Rich nations urged to share vaccine knowledge as WTO debates waiving patents

Members of the World Trade Organization discussed a proposal to waive intellectual property rights for Covid-19 vaccines and treatments Wednesday amid growing international pressure for greater access for developing nations.

While no decision was made, the discussion was “far more constructive, pragmatic, it was less emotive and less finger-pointing” than on previous occasions, WTO spokesman Keith Rockwell told a media briefing.

India and South Africa are expected to put a revised proposal before WTO members next month, Rockwell said. No details have yet been given on what may change except that it may concern the timeline for the temporary waiver, he said.

Rights campaigners have also called for G7 foreign and development ministers who are meeting in London to consider the question of overriding pharmaceutical companies’ Covid-19 patents.

Activists and many world figures argue that the step is the only way to speed up access to life-saving Covid-19 vaccines for developing nations at a time when richer countries have bought up a large part of the global supply.

While the United States has now fully vaccinated 32% of its population — and could authorize use of the Pfizer vaccine for 12- to 15-year-olds by next week — many poorer nations are struggling to obtain vaccine doses for their elderly and most vulnerable through COVAX, the global vaccine-sharing initiative that provides discounted or free doses for lower-income countries.

India — where Covid-19 infections continue to rage, with devastating effects — has administered more than 160 million Covid-19 vaccine doses since mid-January but doses are now in short supply for its nearly 1.4 billion population. Only about 30 million people have been fully vaccinated so far.

The contrast between those with vaccines and those without is clear. Western nations where vaccination programs are well advanced are now lifting many of the restrictions introduced to curb the spread of the coronavirus. Mask mandates have been eased in the US and Israel, while across much of Europe, hospitality venues are reopening and residents are planning summer vacations.

At the same time, global infection rates remain alarmingly high. World Health Organization chief Tedros Adhanom Ghebreyesus warned Monday that more Covid-19 cases had been reported globally in the past two weeks than during the first six months of the pandemic. “India and Brazil account for more than half of last week’s cases but there are many other countries all over the world that face a very fragile situation,” he said.

The patent-waiving proposal, first put forward by South Africa and India last October and since backed by dozens of mostly developing countries, was being considered by the WTO’s General Council following discussion last week by its Council for Trade-Related Aspects of Intellectual Property Rights (TRIPS).

The proposal calls for a waiver for all WTO members of certain provisions of the TRIPS Agreement in relation to the “prevention, containment or treatment” of Covid-19. Its proponents’ objective, according to the WTO, “is to avoid barriers to the timely access to affordable medical products including vaccines and medicines or to scaling-up of research, development, manufacturing, and supply of essential medical products.”

Rockwell said it was notable that those present Wednesday shared the same objective of increasing vaccine supply to parts of the world where there are “huge shortfalls.”

Those with reservations say they are concerned that waiving patents could “in some way stifle innovation, creativity, the very things that have helped to bring about this miraculous invention of these vaccines in less than a year,” Rockwell said. However, proponents of the TRIPS waiver argue that this will not happen, he said.

WTO Director General Ngozi Okonjo-Iweala welcomed the discussion and said the WTO needed to have “a sense of urgency” in its response to Covid-19, the spokesman said.

Countries are urged to donate any surplus vaccine doses to COVAX, ensure export restrictions and bureaucracy don’t slow manufacturers’ progress and look at underused production capacity in parts of the world such as India, Bangladesh, Pakistan, South Africa, Indonesia and Senegal, Rockwell said.

If the proposed waiver were to be approved, then technological know-how must be transferred to new production sites as well as the intellectual property rights, Rockwell said. Countries must also ensure that they have a strict but transparent regulatory infrastructure in place, he added.

The proposed waiver has previously been obstructed by a “small number” of wealthier nations, according to Doctors Without Borders.

When it was blocked at the WTO in March, aid organization Oxfam slammed the decision as a “massive missed opportunity” to speed up worldwide vaccine production, and accused rich countries of “siding with a handful of pharmaceutical corporations in protecting their monopolies against the needs of the majority of developing countries who are struggling to administer a single dose.”

‘Gross failure of leadership’

Rights group Amnesty International and the People’s Vaccine Alliance urged G7 leaders Wednesday to listen to their people and ensure vaccine knowledge is shared.

