 14% of the world’s population have successfully laid claim to 96% of the Pfizer vaccine, and near 100% of the Moderna vaccine.
Only one of the twenty-nine poorest countries had received any vaccines as of last week – Guinea, who received a total of 55 doses of Russia’s Sputnik vaccine.
Poorer countries often rely on initiatives such as the UN’s COVAX scheme, intended as a way of encouraging wealthier nations to send surplus vaccines to the developing world. But solving the inequality of vaccine distribution cannot depend on voluntary charity, it needs to be solved by removing profit from public health.
The inequality inherent in our current global vaccine distribution rollout is no accident. It is the result of the monopoly held by a handful of pharmaceutical companies and the neo-colonial legacy of Intellectual Property Rights.
Innovation or Apartheid?
Intellectual Property Rights were first codified in 1883 at the Paris Convention for the protection of industrial property. It was a meeting brokered by colonial powers to establish a mandate to protect patents, trademarks, industrial designs, and “repress unfair competition.”
It initially had 11 member states but is now comprised of 177 member states. More important is the Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement, established in conjunction with the World Trade Organisation. TRIPS was the culmination of a decades long campaign by wealthier countries to protect the profits of big companies like Pfizer.
TRIPS was preceded by a rigorous PR campaign by these countries to warn people about the dangers of “Intellectual Property Piracy.” In the mid-twentieth century, when new drugs came on the market, companies in the developing world would produce generic versions of drugs developed by big pharmaceutical companies so they could be made widely available to people in poorer countries.
This undermined the profits of these big pharmaceutical companies. Therefore, much like with the Famine Commission in India cited above, the ruling class propagated a moral narrative to justify its policy decisions that inevitably lead to mass death and suffering.
The ruling elite, driving in large part by pharmaceuticals themselves, argue that the profit-motive is central to driving innovation and encouraging Big Pharma to produce life-saving drugs. Any well-meaning attempts to interfere with the market will only undermine the objective of saving lives.
However, there is not a lot of money to be made in vaccine manufacturing. Big Pharma prefer to deal in the kind of drug that is taken regularly for years, at exorbitant prices. A vaccine is often only administered once or twice. In the case of a pandemic, it needs to be distributed to everybody in the world, the vast majority of whom are unable to pay exorbitant prices.
$100 billion dollars in public funding has been pumped into the efforts to research, develop and manufacture Covid-19 vaccines. Aside from a contribution from Dolly Parton, the Moderna vaccine was 99% publicly funded.
Moderna have said publicly that they would not try to enforce their patent, yet Lonza, the Swiss company that is manufacturing the vaccine, will not share the technological knowhow necessary to produce it at scale. A treasure chest of tax-payer money has been dropped in the lap of Big Pharma for the research and development, and yet they still dictate the terms on which the vaccine is produced and distributed.
It is also worth looking back to the SARS epidemic in the 2000s. SARS and COVID-19 possess 80% of the same genomes. There is evidence to suggest that had a vaccine been developed for SARS, as was called for by many academics wary of the risk of future epidemics, it would have been 30-40% effective against the novel coronavirus. This would have presented a significant head start for scientists in finding an effective Covid vaccine.
The notion that the profit-incentive drives innovation too often goes unquestioned. Even in the current system where Big Pharma profits off a pandemic, vaccines were made possible through state funding. Big companies entered into the “race” to find a vaccine, not against the rising numbers of cases and deaths, but against each other to be the first to find a vaccine that they could patent and receive all of the inevitable fanfare.
Some will argue that this competitive dynamic leads to innovation, the reality is that the spirit of “competition” inevitably leads to companies withholding information from each other. Jonas Salk, who discovered the Polio vaccine, when asked who owned it responded “Well, the people I would say. There is no patent. Could you patent the sun?”
Rather than operating in this spirit of solidarity, a company like Pfizer’s sole objective is to boost its share value and producing life-saving medicines is simply the means by which they do that.
