More than 4,000 people in the US died of Covid-19 on January 20, the day Biden was sworn in as President. In the seven days running up to inauguration, the US was averaging more than 3,000 deaths a day. To confront the devastating toll of the pandemic, the Biden administration made access to the Covid-19 vaccine a top priority. As of Thursday, 44.7% of all Americans have received at least one dose and 32.3% are fully vaccinated. In contrast, as of April, only 0.2% of people in low-income countries had been vaccinated due to a lack of access to vaccines. According to the World Health Organization, more than 87% of the world’s vaccines had gone to people in high-income countries.Covid cases are again surging around the world, while the virus continues to mutate. The images of Covid-19 victims in India have shocked the world, rightly, but Turkey, Iran and South America are struggling as well, and no country or region is fully protected from further surges. The pandemic’s impact on global health, the economy and political stability cannot be confined within national borders just by locking down. We live in an era of global integration in the way we travel, trade and work and therefore, we need a collective and globally integrated approach to manage the pandemic.The unprecedented speed with which safe and effective Covid vaccines have been developed marks a tremendous scientific triumph. In the US, much of the underlying research that enabled these scientific advances was funded by the US government.With the Moderna vaccine, a significant portion was funded by the US government — which is to say, by American taxpayers. Despite such massive public investments in research and development (R&D), due to the globalization of intellectual property rules in the 1990s through the World Trade Organization (WTO) agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS), decisions about the production, licensing, distribution, and pricing of the vaccines are largely decided by private pharmaceutical corporations. These companies have a monopoly not only on the patents but also the technology and know-how that would enable others to be able to produce billions of vaccines to meet global need. Waiving the intellectual property of the vaccines is the crucial first step to ramping up global production — it opens the door to transferring the technology on how to manufacture the vaccine and allows for investment in its production.Given the limited number of Covid vaccines and the global inequities in access that have resulted from this, India and South Africa submitted a proposal to the WTO last October for a temporary emergency waiver on relevant intellectual property for Covid-related technologies, including vaccines.While the Trump administration deserves credit for ramping up the production of Covid-19 vaccines under Operation Warp Speed, they vehemently opposed a waiver. Its “America first” approach was not just misguided — it was shortsighted. If we do not pursue wide-scale vaccination as aggressively overseas as we did in the US, we will only prolong the pandemic. The Biden administration should be commended for its humanitarian decision this week in support of the waiver. More than 60 former heads of state, 100 Nobel laureates, 100 members of the US House and Senate, countless NGOs and civil society organizations have also supported the waiver, which would help fight the “vaccine apartheid” that exists today. Even Pope Francis warned about the risk of prioritizing access to the vaccine for the richest. Tai, the US Trade Representative, announced her willingness to engage in “text-based negotiations at the World Trade Organization” to work with the private sector on ramping up production and distribution. It remains to be seen how long these processes might take and whether the US will support a waiver beyond Covid vaccines to include all other essential Covid treatments, vaccines, and other health tools. And there must now be clear mechanisms in place to ensure sharing of technology and know-how and large-scale investments in production capacity around the world so that billions of doses can reach those in need. But a critical deadlock has been broken and now other rich countries must follow suit.
If ever there was a time to ask ourselves whether we as a global community believe in the equitable sharing of the benefits of scientific progress — to break with the past and ensure nothing stands in the way of life-saving innovations reaching even the poorest, most marginalized, and most vulnerable — surely it is now.
The US has once again taken its place in the global community as a leader, willing to make bold decisions to accomplish big things. The mechanics of the next steps may take some time to work out, so the global community needs to continue to support the COVAX Facility which was set up to donate excess vaccine doses to reach the world’s poorest countries. Its initial goal was to distribute 2 billion vaccines by the end of the year but to date they have only managed to ship some 53 million doses due to a lack of supplies.In March, India announced it was temporarily suspending vaccine exports in order to prioritize its domestic needs amid an escalating crisis within the country. This month, Sweden committed to donating one million doses of the AstraZeneca vaccine to COVAX. US drug maker Moderna also agreed to supply 500 million doses at a reduced price, but its current supplies are committed until 2022.
The US will need to become the convenor in chief to nudge pharmaceutical companies and countries to take all the necessary steps to remove the obstacles and accelerate the complex process of ensuring equitable global access to Covid vaccines and other life-saving health technologies.
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