When future generations speak of this time they will surely highlight the tension between saving lives and humanity, and the narrow accumulation imperatives of those who commodify and make scarce the knowledge we all need to survive.
Whatever institutions we have created to mitigate the impact of the unbridled pursuit of wealth by the few, those institutions can do little when the process of vaccinating the world stutters along at a snail’s pace, not due to scarcity but due to material self-interest.
Even with the seemingly fair distribution system of the Covax framework the scope of demands in the bilateral agreements between countries and Big Pharma is what gives rise to the “vaccine apartheid” a wide cross-section of voices have decried. From Indian development economist Jayati Ghosh to former British prime minister Gordon Brown there is growing consensus — even within the corridors of global power — that placing the vaccination of the world in the hands of “market forces” may result in delays and multiple mutations of the Covid-19 virus, putting the global economy at increased risk.
Ghosh suggested in an article in March that “because a pandemic can be overcome only when it is overcome everywhere, embracing an ‘every-country-for-itself’ approach would seem irrational”. Yet that seems to be the reality. Even the way we speak of the vaccination drive — outside SA’s own apparent bureaucratic weaknesses — is laced with a competitive mood, as if delays in vaccination programmes are weaknesses that can be confined to one country without the effects being transmitted through trade and movement to other countries.
A narrow nationalism has emerged in the middle of a season of paranoia and each one for himself, seemingly oblivious to the concrete reality of the intersecting realities brought about by globalisation. Big Pharma and many of its sub-licensees have used our veneration for the “price mechanism” to maximise profits rather than to prevent avoidable deaths and other social, health and economic costs.
The C19 People’s Coalition, an alliance of organisations committed to an equitable vaccine rollout in SA, says the disparity in prices for the same vaccines sold to different countries has not been explained by many of the pharmaceutical firms. While the public focus has correctly been on the bureaucratic and planning failures that have given rise to delays in our own vaccination programme, little attention has been paid to the role patent, licensing and manufacturing contests have played in delaying the distribution process.
South Africans would be familiar with the role played by our trade officials, alongside their Indian counterparts, in global trade bodies to fight for the know-how and intellectual property waivers that would allow for domestic mass production of patented medicines in the Global South. Many have also noted with concern the unreasonable demands of some of the large pharmaceutical firms that have sought to be indemnified from fault and secure a claim to SA’s sovereign assets. In our case they have even tried to dictate who should sign vaccine supply agreements.
When these firms are asked to make public these secretive claims on the future, as the People’s Vaccine Campaign of SA did, the responses are a mix of terse, wordy and empty spin that provides few answers. It is this aversion to solidarity and accountability in the context of a once-in-a-century crisis that displays the crude pursuit of profit inherent in the global market system.
Big Pharma suggests that its negotiating positions are about protecting the erosion of profits, but it is inadvertently admitting that the expected mutation and recurrence of the pandemic will require diverse pharmaceutical responses over time. It’s about cashing in on both the current crisis and future crises.
In these circumstances it would be dangerous to assume a commonly shared framework of interests between Big Pharma and the people. We are on our own.
• Cawe (@aycawe), a development economist, is MD of Xesibe Holdings and hosts MetroFMTalk on Metro FM.
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