The World Health Organization (WHO) has “outsourced” its role in vaccine access and sidelined member states by leaving the running of the COVAX vaccine procurement facility to GAVI, The Vaccine Alliance and CEPI (Coalition for Epidemic Preparedness Initiative), Third World Network’s Sangeeta Shashikant told a civil society forum on Tuesday.

“Disparity in access is the ugly reality of COVID-19 right now. This is getting a lot of attention because you can see some countries are getting vaccines but most of the countries are not,” Shashikant told a meeting of the G2H2 Geneva Global Health Hub, a network of civil society organizations that is convening virtually this week to discuss how to influence discussions at the upcoming WHO’s Executive Board meeting, WHO’s 33-member governing body, next week.

Shashikant proposed that WHO be lobbied to adopt four interventions to ensure that vaccines are developed as a public good, namely:

• Securing legal commitments from manufacturers that they will reserve a proportion of their supplies for developing countries,
• Promote vaccine manufacturing in developing countries.
• Showing strong support for a World Trade Organization “TRIPS waiver” proposal, aimed at suspending aspects of intellectual property rights related to COVID health products during the pandemic,
• Promoting more transparency, particularly in reporting about the details of COVAX deals with vaccine manufacturers as well as voluntary license agreements between vaccine manufacturers and production companies,

“AstraZeneca has reportedly signed licensing agreements with several manufacturers around the world, including the Serum Institute of India for one billion doses to supply low and middle-income countries. But one billion doses is never sufficient to address the need of developing countries,” Shashikant said.

“So why have they only licensed Serum Institute? This is what we refer to as limited and restrictive licensing. In the case of Pfizer and Moderna, there is no licensing.

“For the big pharmaceutical industry, it’s really business as usual, as they limit competition artificially, limiting supply because they are not offering global licences.”

Shashikant added that WHO “has also played a peripheral role in this whole setup of the COVAX facility”, where “decisions have primarily been taken by GAVI and its board and WHO member states are not involved in any kind of decision making”.

“The reality is that the developed countries are all relying on bilateral deals for supply. They say they’re part of COVAX, but they have all pre-booked vaccine supply for themselves outside of COVAX. There have been a lot of different issues of transparency, accountability and even scepticism about whether this facility will deliver.

Researcher and activist Els Torreele asked why, “when the US National Institutes of Health and Oxford University were the actual innovators using public money, we have agreements that transfer all of that work to Moderna and AstraZeneca?”

“How can we create a more participative, inclusive governance scheme where the ownership and the control of the vaccine is distributed among the different actors?”

WHO should Consider Human Rights Factors

On Monday, civil society organisations called for WHO to ensure that human rights considerations are part of any pandemic preparedness and response in the wake of widespread state abuse of citizens during the pandemic.

Cristina Palabay of the Karapatan Alliance in the Philippines reported that over 100,000 people had been imprisoned for “quarantine violations”.

“Many experienced physical violence including torture such as being placed in dog cages, being tied and left in the heat of the sun, hit with police batons, or placed in coffins to supposedly teach them a lesson,” said Palabay.

People in compulsory quarantine in Nepal, Bangladesh, India and Malaysia were kept in poor conditions, with reports of rapes and suicide and food shortages, particularly in Nepal, according to Richa Chinton of Jan Swasthya Abhiyan (People’s Health Movement India).

Workers who violated curfews by a few minutes in India were dealt with harshly, and wages were cut or not paid as trading hours were curtailed, she added.

School closures meant many children didn’t get food and exposed children to abuse, while there has been an increase in gender-based violence.

In Kenya, Christine Ajulu of the Health Rights Advocacy Forum said that mandatory quarantine “appeared to be a punishment”.

“If you’re found roaming out during the curfew hours, you are forced on quarantine. If you are found without a mask, you’re forced to quarantine. .The facilities were not up to standard and we have cases where lack of water was reported inadequate food was reported.”

During lockdowns, Israel has closed its borders with the Palestinian Authority, further restricting travel between the two regions, and around 80% of the workforce was affected, according to Ubai Al-Aboudi from the Bitan Centre for Research and Development in Palestine.

Israel has also refused Palestinians access to the COVID-19 vaccine, including around 4000 Palestinian prisoners being held in Israeli jails.

A group of Israeli and Palestinian human rights organizations have appealed to Israel’s Supreme Court demanding that the Palestinian prisoners, who are living in crowded conditions that put them at high risk of infection, be provided with access to the vaccines now being distributed en masse in Israel – in line with a decision by Israel’s Attorney General.  That is a decision that Israel’s hardline Minister of Public Security, Amir Ohana, has so far refused to carry out.

“With the review of the International Health Regulations (IHR) in the context of COVID-19, WHO has the opportunity to strengthen human rights considerations in pandemic preparedness and response, but we have not seen this matter addressed,” according to the G2H2 hub.

“The Covid-19 response requires more immediate action from WHO. The precedent of ignoring human rights abuses in the name of public health is a dangerous one, that should not be allowed to go unchallenged.”

Image Credits: Flickr – Mecklenburg County, United Nations Photo.