Reducing vaccine inequality

‘Ensuring widespread global access to Covid-19 vaccines, which is necessary for preventing cases and deaths and contributing to global population immunity, is a critical challenge and one that could threaten the ability to control the pandemic. Despite efforts to address vaccine access, most notably through the creation of COVAX, which aims to support the development and delivery of Covid-19 vaccines with a particular focus on assisting low- and middle-income countries, significant disparities remain. The latest data from the Duke Global Health Innovation Center Launch and Scale Speedometer, which monitors COVID-19 vaccine purchases, finds that high-income countries already own more than half of all global doses purchased, and it is estimated that there will not be enough vaccine doses to cover the world’s population until at least 2023.’ – an excerpt from March 17 published ‘Global Covid-19 vaccine access: a snapshot of inequality’ by Anna Rouw, et al.

As per the same article, the extent of vaccine inequality between rich, advanced countries, and developing countries can be gauged for instance by the fact that ‘although high-income countries only account for 19% of the global adult population, collectively, they have purchased more than half (54%, or 4.6 billion) of global vaccine doses purchased to date.’ Given acute phenomenon of vaccine inequality, recently two letters were written to the US President, Joe Biden, with regard to waiving intellectual property rights on Covid vaccines, and reaching a vaccine on the basis of open-source information sharing. These demands are also shared by ‘People’s Vaccine Alliance’, which is ‘an initiative to rapidly develop a free Covid vaccine for all people by suspending intellectual-property rights on the technology’, and which asks pharmaceutical companies to share know-how about vaccines openly, so that a ‘people’s vaccine’ can be reached the desired point to deal with many variants of Covid in an effective and meaningful manner. Together, these demands will drastically help reduce vaccine inequality, and price of vaccine, along with increasing its effectiveness against variants.

The first letter written on April 15, among others, by Bernie Senders, urged the U.S. President that ‘We write regarding the urgent need for the United States to support the temporary waiver of some Trade-Related Aspects of Intellectual Property Rights (TRIPS) rules proposed by India and South Africa at the World Trade Organization (WTO) during the COVID-19 emergency. We urge you to support the adoption of this temporary waiver; doing so will help to ensure the most effective and efficient response to this once-in-a-lifetime global pandemic.’ Similarly, the second letter pointed out that ‘We the undersigned former Heads of State and Government and Nobel Laureates are gravely concerned by the very slow progress in scaling up global COVID-19 vaccine access and inoculation in low- and middle-income countries. A WTO waiver is a vital and necessary step to bringing an end to this pandemic. It must be combined with ensuring vaccine know-how and technology is shared openly. This can be achieved through the World Health Organization COVID-19 Technology Access Pool, as your Chief Medical Advisor, Dr. Anthony Fauci, has called for. This will save lives and advance us towards global herd immunity.’

The demand for waiving patents on Covid vaccine is also being strongly voiced by leading global academicians like Mariana Mazzucato and Jayati Ghosh. In their recent Economist article – where the third author of the article was Els Torreele, who ‘is a visiting fellow at the Institute for Innovation and Public Purpose’ – in which they urge for an equitable distribution of Covid-related vaccines. Hence, unlike the projections like the one highlighted in the article by Anna Rouw, et al., whereby it may take up till 2023 to provide vaccines to populations globally, Mariana and others in their article highlighted that ‘The solution is the People’s Vaccine – available to all, affordable by all. It would resolve the “vaccine apartheid” that is creating moral, health and economic catastrophes. The current scarcity of vaccines is artificial and avoidable. If the world were not blocked by intellectual-property claims, we could collectively mobilise enough production capacity to make vaccines to inoculate everyone – 60% of the world this year, and everyone who wants a vaccine by the end of 2022, according to one estimate.’

Moreover, the plea for removing patents on Covid vaccines is not just based on humanitarian grounds, but also because a lot of taxpayers’ money has been invested in enabling private pharmaceutical companies to come up with the vaccine, so it becomes obligatory for firms to see this as a ‘people’s vaccine’ – very cheap, and readily and equitably available vaccines across the countries, where allowance of local production reaching adequate supply, and in a much better timely manner than long time spans currently being projected. This will also help in big way, especially developing countries, to better manage their foreign exchange reserves requirements for meeting vaccines’ much reduced price tag, as these initiatives, which are being called for, get implemented.

In this regard, Mariana, among others, in the same article pointed out that ‘However, this is not about aid to poor countries: suspending intellectual property would benefit people in rich countries too. There would be more doses and less hoarding everywhere. The larger supply would reduce vaccine prices generally. Critically, it would reduce the burden of treating patients and decrease the risk of more dangerous variants emerging, for which current vaccines may not work. … In America alone, six vaccine companies have received an estimated $12bn of public money. Development of the AstraZeneca/Oxford vaccine is estimated as having been 97% publicly funded. The subsidies and advance-purchases reduced firms’ risk and ensured that successful companies would be amply rewarded. In addition, vaccine development has benefited from prior public research and accelerated approval rules that lowered the costs of clinical testing.’

Having said that while such calls for removing patents are indeed welcome, the sense of urgency needs to be even more in the wake of some recent developments, as already decided vaccine supply targets, under the World Health Organization (WHO)-led Covax initiative, reportedly received a supply shock recently, as pointed out in a recent Wall Street Journal article ‘Why Covid-19 vaccination in poorer nations has slowed, posing global risks’: ‘An initiative backed by the World Health Organization and rich countries to supply free vaccines to 92 low- and middle-income countries recently slashed the number of shots it plans to ship by the end of May. That initiative, called Covax, will deliver 145 million doses instead of about 240 million because India, its main supplier, has largely stopped exporting shots as it fights a surge in cases at home. That is widening an already huge vaccination gap between rich and poor countries. While more than 200 million doses have been administered in the US, Covax has so far supplied fewer than 41 million of its planned two billion doses by the end of 2021.’

Reducing vaccine inequality, and doing this urgently, is indeed important to not only minimize the risk of rebounds of the pandemic because ‘no one is safe unless everyone is safe’, but also in bridging the increasing gap in terms of economic recovery between rich, advanced countries – which are recovering much faster than developing countries, mainly on the back of ample supply of vaccines – and developing countries; where slow economic recovery also runs the risk of a ‘debt pandemic’ given many countries globally have seen their fiscal deficits and debt rising significantly during the pandemic. Relatively, much fewer vaccine doses, supplied over longer periods of time, in addition to raising economic recovery concerns, as a consequence also hold strong potential of stoking winds of populism and xenophobia in many parts of the world, especially developing countries, suffering from vaccine inequality, and which could lead to greater political radicalization and violence. It is therefore important that every step is taken to reduce the already large gap of vaccine inequality.

(The writer holds PhD in Economics from the University of Barcelona; he previously worked at International Monetary Fund)

He tweets@omerjaved7

Copyright Business Recorder, 2021