Rich countries are first in line for Covid vaccines because a handful of companies control both the price and quantity | Patricia Ranald
Pharmaceutical company patent monopolies are the elephant in the room in the debate about Covid-19 vaccine shortages in Australia.
Most of debate locally has been about whether the federal government ordered enough vaccine doses last year from Pfizer and other companies. This misses the broader point that a handful of pharmaceutical companies control both the price and quantity of vaccines.
Even in the context of a global pandemic, they can set the terms in closed-door negotiations with rich countries. These companies have already made billions from vaccines which were developed at record speeds and supported with public funds.
Currently, the World Trade Organization (WTO) rules give 20-year monopoly patents on new vaccines before cheaper versions can be produced, and each government must negotiate with pharmaceutical companies which have limited manufacturing capacity and control both quantities and price. Rich countries are first in line, but even countries like Australia are experiencing delays in supply.
Under these rules most low-income countries will not have widespread access to Covid-19 vaccines before 2023 or later. Meanwhile the pandemic rages and millions die as new and more infectious variants like the Delta strain develop and spread to countries like Australia. We read every day about rising case numbers and death tolls in Indonesia, Africa and the Pacific Islands.
The WTO is currently negotiating a proposal sponsored by India and South Africa to temporarily waive certain provisions of the WTO Trade-Related Aspects of Intellectual Property Rights (Trips) Agreement on Covid-19 vaccines and medical products for the duration of the pandemic. The WTO General Council will receive a report on the Trips negotiations on 27 July.
The waiver would enable the ramping up of manufacturing capacity on a regional basis in countries like India and South Africa which are among the world’s largest producers of generic medicines.
Increased global manufacturing capacity for vaccines would also benefit Australia by both easing supply pressures and preventing the development of more infectious variants.
At least 11bn doses are needed to vaccinate the global population of more than 7bn. Without urgent action, unequal access to Covid-19 vaccines is set to further entrench global inequality.
Australia and some other countries are donating money or vaccines to low income countries, through schemes like the COVAX target to donate 2bn vaccines.
However, as the British Medical Journal has reported, this target is clearly not sufficient to address global need, and has not yet been met, since it relies on donations of leftovers from rich countries’ vaccine programs. The waiver would expand global production so low-income countries have local production capacity and are not only reliant on donations.
The waiver was first proposed in October 2020 and is supported by more than 100 WTO member governments. But it has been delayed by opposition from rich countries, lobbied by pharmaceutical companies based in those nations.
There is mounting pressure in Australia and elsewhere in support of the waiver. The 21-nation Apec Trade Ministers’ meeting held on 4-5 June supported the waiver.
The Apec leaders meeting on 16 July, chaired by New Zealand which supports the waiver, said vaccine technology should be shared as a global public good to expand manufacturing and supply.
The European parliament has supported it, despite opposition from Germany and the European Commission, which conducts its trade negotiations.
In Australia, 50,000 people have signed petitions supporting the waiver, and an Essential Media poll published on 16 July showed 62% of Australians support it. The support was consistent across the political spectrum, expressed by 66% of Labor voters, 65% of Greens voters and 64% of Coalition voters.
Fifteen national church, aid and development, public health, union and human rights organisations representing millions of Australians wrote to government ministers on 19 July asking them to support the waiver. These include the Public Health Association of Australia, the Australian Council for International Development, Oxfam Australia, Amnesty International, the Australian Catholics Bishops Office for Justice, Ecology and Peace, the Uniting Church, and the Salvation Army. This follows a previous similar letter from more than 700 health experts.
The World Health Organization (Who) last year set up a technology access pool where patents and other intellectual property for Covid-19 vaccines and treatments can be shared and treated as a global public goods, accessible to all. The Who director general has said “trickle down vaccination is not an effective strategy for fighting a deadly respiratory virus”.
“In low and lower-middle income countries, vaccine supply has not been enough to even immunise health and care workers, and hospitals are being inundated with people that need lifesaving care urgently.”
It is clear most Australians and health, church and development organisations recognise that during a pandemic the knowledge to produce vaccines and treatments should be shared equitably to expand supply and prevent millions of deaths in low income countries. This would also prevent the spread of more infectious strains and shorten the pandemic.
It is time the Australian government listened to them and supported the waiver proposal.