Washington, DC — "Global supply should not be dependent on the purely commercial prerogatives and exclusive rights of pharmaceutical companies holding the technology. There is simply too much at stake."
An international coalition of 250 civil society groups on Tuesday urged the head of the World Trade Organization to embrace a temporary suspension of coronavirus vaccine-related patents, warning against pursuit of a voluntary approach that would keep life-saving technology under the total control of pharmaceutical corporations—and entrench massive global inequities.
The coalition's demand came as WTO Director-General Ngozi Okonjo-Iweala was set to hold a closed-door meeting Wednesday with major drug manufacturers and government officials from around the world to discuss possible solutions to what she described as "glaring" inequities in global vaccine production and distribution. The World Health Organization (WHO) estimates that just 0.2% of total Covid-19 vaccine doses have gone to people in low-income nations.
"Relying on contract manufacturing and voluntary licensing is the approach that has led to massive shortages with a few firms controlling if, where, and when supply will be manufactured and can be sold or distributed and at what price." —Public Citizen
While Okonjo-Iweala has pressed WTO member nations to find a "third way" between the intolerable status quo and the patent waiver proposal led by India and South Africa, the coalition of advocacy groups warned in their letter (pdf) Tuesday that the alternative paths suggested by Okonjo-Iweala and a handful of WTO member nations rely on an industry-friendly strategy that has proved to be a failure.
"The proposed approach is... mainly centered on bilateral agreements controlled by corporate rightsholders," the groups argue in the letter. "The same strategy has already been used by the pharmaceutical industry for the past year, including the oft-cited Oxford/AstraZeneca agreement with the Serum Institute of India. There is considerable experience on the constraints such agreements put on local production and equitable worldwide access to life-saving pharmaceuticals."
"Bilateral agreements that have been signed to date contain restrictive terms and conditions that reinforce vertical control of technology-holding companies, artificially limit production, and supply to constrain global supply options, and are mostly un-transparent with governments," the letter continues. "These agreements also depend on the 'willingness' of the technology holder to license at all and as such are failing to mobilize global manufacturing capacity."
The pharmaceutical industry's unwillingness to share its technology to facilitate more equitable global production is evident in companies' refusal to take part in the WHO's Covid-19 Technology Access Pool, the coalition notes. Not a single company has agreed to participate, with Pfizer's CEO calling the pool idea "nonsense."
"Unfortunately, only limited, exclusive, and often non-transparent voluntary licensing is the preferred approach of some companies, and this is proven to be insufficient to address the needs of the current Covid-19 pandemic," the WHO told the Washington Post last month. "The entire population and the global economy are in crisis because of that approach and vaccine nationalism."
The best way to quickly overcome industry intransigence and ramp up vaccine production to meet global needs, the coalition argues, is to "remove barriers towards the development, production, and approval of vaccines," a step that would allow manufacturers to replicate vaccine formulas and massively ramp up production for developing countries.
"Global supply should not be dependent on the purely commercial prerogatives and exclusive rights of pharmaceutical companies holding the technology," the letter states. "There is simply too much at stake. In the context of WTO, temporarily waiving relevant intellectual property rules that reinforce monopolies is an important contribution."
Among the letter's 250 signatories are Amnesty International, Médecins Sans Frontières (MSF) Access Campaign, Save the Children South Africa, and the People's Vaccine Alliance.
In a statement on Tuesday, consumer advocacy group Public Citizen—one of the letter's signatories—dismissed the WTO's meeting Wednesday as "a distraction from an effective initiative that falls squarely within the WTO's actual remit."
"That would be a temporary Covid-19 waiver of patent, copyright, industrial design, and undisclosed information terms of the WTO Trade Related Aspects of Intellectual Property (TRIPS) agreement," Public Citizen said. "Relying on contract manufacturing and voluntary licensing is the approach that has led to massive shortages with a few firms controlling if, where, and when supply will be manufactured and can be sold or distributed and at what price."
"Horrifyingly," the group added, "the world is not expected to reach herd immunity until 2024 under this regime."
While Okonjo-Iweala has been outspoken about the need to confront "vaccine nationalism" and tackle "morally unconscionable" inequities in access, she has thus far declined to join the WHO chief in supporting India and South Africa's proposed patent waiver, which is backed by more than a 100 countries. Instead, she has called for a "pragmatic" approach—which critics view as a bow to Big Pharma's political power in the United States and Europe.
Because the WTO operates by consensus, just a handful of rich nations—including the U.S., the United Kingdom, and Canada—have been able to block the patent waiver, an idea that the pharmaceutical industry has aggressively lobbied against.
With the next full meeting of WTO member nations set for May 5, progressive advocacy groups are pressuring President Joe Biden to throw U.S. support behind the push for a temporary patent suspension as scientists warn that failure to quickly ensure global vaccine access could allow dangerous vaccine-resistant mutations to emerge and spread widely.
Next week, advocacy groups led by Justice Is Global are launching a "Week of Action for Vaccine Internationalism" to pressure Biden to support the patent waiver.
"We need 12-14 billion doses distributed this year to people all around the world," the campaign's website declares. "To do that, we need to waive patents, share production know-how, and fund vaccine production and distribution. The Biden administration has the power to deliver on all of this."