Africa: Health, not wealth, should determine access to a Covid-19 vaccine

More than 1 million people around the world have lost their lives to Covid-19. At least another 38 million people were infected. many have become seriously ill. With almost every country in the world reported cases of Covid-19, the social and economic consequences of the pandemic have been devastating and far-reaching. A Covid-19 vaccine is critical to ending the pandemic and saving lives. The race to develop such a vaccine is on. But who will ultimately be able to access and afford it? Birgit Schwarz Meetings with Human Rights Watch’s Senior Counsel for Business and Human Rights, Aruna Kashyapand lead researcher on children’s rights, Margaret Wurthon the need for more transparency and fair distribution of vaccines based on health needs, not money.

Who is involved in the development of a Covid-19 vaccine?

AK: The World Health Organization (WHO) maintains a list of companies and other institutions currently involved in the research and development of Covid-19 vaccines. Almost 200 vaccine candidates are in preparation. As of October 19, only 10 vaccine candidates were in the final stages of clinical trials, according to the WHO. High income countries such as the US, Germany, UK, Norway, South Korea, Saudi Arabia and Canada, along with the European Commission, are investing huge amounts of public money in research and development of Covid-19 vaccines, mainly through funding from private companies and other companies, who lead the research. By mid-September, more than $ 19 billion had been used to fund vaccines.

What do governments expect in return?

AK: Governments with the resources are negotiating bilateral agreements for their own countries with companies and other institutions to reserve large quantities of future vaccines. As far as we know about the current production capacity, this means a limited supply for countries that cannot afford it. The exact terms of these financing agreements are kept secret.

MW: This is one of the key points that we address in our “Whoever Finds the Vaccine Must Share” report: Strengthening human rights and transparency on Covid-19 vaccines. Despite the enormous amount of public money being spent on vaccine development, there is no open and transparent way to track how those funds are being used and whether governments have ensured that they are being used for public purposes rather than private gains be used.

What do these bilateral agreements mean for vaccine accessibility?

AK: The current approach of secrecy, competition and a race to fund and close vaccine deals has resulted in “vaccine nationalism” rather than collaboration. This is a severe blow to any global vision of universal, equitable, and affordable access. It is for this reason that one of the most important demands of our work is that governments not sign bilateral agreements in a way that undermines a fair global allocation according to public health needs.

MW: The fear expressed through the intellectual property rights and access to medical professionals we interviewed is that pharmaceutical companies will have the ability to determine how far a vaccine will be made and made available because of that own intellectual property and know-how. As one expert put it, she fears that pharmaceutical companies will “play god”. Governments should use their power to ensure that once we have a safe and effective vaccine, once we have a safe and effective vaccine, access to this vaccine, including the ability to manufacture and distribute it, is fair and equitable.

Don’t governments have a responsibility to protect their own citizens first?

MW: While governments have obligations to protect the health of their own people, they also have obligations not to disturb or prevent other governments from fulfilling their obligations to their citizens. There are moral, practical, and strategic reasons – as well as human rights obligations – to work together, especially at times like this when we are grappling with a global public health crisis that affects every country in the world. The virus knows no borders. No country can be completely safe and protected from Covid-19 until the people of other countries are also protected. It is therefore in everyone’s best interests that their governments work together.

AK: Countries and supply chains are globally interdependent. Economies, people’s lives and livelihoods will not recover if countries choose a vaccination strategy that only considers their own people.

Will there be enough vaccine for everyone?

MW: There won’t be nearly enough vaccines to reach the entire world population immediately, but to ensure that we can increase production of vaccines once they are approved, we need to remove some of the barriers that exist in contributing to this shortage, such as exclusive ones Licenses to use the technology behind a vaccine. This is one of the reasons India and South Africa have proposed suspending some provisions of the World Trade Organization (WTO) Convention on Intellectual Property Rights until new infections with Covid-19 have decreased significantly and most countries vaccinated their populations.

AK: A system that allows companies to take control of vaccine supplies and prices without taking relevant intellectual property actions will bring vaccines out of the reach of many resource-poor economies. There are already intellectual property lawsuits against companies developing Covid-19 vaccines and attorneys have publicly warned of the impact intellectual property barriers will have on vaccine availability. Typically, with no government intervention, companies voluntarily license few or even one partner. This strategy aims to increase profits rather than gain access to medication. If companies that manage to get a vaccine approved passed their technology and intellectual property to as many vaccine manufacturers as possible, manufacturers could produce much larger quantities of vaccine doses. This would also reduce the price per dose. This is why technology transfers and IP sharing are so important. It would be inconceivably tragic to allow intellectual property to save lives during a pandemic.

Will Covid-19 Vaccine Be Affordable For Low- and Middle-Income Countries?

MW: Many experts say that the current costs mentioned are too high and there is a risk that the vaccine will become inaccessible for countries that may not have the purchasing power of richer countries. Governments must leverage their leverage, not least because of the huge amount of public funding, to demand transparency from pharmaceutical companies involved in vaccine development and to push for affordability. Given the devastating economic impact of this pandemic and the reality of global poverty, “affordability” in many places means that the vaccine must be free for the patient.

AK: Companies claim they need to get back the money they and their investors spent on research and development. The listed cost per dose – from $ 3 to $ 72 – requires more control. We need transparent pricing coupled with third party audits to ensure that public funds are used to the maximum for the public.

Given the scarcity you describe, what are your thoughts on how limited vaccines might be distributed on a national basis?

MW: Distribution decisions must be based on public health strategies that take into account human rights obligations related to the right to health, life and livelihood. WHO has outlined its initial considerations on distribution during scarcity, which focus on reducing mortality and protecting the health system. You have a group of experts from different fields who will advise you on this subject in the future.

AK: Regardless of the criteria that WHO or governments develop to ensure fairness and equity in distribution, the final solution must be based on government cooperation to resolve the scarcity. Under the WHO framework, an estimated 20 percent of a country’s population could be covered in the initial phase. To expand this, the challenge for all governments acting in good faith is to work together to maximize production and increase that percentage so that there is universal and equitable access.

What lessons can be learned from previous vaccine introductions?

AK: In the past, the availability of vaccines has been limited due to obstacles arising from intellectual property claims. This is what makes vaccines against human papillomavirus (HPV), or pneumonia in children, out of reach for many poor people. If there is one vaccine we need to make sure it is affordable and produced in large quantities and quickly, it is the Covid-19 vaccine.

MW: Too often, decisions about access to vaccines and drugs have been made by opaque, for-profit systems that allow large pharmaceutical companies that have the technology to determine how that technology is used. But this pandemic is unprecedented. If ever there was a time to challenge these systems, this is the time. There are so many people whose lives could be saved and protected from serious illness if a vaccine were made available on an equitable basis around the world.