“G7 governments have clear human rights obligations to put the lives of millions of people across the world ahead of the interests of the pharmaceutical companies that they have funded,” said Steve Cockburn, head of economic and social justice at Amnesty International, in a news release.

“It would be a gross failure of leadership to continue blocking the sharing of life-saving technologies, and would only serve to prolong the immense pain and suffering caused by this pandemic.”

Wednesday’s WTO meeting comes a day after the chief of Pfizer said the company was expecting approximately $26 billion in revenue from its Covid-19 vaccine in 2021.

More than 300 public health experts signed a letter Friday arguing that the United States should join an effort to force vaccine makers to waive intellectual property rights to coronavirus vaccines and treatments so more countries can start making them.

The group, led by Columbia University professors Terry McGovern and Chelsea Clinton, said the so-called TRIPS waiver would allow local manufacture of vaccines, treatments and diagnostics. “Allowing countries to manufacture locally will speed access to vaccines and treatment, prevent unnecessary deaths, and facilitate a stronger, faster economic recovery,” they wrote.

“Until vaccines, testing, and treatments are accessible to everyone everywhere we risk recurring new variants, drug resistance, and greater loss of life and suffering at home and globally.”

That appeal came a fortnight after more than 170 former world leaders and Nobel laureates, including former UK Prime Minister Gordon Brown, former President of Liberia Ellen Johnson Sirleaf and former French President François Hollande sent an open letter to the White House urging President Joe Biden to support the temporary waiver on IP rights for Covid-19 vaccines at the WTO.

Legal battles

But even as public pressure grows, some experts argue that handing over the IP rights for Covid-19 vaccines won’t necessarily mean that more can be rapidly produced worldwide at large scale.

US infectious diseases chief Anthony Fauci told the UK’s Financial Times on Monday that he was not convinced that forcing companies to share their intellectual property was the most effective approach, warning that legal battles could slow the process.

“Going back and forth, consuming time and lawyers in a legal argument about waivers — that is not the endgame. People are dying around the world and we have to get vaccines into their arms in the fastest and most efficient way possible,” he said.

Thomas Bollyky, director of the Global Health Program at the Council on Foreign Relations, told CNN on Friday that what’s really needed to scale up global manufacturing of vaccines is technology transfer. “It’s not just a matter of intellectual property. It’s also the transfer of know-how,” he said. “I don’t think there’s clear evidence that a waiver of an intellectual property is going to be the best way for that technology transfer to occur.”

Waiving patents will not work in the same way for vaccines as it has for drugs, Bollyky said. For HIV drugs, for example, manufacturers were more or less able to reverse engineer them without much help from the original developer.

“It’s very different for vaccines, where it’s really a biological process as much as a product. It’s hard to scale up manufacturing in this process for the original company, let alone another manufacturer trying to figure this out without assistance,” he said. “It requires a lot of knowledge that’s not part of the IP.”

The deal between AstraZeneca and the Serum Institute of India is a successful example of such technology transfer, Bollyky said, where the licensing of IP happened voluntarily. “The question is what can we do to facilitate more deals like the one between AstraZeneca and the Serum Institute of India to have this transfer,” he said.

Michael Head, senior research fellow in global health at the University of Southampton, in England, told CNN that increasing regional manufacturing capacity, particularly in the global south, was key — and should be a focus between pandemics.

“Sharing intellectual property during the pandemic is something that should happen but that doesn’t resolve the issues,” he said. “Manufacturing vaccines is hard. It’s hard to rapidly set up a new site with all the equipment, infrastructure, all the vaccine ingredients, with suitable staff to produce a large number of high quality vaccine products.”

Philanthropist Bill Gates, a major supporter of global Covid-19 vaccine equity through the Bill & Melinda Gates Foundation, also told Sky News last month that he did not believe overriding IP rules was the answer.

“There’s only so many vaccine factories in the world and people are very serious about the safety of vaccines,” he said.

“The thing that’s holding things back in this case is not intellectual property. There’s not, like, some idle vaccine factory with regulatory approval that makes magically safe vaccines. You’ve got to do the trials on these things and every manufacturing process has to be looked at in a very careful way.”