Right now in the world, there’s a dire shortage of the vaccines, the treatments, the tests we need to defeat COVID. And it puts the whole world at risk. There are now 10 countries that have consumed 85% of the 5 billion vaccines that have been made. As many as 14 billion vaccines are needed to be able to vaccinate the world. We’re no where close to that production capacity. Globally, more COVID-19 cases were reported in the first 5 months of 2021 than in the whole of 2020. While vaccinations now offer protection from severe disease and death, low-income [LIC] nations have received less than 1% of vaccines administered globally. Gaps between high-income and low-income countries have never been more apparent. All countries are experiencing new waves of infections, seeing erosion of public trust, resistance to public health and social measures. But while high-income countries have implemented widespread vaccination, put more robust testing systems in place and made therapies available, low income countries are still struggling to access these tools. Additionally, governments are making increasingly divergent policy decisions that address narrow national needs which inhibit a harmonized approach to the global response. In January 2021, compelling evidence was published supporting the economic imperative for investing in the ACT-Accelerator. This study, commissioned by the International Chamber of Commerce, demonstrates that should countries continue to pursue an uncoordinated approach in access to COVID-19 tools, or “vaccine nationalism” – when governments sign agreements with pharmaceutical manufacturers to supply their own populations – the world risks US$ 9.2 trillion of GDP loss by 2025.
And the reason why, is that, under intellectual property rules that are enforced by the World Trade Organization [WTO], a handful of vaccine producers are allowed to control if, when, how much, and where vaccines and other COVID medications are produced. Big Pharma is not looking at this as a public health matter, they’re looking this as a business matter. So from their perspective, the increase in production necessary to actually make sure everyone can get vaccines and that we’re all safe and that we can beat COVID is not a priority. The WTO helps by obligating every member country to enforce long monopoly protections of intellectual property for drug makers. For many months, starting in October of last year, South Africa and India made a proposal to temporarily waive those restrictions. And the United States under Trump led a small coalition of countries to block this. The Biden administration on May 5th reversed course and came out in support of a waiver of these rules, at least with respect to vaccines. And then twisted some arms and got firstly Japan then Australia, Canada and Mexico to stop blocking. Yet at this moment, even though they’ve been negotiating for two months, the Delta variant is burning through the global south, murdering people – causing untold unnecessary death. Despite this Germany has pushed the entire EU to oppose the waiver, and hiding behind them are the UK and Switzerland. It is those three entities versus 140 countries that want this waiver, and the whole thing is jammed.
What’s going on is nothing short of obscene. Basically it’s governments standing behind big pharma companies at the expense of everyone else in the world. Hundreds of thousands will die in the months to come, unnecessarily. And it has been allowed to happen because pharma companies are restricting production, and governments are allowing them to do this. Moderna is almost entirely publicly funded. The United States government could tell Moderna, “We gave you all the money. We created the technology, share it. We will refund you. We will reimburse you for this.” But they’re not doing that. The mRNA technology has been publicly funded, those companies like BioNTech that were involved didn’t pay anything for the initial development. So you could twist the arms of the companies that are making these vaccines and say, “Share your technology.” There is in fact a mechanism to sidestep the monopoly. The WHO set up a COVID-19 technology access pool, as part of its, what is called ACT-Accelerator action on COVID.
Since April 2020, the ACT-Accelerator partnership, launched by WHO and partners, has supported the fastest, most coordinated, and successful global effort in history to develop tools to fight a disease. With significant advances in research and development by academia, private sector and government initiatives, the ACT-Accelerator is on the cusp of securing a way to end the acute phase of the pandemic by deploying the tests, treatments and vaccines the world needs. Yet not one major company has joined that. ACT-A’s funding gap for this year – US$ 16.8 billion – represents less than half a percent of the amount that G20 countries have spent to deal with the domestic consequences of the COVID-19 outbreak, according to the International Monetary Fund. Here’s the thing: the business model of these big pharma companies would actually prefer a situation where this is an endemic disease and patients have to keep having boosters. The natural tendency of a big pharma company will be to create a situation where sufferers are constantly requiring different versions of the vaccine. And that’s what they will get as long as you can allow this disease to proliferate. And you can do that by denying the rest of the world vaccines. So, in other words, it’s not an accident that we’re getting this.
