Uttam Maharjan

With the rollout of vaccines against COVID-19, the question of fairness and equity in the distribution of the vaccines has cropped up. The world's leading drugmakers are producing COVID-19 vaccines. It is almost like a miracle to develop the vaccine in a short span of time. However, wealthy countries are taking advantage of the vaccines. As many as twenty-nine poorer countries have received just 0.3 per cent of the vaccines, whereas some wealthy countries have stocked up on vaccines in excess of their requirements.
It is estimated that as many as eleven billions doses are required for inoculating seventy per cent of the world population, whereas just 1.7 billion doses have been manufactured so far. Nobody is safe until everybody is safe. So a large chunk of the world population needs to be inoculated against COVID-19 so as to develop herd immunity in the population. The WHO said in April that out of 700 million vaccines globally administered, low-income countries got just 0.2 per cent. In fact, rich countries had already booked vaccines even when they were in the testing phase. This has created a situation in which the distribution of vaccines is grossly lopsided, with the lion's share of vaccines concentrated in wealthy countries.

Global access
Wealthy countries have both technology and funds for research on and development of COVID-19 vaccines. They are in favour of having such vaccines patented. In October 2020, India and South Africa floated a proposal on waiver of Intellectual Property Rights (IPR) on COVID-19 vaccines, arguing that patents, industrial designs, copyrights and protection of undisclosed information under the IPR provision would hamper global access to vaccines and medicines required for combating the viral disease. They demanded that the waiver last for an unspecified period of time with a yearly review until it terminates. They also urged an unfettered global sharing of technology and knowhow. It may be noted that lack of access to life-saving medicines in the early years of the incidence of HIV-AIDS claimed at least 11 million lives in Africa.
The USA has pledged itself to support the India-South Africa proposal. However, the decision of the WTO backed by all of its 164 members is essential to make good the implementation of the proposal. Further, a global advocacy campaign is working in this direction, thinking that this would make it possible to mobilise additional drug manufacturers and address unfair access to vaccines.
There are, however, other groups that do not support the waiver. First, drugmakers are completely opposed to the idea of waiver. They argue that vaccine development is not only costly and difficult but also unpredictable. It is not certain whether a vaccine against a particular disease will prove to be effective after spending billions of dollars on its research and development. They are of the view that IP protection would de-motivate the development of vaccines in a short period of time. As new variants of the coronavirus are appearing, the existing vaccines may require a modification or booster vaccines need to be developed. Also, the current pandemic may not be the last pandemic.
New vaccines may be required to cope with other pandemics in the future. Further, complex vaccines require collaboration between developers and manufacturers to ensure that the vaccine is effective, failing which the public may lose confidence in the vaccine. There are other experts who argue that exempting COVID-19 vaccines from the IPR provision will not enhance manufacturing capacity. Neither will this improve equity and global access. They are of the view that technology transfer, voluntary licensing and tiered pricing are important in ensuring global access.
Proponents of the waiver argue that some public funds (taxpayers' money) are involved in vaccine research and development. They opine that by exempting IP protection on COVID-19 vaccines, technology can be transferred to poorer countries, where the vaccines can be manufactured. Or, drugmakers in poorer countries will be able to join international vaccine-makers to build capacity. However, funds will be a problem. At a time when poorer countries are finding it difficult to manage funds even for procurement of vaccines, making vaccines in larger quantities will be a Herculean task. In this context, wealthy countries can help them financially. In this regard, drug companies that share their technology and knowhow can be allowed to enjoy royalties or other benefits by way of remuneration.
Technology transfer is not a tough proposition. Several manufacturing outsourcing and production sharing agreements have already been implemented like BioNTech and Pfizer, Oxford/AstraZeneca and Novavax with Serum Institute of India and Novavax and the Canadian government. Moreover, under the existing TRIPS agreement, governments can allow their manufacturing companies to make patented products without taking consent from the patent owners. The major issue is how to enhance capacity for manufacturing vaccines in large quantities and how to equitably distribute them among all the countries. Wealthy countries are hoarding vaccines in excess of their requirements. Such vaccines need to be released to where they are required.

Common enemy
The Coalition for Epidemic Preparedness Innovations (CEPI) has been playing a pivotal role in vaccine development and investment of at-risk capital to enhance manufacturing capacity. It is also involved in developing partnerships for technology transfer. Development financiers need to invest in creating a knowledge network for vaccine development across the world. Knowledge sharing and technology transfer are key to development of vaccines and fair and just distribution of vaccines on a global scale. COVID-19 is not an enemy of a particular country. In this global age, the virus cannot be eliminated without facilitating global access to vaccines. So there should be a concerted initiative on the part of wealthy countries, global institutions like the WHO and WTO, medical community and other stakeholders to extirpate the coronavirus from the face of the world.

(Former banker, Maharjan has been regularly writing on contemporary issues for this daily since 2000. uttam.maharjan1964@gmail.com)