Today, even the most remote communities have been impacted by the covid-19 pandemic and only a global approach can fight it efficiently. Whilst the pandemic is being contained and vaccination rates climb in developed countries, developing nations are receiving few vaccine doses and leading the charts of infections and deadly cases. The World Health Organisation’s Director-General, Tedros Adhanom Ghebreyesus, alerted, “The global decline masks a worrying increase in cases and deaths in many countries.” The recent number of deaths per 100 confirmed cases were 9.4% in Peru, 9.2% in Mexico, 4.2% in Afghanistan, 3.5% in Tunisia, 3% in South Africa, 2.6% in Indonesia. [1]
Although we welcome the G-7 countries’ initiative to send close to 1 billion vaccines to low and medium-low income nations, this strategy alone will not solve the pandemic, as it is far from the 11 billion vaccines needed to achieve the goal of vaccinating 70% of the world’s population to end the pandemic by next year. Moreover, since vaccines are expected to be administered by 2022, this initiative only provides a minimal solution to a problem that requires a more urgent approach to diminish social, health and economic crises and reduce the possibility of mutation of the virus.
An extraterritorial legal obligation
In April 2021, the UN Committee on Economic, Social and Cultural rights outlined States’ duty of international cooperation and assistance to ensure access to vaccines against covid-19 wherever needed, so as to contribute to the achievement of universal and equitable access to vaccines. This translates into a legal obligation, both for high-income countries to support the COVAX initiative, and for vaccine-producing countries to facilitate access to the health treatment.
Inequitable distribution of vaccines
As of April, 87% of all vaccines administered worldwide had gone to high-income or upper middle-income countries, while low income countries received a mere 0.2%. In addition, within countries throughout the world, the response to the pandemic has exacerbated inequalities already faced by many minority and vulnerable groups, such as people of African descent, indigenous peoples, migrants, refugees and asylum seekers, and have left behind the vast majority of people living in prison, detention centres, and in places of custody. These discrepancies are exacerbated by the devastating human cost of corruption, with human rights abuses committed where governments fail to guard against fraud and bribery in healthcare supply chains as they secure essential medicines in the fight against covid-19.
Such discrepancies are particularly alarming since they pose a threat to global public health. Experts have demonstrated that the longer community spread is sustained, as it occurs in non-vaccinated communities, the more likely that the virus will mutate, opening the grounds for more aggressive strains to arise. Mutations can cause vaccines to stop working, since they work by teaching our antibodies to recognize a virus by its genetic code—a code that changes when mutated. This means that even those who have been vaccinated and live in areas where the population has been vaccinated will be at risk of infection if further mutations develop, spoiling all hard-won progress reached until now. Global herd immunity is essential in the fight against the pandemic and cannot be achieved by excluding entire regions of the globe from vaccination.
Priorities need to shift
In the wake of such discrepancies, it is of serious concern that vaccination of low risk sectors, such as young people without health problems, is prioritised in high income countries over that of frontline healthcare professionals which remain unvaccinated in developing countries due to lack of vaccines. Countries such as the United Kingdom and Canada have procured enough supplies to give each person eight and 10 vaccine doses, respectively, [2] while in countries like Niger, Democratic Republic of Congo, Cameroon, Syria, Yemen, and Tajikistan, among others, vaccination rates have not even reached 1%.
For these reasons, we urge high income states with excess vaccines to immediately send doses—including the doses previously identified for minors in their countries—to poorer countries. COVAX donations should be prioritised over the vaccination of minors with little or minor health issues and who are at a low risk of suffering severe covid-19 symptoms.
Slow vaccine production
While many States worldwide do not produce vaccines themselves, the UN Committee on Economic, Social and Cultural rights outlined how “intellectual property rights are not a human right, but a social product, having a social function. Consequently, States parties have a duty to prevent intellectual property and patent legal regimes from undermining the enjoyment of economic, social and cultural rights." [3]
Besides COVAX, the most effective way to fight against the virus in a timely manner will be to increase and cheapen production of the vaccine, mainly by expanding the number of manufacturers that are currently producing the vaccine. While we note the G7 decision to increase the coordination of global manufacturing capacity on all continents, these fall short of important decisions called for by UN human rights experts to lift legal protection for intellectual property and patents in order to facilitate the right of everyone to get access to safe and effective vaccines, as called for by nine UN Human rights experts, on the eve of the meeting.
Intellectual property cannot be an obstacle to fight a pandemic that so far has caused over 4 million deaths worldwide. We thus urge the high-income Nations to agree on a temporary suspension of patents for vaccines, treatments, and technologies fighting against covid-19 that is being discussed at the WTO.
In addition, the claims that insist that suspension of patents would undermine the intellectual property incentive for vaccine research are not true. The suspension would be limited in time and scope and would have a clear objective: facilitate global access to covid-19 related products. Moreover, pharmaceutical companies that have conducted vaccine research have already received extensive R&D support from governments, reducing the need for patent monopolies. More than €7 billion of public funds have been used to support research of a selected number of multinational pharmaceutical corporations on covid-19 vaccines, which contrasts with the gains companies have received from selling the vaccines, arising to over $15 billion for Pfizer, over $18,4 billion for Moderna and over $10 billion for Johnson & Johnson, without including the price of their shares, which have skyrocketed between 400-700% since February 2020.
Another misconception is that lower or middle-income countries do not have enough capacity to produce the vaccines, which does not reflect reality, as there are numerous companies specialising in generic treatments capable of producing the vaccine. The largest manufacturer of vaccines, the Serum Institute that produces the AstraZeneca vaccine, is based in India, and thus acts as the manufacturer for high income states at its own expense, whilst most of the benefits, including vaccines and ownership of patents, profit high-income countries.
In a vicious cycle, poverty has exacerbated the pandemic’s impacts on lower income countries and simultaneously the pandemic has exacerbated poverty. It is imperative that all decisions regarding covid-19 follow States’ extraterritorial human rights obligations and health experts’ recommendations to avoid an even greater global social, economic, and health crisis from which we cannot recover.