There’s another way in which this protection of intellectual property rights and this control over publicly funded technology by big pharma has had terrible impact even in the developed world. And that is because we’re really spending far too much on these vaccines. There’s a brilliant report out today from Oxfam and the People’s Vaccine Alliance, which using research done by Public Citizen, has calculated the cost of these mRNA vaccines at between $1.85 and $2.15. Going by that, they are charging governments anything in the range of four to 40 times the cost of production. I mean, it is absolutely crazy what has been happening. And the estimation in this very interesting paper, is that the United States has paid $1.8 billion extra to Pfizer and $17.4 billion extra to Moderna. This is the excess that they have paid. The European Union has paid $31 billion more. Germany, which is protecting Pfizer, BioNTech, has paid $5.8 billion more. This is money that could be used to pay health workers, it could be used to make sure that all kinds of other health is improved. This is money that could have been spent in lots of better ways, even in advanced economies. So citizens in the advanced economies are in this together. And it’s them against everybody in the world. It’s them against humanity.
So on the first point, the arguments are three, and they range between disgusting and bogus. The first is just neocolonialist racism, which is those countries can’t make a vaccine as sophisticated as those available from big pharma. So there’s no point in waiving intellectual property barriers or doing the technology transfer. It’s just too fancy, too technical. And it is so disgusting in that the mRNA research has been government funded. The big pharma companies weren’t into it. They didn’t think it was going to be profitable.Pfizer came in at the very end, bought the worldwide manufacturing and distribution rights. They had never had anything to do with mRNA vaccines. It’s been scientists from around the world. And that is the reason why right now China is developing its own mRNA vaccines, because the technology has been developed by scientists around the world. The capacity was developed by people from those countries in partnership with people from Europe, and from the U.S. and from developed countries. So it’s been a scientific partnership of geniuses who have got this platform in a place where they were researching for AIDS, researching for malaria, for cancer. And just this methodology of medical delivery has been developed at the point where now it can also be used for this kind of vaccine.
When the WTO had a summit about how to improve the volume of vaccine production, countries could report about 2 billion doses still on the table to be made in 2021. If there was technology transfer, then the question is, do you need a year to reverse engineer how to make the damn stuff? Pfizer figured it out, going backwards, having never made a single dose in about five months. According to Moderna’s chief scientists, it can be done in three to four months in existing facilities. Because mRNA technology is not living cell lines, the process doesn’t need ginormous eight story vats and weeks to brew a virus – that’s the J&J technology. So, if you have a clean manufacturing facility, you have the IP unlocked, and you have a technology transfer, you could have more vaccines made. In India, in South Africa, and two or three different companies that can do it. So it’s not trade barriers. It’s not supply chains, that is somehow the crisis of the inability to make more glass vials. No, the issue is at the core, the intellectual property and technology transfer is not there.
The third argument that is made is basically the same disgusting argument that was made during the HIV/AIDS fight. Which is, people in the developing world, there’s no way to distribute these vaccines. So, even if IP were the issue and even if countries could make more of them, there’s no way to keep it cold to get into people’s arms. And of course, that’s been empirically proved to be a damn lie, because with the HIV/AIDS epidemic, those arguments were made and disproved. And that was 25 years ago. But currently, actually, right this moment, developing country producers, world-class producers, are pushing out biologic, cutting-edge medicines for HPV vaccines, which have to be refrigerated for distribution, having wide distribution for cutting edge biologics, AIDS meds, they’re being distributed. So those three arguments are just baloney.
This is about greed and profits. They don’t want developing country manufacturers, to have the ability to operate on this platform, because they see this as just a cash cow forever. Treating variants with boosters, but also whatever new platform, treatments, and medicines we build in the future, the big pharmaceutical companies want less volume because they want pandemic pricing to be over. And then, as Pfizer announced, charge $150 to $175 per shot, not the $20 per shot, which is already multiples of what it actually costs them to make it. That is what’s going on.
