How can governments negotiating a new deal on pandemic preparedness and response make sure they don’t repeat the failures of COVID-19? They must ignore corporate lobbying and address the patent regimes that blocked billions from accessing lifesaving vaccines, says Abha Jeurkar
The failure to get COVID-19 vaccines to billions of people living in the poorer parts of the globe has rightly been described as “a broken promise to the world”. In 2021 alone, more than half a million lives could have been saved if G7 nations had not fallen woefully short of their vaccine donation targets. As delegates gather for next week’s World Health Assembly, a huge question will loom over the summit: how do we avoid this terrible health injustice and loss of life in the next pandemic?
A new global pandemic framework
Since December 2021, delegates from 194 countries have been negotiating what has come to be known as the “pandemic treaty” that will set out agreed mechanisms to improve pandemic prevention, preparedness, and response. Research suggests that there is a 38% chance that we will experience another COVID-19-like pandemic in our lifetimes, and climate change further increases that risk. If we are to live with the threat of pandemics, countries must work together to be able to prevent and respond effectively. A lot is at stake; especially since early evidence indicates attempts by powerful blocs of nations to water down some of the important treaty provisions.
Secret discussions don’t give us confidence
From February 2022, negotiators for the pandemic treaty have convened five times. Yet many of these discussions were held behind closed doors, excluding any meaningful participation and scrutiny from civil society organisations, media, and the public. Both China and the United States have voted to keep the negotiation text private, showing unusual solidarity and prioritising political interests over principles of transparency and accountability.
Civil society organisations, including the People’s Vaccine Alliance and Oxfam, have repeatedly raised their concerns regarding the secret nature of these negotiations warning that this practice has “set a dangerous precedent for norm-setting at the multilateral level”. At a time when public trust in multilateral institutions, such as the UN or WHO, has been waning, it is critical that these discussions be thrown open to scrutiny from people whose very lives will be impacted by them.
The dangers of capture by Big Pharma
Pharmaceutical companies were hailed during the COVID pandemic, for having produced vaccines in record time. However, it was their blinkered approach to profit maximisation that was primarily responsible for the gross inequity in vaccine access around the world. These companies struck secret deals with governments, prioritised high-income countries, sold vaccines at excessive prices, refused to share intellectual property, and monopolised supply.
The original “zero draft” of the treaty recognises that “equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness and response”. Although many countries provide lip-service to the importance of equity as a guiding principle for the treaty, they must translate this rhetoric into action. To achieve truly equitable access to health tools during a pandemic, countries must boldly challenge the orthodoxy of intellectual property (such as patents) laws at the root of the inequitable COVID-19 response, mandating pharmaceutical companies to share technology and know-how of life-saving drugs, particularly to ramp up manufacturing capacity in low- and middle- income countries.
And the record of richer countries on promoting equity so far has not been good. In fact, countries in the Global North – US, UK, Canada, Australia, and Japan, among others – have consistently opposed provisions in the treaty that mandate action from companies or countries. A leaked draft of the negotiations is peppered with comments from country delegates that blunt the edge of the mandatory provisions with clauses such as “where appropriate and feasible”, “voluntarily”, and “on mutually agreed terms”.
What we have learned from previous pandemics is that leaving global health dependent on the generosity of rich countries and pharma corporations in this way does not lead to improved access to medicines. In fact, three years into the COVID-19 pandemic, there have only been a couple of instances of pharma companies voluntarily licensing production to companies in the South. At the same time, radically new models like that of the mRNA Technology Transfer Programme based in South Africa face an uncertain future, as they wade through the thicket of patent barriers around mRNA technology.
Battle lines between Global North and South
These treaty negotiations have laid bare the geopolitical tensions between the Global North and South. Whereas countries such as Nigeria, Chile, Brazil, and Egypt support time-bound waivers of intellectual property rights, countries such as the US and UK oppose them.
Another disputed issue between the two blocs is that of “pathogen access and benefit sharing”. Crucial genetic data – about the pathogens that cause infections – needed to develop new drugs comes from the Global South, and yet these countries are pushed to the back of the queue for these same drugs. It is perverse that the very people taking part in trials to develop these lifesaving medicines are last in line to get the finished vaccines. South African scientists compared this to a country making goods for the world and watching them be shipped to richer countries, while its own citizens starve.
Similarly, the principle of “common but differentiated responsibilities (CBDR)” has been a bone of contention. The principle, originally applied in climate justice negotiations, means that states have different obligations when it comes to global challenges, and that these can vary depending on how wealthy a country is and how much it has historically contributed to the problem (so rich countries have greater responsibility to tackle climate change, for instance). Brazil, the Africa Group, Malaysia, India, and small island countries support applying such differentiated responsibilities in the pandemic treaty, but Japan, US, and the EU do not.
People over profit
We are not going to be any better prepared for the next pandemics if countries continue to put their national interests over global public health. Profit will not drive the vast and more equitable manufacturing and distribution effort needed to meet the challenge of a global health emergency. We should not promote the same old colonial model where richer countries control access to resources, as poorer nations wait, dependent on their charity.
Without concrete actions to meet the health needs of people in poorer countries, the treaty will be nothing more than beautiful words on paper. The challenge of future pandemics will loom large at next week’s World Health Assembly. What is clear is that the new pandemic treaty needs to radically challenge the status quo and take on special interests that have led to profit, not people’s health, driving policy making.
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