WHO Calls On World Leaders To “Honor Their Pledge” To Fund COVID-19 Vaccines; South Africa Raises Spectre Of “Vaccine Apartheid”
The WHO Director General said that COVAX is “in danger of becoming no more than a noble gesture” if funding is not secured.

WHO’s Director General Dr Tedros Adhanom Ghebreyesus on Friday issued yet another plea to leaders of rich countries to “honor their pledges” to fund COVID-19 vaccines sufficient to immunize the highest risk groups across the world.

He spoke a day after South African officials raised the spectre that the world was heading towards a state of “vaccine apartheid” whereby rich countries would be able to immunize large sections of their population with vaccines now coming on the market – to which poor countries would not get rapid and widespread access.”

“Our political leaders have pledged to make vaccines a global public good, but that pledge has to be translated into action,” said Dr Tedros, speaking at a Friday WHO press conference.

“I call on world leaders to honor their pledges,” he added. “Sharing the vaccine and having the inoculation everywhere means faster recovery and it’s in the interest of each and every country in the world, lives and livelihoods will get back to normal.”

Speaking earlier in the week at a UN high level meeting, the WHO DG said that COVAX is “in danger of becoming no more than a noble gesture”.

Soumya Swaminathan, WHO Chief Scientist.

Countries also need to ensure that they have logical distribution plans at the domestic level – so that people most at risk of dying from COVID-19 will get the vaccines first, said WHO’s Chief Scientist Soumya Swaminathan, also speaking at the WHO Friday briefing.

“The fact is we are going to have limited doses all over the world, and we need to prioritize those at highest risk of getting the infection and dying from the infection – those are the front line health care workers and the elderly. The rest of us have to be more patient, and rely on the [masking and social distancing] measures we have already been using,” said Swaminathan.

WTO Member States Fail To Agree On “Waiver” For COVID-19 Vaccines & Medicines

WHO has tried to persuade rich countries to come up with some US$ 4.3 billion immediately and US$ 28 billion over the next year, to adequately fund vaccines, medicines and tests through its massive ACT Accelerator Initiative.

Arguing that philanthropy is no longer the solution to the gaping disparities in access to COVID health products that is emerging, South Africa and India have been leading a countermeasure – a World Trade Organization initiative for a broad intellectual property (IP) waiver on any COVID health products.

The proposed waiver would cover patents, copyrights, trade secrets and industrial designs – a measure that the sponsors say would allow low- and middle-income countries to legally acquire and use proprietary technologies more easily than is possible under the current exceptions available for health emergencies under the WTO TRIPS Agreement (Trade-Related Aspects of Intellectual Property Rights).

However the measure was shelved for the time being after Thursday’s WTO meeting, where developed countries, including the United States and members of the European Union blocked advancement of the waiver proposal.  The measure had won the support of a large bloc of low- and middle-income countries in Africa, Latin America and Asia – although other big powers such as China and Russia have also straddled the fence.

South Africa, in its remarks at the meeting, charged that the opponents would be “reinforcing vaccine apartheid” by their inaction.

The proposal, originally submitted to the WTO on 2 October asks that the Organization allows countries to suspend the protection of certain kinds of IP related to the prevention, containment and treatment of COVID-19. Under the proposal, the wiaver would last until widespread COVID-19 vaccination is in place globally, and when the world’s population has developed immunity to the virus.

Despite support from countries including Kenya, Jamaica and Argentina, objection from larger members has meant that the proposal has been shelved until the next meeting in March.

Negotiators have argued that countries in the global South lack an “enabling” environment to develop vaccine industries. “Manufacturers should be able to go ahead and produce without being sued for infringing intellectual property rules,” one expert was reported as saying after yesterday’s negotiations.

Patents, IP and other legal barriers severely hinder a country’s ability to access tools like vaccines and treatments in a timely manner, the South African delegation argued.

“Those delegations opposing the waiver proposal have repeatedly suggested that voluntary approaches offer the best solution,” stated South Africa in its closing arguments Thursday. “As would have been emphasized, the TRIPS waiver proposal is supportive of any voluntary licenses issued by companies, however the terms of such licenses are often such that they may restrict access or reserve supply only for wealthy nations.

“Similarly, for vaccines, bilateral deals are being signed by pharmaceutical companies with specific governments but the details of these deals are mostly unknown. Usually these agreements are for manufacturing of limited amounts and solely supplying a country’s territory or a limited subset of countries.”

The delegation also pressed for information on the European Commission’s IP action plan, which calls for the “voluntary pooling and licensing of intellectual property related to COVID-19 therapeutics and vaccines … to promote equitable global access as well as a fair return on investment”.

In its address, South Africa also questioned how the EU intends to act on its “lofty rhetoric”, citing that there has been limited transparency or explanation as to the mechanisms it proposes that would enable the pooling of IP.

Among the opponents, Canada was among the high-income countries that appeared to be seeking a mediating role. It urged WTO members to continue discussions based on “mutual understandings and consensual solutions” – although its statement also suggested that the “overall TRIPS system works well”. Countering that, advocates pointed to a recent South Centre study of IP regimes and TRIPS flexibilities in almost 30 African countries, which found that the regime is is “far from optimal”.

A handful of other middle and high-income countries countries, including Kenya, Jamaica and Argentina also expressed favorable views about the proposal. But the overriding objections from most of the WTO’s most industrialized member states effectively means that the WTO TRIPS Council – which oversees the WTO agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) –  will be shelved for the time being.

The next TRIPS Council meeting is in March 2021; meanwhile members have agreed to submit an oral status report to the General Council for next week.

Pardoxically, the meeting came just a day before the Medicines Patent Pool, a UN-backed organization, celebrated its 10 year anniversary. The MPP was created to facilitate access to medicines through voluntary licenses with patent holders. Over the past ten years, MPP has secured 15 billion doses of HIV, hepatitis and tuberculosis medicines across 141 countries.

COVAX: Insufficient Funds and Targets?

In Thursday’s debate South Africa also drew attention to the failings of the COVAX facility so far to raise sufficient funds for the massive distribution of 2 billion vaccine doses, sufficient for immunizing 1 billion people in 2021. So far, the facility has raised funds and made deals for the procurement of about half that amount of vaccine doses, said Dr. Tedros on Friday.

But even if the COVAX Facility’s 2021 targets were met, those would be “insufficient to meet global needs of the 7.7 billion people of this world”, South Africa said in its statement at the WTO meeting.

The COVAX target to provide 245 million courses of treatment for low- and middle-income countries is insufficient, the delegation said.

It noted that the targets to immunise 1 billion people globally, and bring 245 million courses of treatment and 500 million diagnostic tests to low- and middle-income countries are not enough to make equitable care and timely access “a reality.”

And anyway at the moment, South Africa charged, “more than 90% of all future production of likely vaccine candidates being reserved for rich developed countries”.

“Ad hoc, non-transparent and unaccountable bilateral deals that artificially limit supply and competition cannot reliably deliver access during a global pandemic,” warned South Africa on Thursday. “These bilateral deals do not demonstrate global collaboration but rather reinforces ‘vaccine apartheid’ and enlarges chasms of inequity.“

Switzerland, for instance, has already bought up some 16 million vaccine doses through bilateral deals with Pfizer, Moderna and AstraZeneca, enough to vaccinate its entire population, in spite of the fact that half of the country’s citizens have declared that they would not want to get a COVID-19 jab, even if it were proven to be safe and effective.

Image Credits: WHO, Eli Lilly.

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