Eighteen months after SA and India began their campaign for a temporary waiver on intellectual property rights for coronavirus vaccines to make it easier for more countries to make their own more affordable jabs, their efforts are being stymied by rich nations. Talks at the World Trade Organisation are moving at a glacial pace, despite the support of more than 100 countries, as the EU, UK and Switzerland show little sign of softening their opposition to change.
The waiver campaign is a response to the yawning divide in vaccine access that has become a defining feature of the coronavirus pandemic. Today barely 17% of people in Africa have been inoculated, while in rich nations the figure exceeds more than 90%. The continued inequity now sees wealthy countries providing booster shots to their citizens before the majority of people in poor ones have received their first.
Many factors have fuelled the divide. Rich countries had the means to place advance orders for vaccines and snap up supplies before they had even been proven to work; pharmaceutical companies prioritised the governments that had helped fund their research; and politicians imposed temporary export bans to protect their constituencies.
But the central issue is that global vaccine manufacturing capacity has contracted sharply in the past two decades and is now largely concentrated in a handful of wealthy nations. Africa is particularly vulnerable, importing 99% of the vaccines it uses. That many pharmaceutical companies continue to refuse to share their know-how, despite receiving extensive public funding, has amplified and prolonged the problem.
Countries opposed to the waiver say expanding vaccine manufacturing capacity is unlikely to alter the pandemic’s trajectory because sharing recipes, transferring knowledge and building the requisite infrastructure would take years to yield results.
But the recent success of scientists at the World Health Organisation mRNA vaccine technology transfer hub in Cape Town challenges this notion head-on.
The mRNA technology used in the vaccines made by Pfizer-BioNTech and Moderna can be most quickly adapted to new coronavirus variants yet remains tightly protected. So much so that scientists at the hub recently produced small quantities of their own mRNA coronavirus vaccine using publicly available information on Moderna’s shot, but without the company’s involvement. If Moderna had given them a helping hand, scientists say it would have drastically reduced the time required to demonstrate the jabs they have made are safe and effective.
Given the 21-million vaccines the government has on hand, it would be easy to think the waiver campaign no longer matters. But that would be a mistake.
First, these are not doses in excess of the nation’s need. The stockpile that has built up is largely a reflection of faltering demand, due in no small part to the fact that the government has shied away from imposing vaccine mandates. As a result, daily vaccination numbers have fallen to about a third of their August peak of more than 241,000 and the government is now scrambling to ensure 7m Pfizer-BioNTech jabs that will expire midyear do not go to waste.
Second, the waiver campaign is broader than vaccines. It includes treatments and tests, which remain stubbornly expensive in SA. Relaxing the rules on intellectual property rights would enable more competition and drive down prices. New generation vaccines are also coming through the pipeline.
Without new measures to enable more manufacturers to enter the market, and reduce dependence on the excess production capacity of wealthier countries, SA risks being pushed to the back of the queue again if new coronavirus variants emerge that require novel technology to hold them at bay.
SA has been one of the few African countries that could afford to purchase vaccines directly from pharmaceutical manufacturers. Even so, it was subject to unexpected delays that left the country’s most vulnerable citizens largely unprotected when the third wave struck last winter. A replay of those tragic events would be unconscionable.
It is clear the trade rules have failed to provide the right environment for the production of enough tests, vaccines and treatments to combat the pandemic in a just and fair manner. It is time for change.
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