The Developing World Abandoned
North and South, the governments here have committed to vaccinating 70-80% of the population by September, causing many to feel that there is an end in sight. Setting aside any concerns about the government’s capacity to follow through on that promise, at present many parts of Sub-Saharan Africa are not set to receive vaccines until as late as 2024. This is extremely worrying given the speed of the global spread from January to March of 2020; or the global spread of the new Kent variant in the past two months.
Vaccine Apartheid will mean the needless death and suffering of millions in developing countries over the next three years or more. It will increase the likelihood of more Covid variants, as the virus remains in circulation in large parts of the world. While initial concerns about the increased transmissibility of new variants may have been inflated as cover for government mismanagement of the crisis, these variants do present a significant danger in prolonging the pandemic.
New variants not only impact the efficacy of vaccines, but also impact emerging treatments for Covid. While there have been promising signs in this area, it recently emerged that no drug was successful against all of the Brazilian, Kent and South African variants. The rise of these variants has also underscored the need to implement a Zero-Covid approach to prevent transmission from spiralling out of control, as it did over Christmas.
Scarcity of vaccines is artificially produced. There are as many as 10,000 factories in India at present that could produce the Moderna vaccine. Suspending intellectual property rights will enable poorer countries to mobilise their own capacity to manufacture vaccines. It is not a question of aid or charity. Wealthier countries anticipated this scarcity, which is why they began pre-ordering doses as early as August, well before there was any data published on their efficacy.
The EU had purchased enough doses to vaccinate its population 3 times over, the UK and the US 4 times, and Canada 6 times. Bodies such as the UN have urged these countries to donate any excess to countries in need, but Nicaise Ndembi, senior science advisor for the African CDC recently stressed that “[we are] not going to the table to beg for vaccines. We’re going to the table to buy….All these doses.” The neglect of the Global South is not an accident, they have been shut out of the vaccination procurement process by Big Pharma and wealthy nations.
Vaccine Nationalism and Bill Gates
It is clear that the world’s wealthy are being catered to over poorer countries, but tensions are flaring over the distribution of vaccines between wealthy nations as well.
At the end of January, the EU invoked Article 16 to try and prevent vaccines being transported into the UK via the six counties. This is a result of the EU and the UK’s respective vaccine deals agreed with Anglo-Swedish company AstraZeneca. AstraZeneca’s CEO has said publicly that as the UK’s deal was struck first, theirs takes precedence over the EU’s, which is why when it was announced that there were significant complications in the manufacturing process, it transpired that it would primarily impact EU member states.
Let’s review the EU’s deal with AstraZeneca briefly:
- The deal was signed in August, before vaccines had been fully tested and approved
- The EU expected at least 100 million doses to be delivered by the end of March, and possibly as many as 120 million
- In early December, AstraZeneca revised it down to 80 million
- Then in late January, AstraZeneca announced manufacturing issues would mean they could only deliver 31 million doses
AstraZeneca failed to show up to a meeting with the EU to explain why exactly they were unable to follow through on the quantities of vaccine in the original agreement. But soon after, the media then spun an optimistic report when AstraZeneca increased its figure back up to 40 million doses in January.
The AstraZeneca vaccine was known for a time as the Oxford vaccine because it was developed by Oxford University. In an unexpected but welcome move Oxford made the vaccine open source, meaning that any company would be able to manufacture it.
It was at this point that the Bill and Melinda Gates Foundation decided to intervene.
While Gates has received plaudits for his “philanthropy” in the developing world, we must scrutinise the ways in which the Gates Foundation exploits the Global South to exert their power and influence. Around the world, the Gates Foundation funds everything from governments to civil society organisations to health journalism outlets, as well as contributing 12% of WHO’s total budget, meaning Gates has enormous influence in how health policy develops and is communicated globally.
The Gates Foundation is predicated on neoliberal capitalist ideology, so they believe that the profit-incentive is central to innovation when it comes to drug manufacturing. This is not surprising to anyone with an awareness of the extent to which Gates’ wealth is built on the intellectual property rights that maintain his tech monopoly through Windows and Microsoft.