People around the world see the developed countries have the most amazing mRNA vaccines. They are extremely effective. They are the fastest to gear up to manufacture; but they’re not sharing and they’re not providing. And, in fact, they’re not only lying to themselves and other countries, they have made mass mortality unnecessarily. We are courting the zombie apocalypse of being all locked up with the actual variant getting around the vaccines altogether, because we let variant after variant, after variant, brew wherever there are these mass outbreaks. So we already see what the Delta variant, what’s starting to happen, breakthrough infections. So China has some vaccines, they are less effective. They’re an older technology. They’re perfectly good vaccines, but the way they are made, the technology is such that, you are using basically the existing original alpha virus of COVID. So it is not as broadly effective against the variants. But China has made production partnerships, as has Russia, with the Sputnik vaccine, which is totally open source. They’re not doing any monopoly licensing. They’ve made partnerships all over the world to transfer the technology and to actually make the vaccines. So these are somewhat less effective. But the world is seeing that these are where the partners are, not with democracies, but with autocracies.
Just consider it from the point of view of the average developing country citizen. What have we seen? We’ve seen vaccines being developed at a dramatically rapid rate because of investment by these rich countries who can afford to do so. We’ve then seen them grapple with the vaccines, ordered 11 times what they need. And then hold on to them, stockpile these vaccines. So they’re still stockpiling vaccines that they could distribute tomorrow. And then we’ve seen them say, “Well, we know how to make this but we’re not going to let you know how to make this. And we’re going to prevent anybody else who tries to help you to make this.” So we have also seen the western governments go to developing countries saying, “Don’t use the Russian vaccine. Don’t use the Chinese vaccine.” It is breeding a lack of trust in the advanced economies which is going to damage all things in future. But they have realized what the Chinese realized a decade ago, that there’s no point relying on these guys for knowledge, they’re going to hold it. There’s no point relying on these guys for investment, because they will only do the investment that suits them. There’s no point even relying on these guys for trade because that trade will be on their terms, but also they will stop it when they think that they can get more profit for their companies.
What can we do about it? I would say, there are some things that governments could do very easily. The U.S. could release all the stock piles. It really doesn’t need 80 million AstraZeneca shots that it’s never going to use. By the time it finally decides to distribute them, they may have expired. They are not going to be valid for very much longer. Distribute all the extra vaccines that are still being stock piled in all these countries. Just give them away immediately. Second, actually just bring to the table these guys, you could do it with J&J and Moderna and say, “Listen, you’ve made your money. We paid for this vaccine. Now you’re going to share the technology.” There are many things governments can do to big companies that would make life difficult for them otherwise. To persuade them to part with the technology for a cost, not for free. And they could just do that tomorrow if they really wanted to. The technology is there. The money is there. It’s only the political will. This is a political problem, not a technology problem. It’s a power problem. There are three things that need to happen to get the scale up that’s needed to beat the pandemic. One, the intellectual property needs to be liberated, the WTO TRIPS Waiver. Two, the technology needs to be transferred. And some countries have more leverage than others. The US government has enormous leverage over Moderna because it has never paid for two government-owned patents, that are at the fundament of that vaccine. This is a struggle literally for the future of humanity, it can’t be gotten wrong.
This pandemic has created geopolitical changes; it’s surprising that nobody has warned the White House that, “Listen, you’re really heading for a major, major decline in viability of the US globally, way beyond anything Donald Trump could have achieved. Because of this complete cynicism in terms of what you are doing.” In a large part of the developing world, there is increasing realization that these are not countries to be relied upon. It will generate a desire for regional industrial policy, for a more democratic approach to the way capital is regulated and where capital flow and finance is regulated resulting in less of an appetite for the kind of corporate driven globalization that we’ve had. There is a generalized distrust in the economic system that has been propagated largely by the advanced economies. It’s not a happy day. But it’s also surprising that political leaders are in so much denial and have so little awareness of the huge implications of inaction on this. Because these capitalists don’t believe in markets and are against more competition in creating these vaccines. They’re wanting to hold onto monopoly rights, which have been unjustly acquired, and then they’re trying to extract as much as they can. Which is fine, this is what big capital does. There’s no surprise there. What is surprising is that governments are allowing themselves and their citizens to be taken for such a ride. The bottom line is the situation is not tenable. It’s not survivable.
This is an edited extract from a podcast at:
getupsolomon 