Ultimately, exulting the divine virtue of Intellectual Property Rights and the magical qualities of the free market is an imperative for Bill Gates, as it is foundational to maintaining his power and influence, no matter how many of us must suffer for it. He used his influence to pressurise Oxford University to sell the intellectual property rights of its vaccine to AstraZeneca, closing the book on the only open source vaccine.
The People’s Vaccine and Zero-Covid
We want to put this pandemic behind this. We can do this with a two-pronged approach: Zero-Covid and a People’s Vaccine. We need to take the virus out of circulation. Variants can emerge only if there is uncontrolled spread.
As the public outcry for an elimination strategy began to escalate, the Irish government and NPHET pushed back against the notion of such a strategy being considered here. When pressed on why they felt Zero-Covid could not be implemented here, they cited political reasons, for example the land border with Northern Ireland.
HSE CEO Paul Reid remarked that anyone who felt a Zero-Covid approach was possible should take a look inside a meat plant or direct provision centre, as if the poor management of these were as inevitable as the laws of gravity. It is utterly maddening to have the Irish state point to the challenges of implementing a Zero-Covid strategy and concluding that nothing can be done about them.
The Stormont Executive have followed the same pattern, consistently scoffing at the idea of Zero-Covid in order to delegitimise it.
Many of the challenges to implementing a Zero-Covid strategy, like meat plants, direct provision centres, and the under-resourcing of our health services are perpetuated by a government that puts profits before people. Many cry that “we are not New Zealand,” but the countries that have succeeded in implementing strategies (China, Taiwan, Australia, Atlantic Canada, Singapore etc.) are a diverse bunch, and in recent weeks Germany has begun to suggest that they will pursue a “No Covid” strategy themselves, which will involve doubling or trebling their capacity to track and trace the virus.
This is the elephant in the room. Governments, north and south, are refusing to take responsibility for leading us out of this crisis and would rather put us through another series of yo-yo lockdowns than expand the state’s capacity to manage and preserve public health. One can hope that Germany pursuing a “No Covid” strategy will set a precedent and clear the way for a coordinated push toward elimination across Europe. If some countries implement it and succeed, the pressure will grow on others around them to follow suit. This will take the pressure off our public health systems and provide a sensible alternative to simply trying to vaccinate our way out of this pandemic.
In addition to that, suspending intellectual property rights and mobilising the potential of all countries with the industrial capacity to produce vaccines will enable us to inoculate the globe at a much faster and cheaper rate and effectively put an end to the pandemic.
Along with the pandemic, we are facing into an era of ecological catastrophe. Unprecedented global cooperation and solidarity is a prerequisite to earnestly engaging with the challenges ahead of us. This is a golden opportunity to set that precedent through the global implementation of Zero-Covid and a People’s Vaccine.
Looking into the future, we must also reckon with the legacy of Covid. Taiwan, one of the countries that successfully implemented an elimination strategy for the virus, had the infrastructure in place to respond to a pandemic because of the scars left by their experience with SARS. SARS was far less contagious than COVID but had a far higher death rate. Of the 668 people who became infected, 181 (27%) died. In one hospital in Taipei where there was an outbreak amongst 57 hospital staff, 7 of them died from SARS.
People across the political spectrum from Mike Davis to Bill Gates have been saying that a pandemic was inevitable for years. This is partly because of how interconnected the world is between travel and trade, but it is also because of the heightened risk of zoonotic transmission endemic in industrial agricultural practices, characterised by constant expansion into new natural environments and increased contact with wildlife that would not generally interact with humans.
Whilst this may be the most world-altering pandemic we have experienced in a century, it would be naïve to assume it will be the last of our lifetime.
Moreover, the world has not learned from Taiwan’s mistakes. The UK suspended its pandemic response committee six months prior to the COVID-19 outbreak. You could say that neoliberalism is defined by optimism, or perhaps wilful ignorance. It proclaimed the end of history in the nineties. It cannot accept the reality of the crises ahead of us, let alone tackle them.
Beyond the current pandemic, we need to ensure that we have adequate structures in place to deal with future outbreaks. In addition to looking at the role of industrial agriculture, we need to set the precedent of establishing public pharmaceutical companies that research and develop medicines for the public good and not for profit.