Hurdles for universal vaccination
June 15, 2021
Will patent-free vaccines and medicines really become a reality? Or will poor countries have to buy expensive medicines from the companies, thereby forcing people to die without medicines and vaccines if they are unable to buy them? — Dr. Ashwani Mahajan
Today, the pandemic, which the whole world is constantly battling, has shaken the entire humanity. Even the mighty nations, despite their immense economic power and advanced health facilities, appear awfully helpless. India, too, faced such a situation in the months of April and May, when we had to deal with an acute shortage of oxygen, hospital beds and even medicines.
Vaccination is being considered across the world as a panacea for Covid-19. Significantly, six countries, including the US and Israel, have freed their people from the compulsion of wearing masks while vaccinating the majority of their adult population. Therefore, it is believed that if we vaccinate our entire population, we will also be able to minimize the health and economic damage from this pandemic.
Unequal distribution of vaccines
If we look at the availability of vaccines in the world, we find the distribution to be highly skewed. If our aim is to eliminate this pandemic from the world, it is necessary to vaccinate the whole world. It has to be understood that all the countries of the world are connected with others, in some way or the other. If any country is completely or partially left, this pandemic can raise its head again.
Significantly, after the outbreak of this pandemic, vaccination was found to be the only trustworthy solution. Work for vaccine development then started in India with both indigenous and foreign efforts. Two indigenous efforts have been fruitful in India. One of these is for the manufacture of Covaxin by Bharat Biotech Company, which has set the target of manufacturing 550 million vaccines between August and December. The second one is the vaccine of a company named Biological E of Hyderabad, which has booked an order for 300 million doses from the Government of India to be delivered between August and December this year. Apart from these, a major effort was made for vaccine development in India by the Serum Institute of India in collaboration with the Oxford University. According to the estimates of the Government of India, between August and December, the Serum Institute will manufacture and make available 750 million vaccine doses. The Government of India has announced that the entire population will be vaccinated by the end of the current year. On June 7, 2021, Prime Minister Narendra Modi also announced free vaccines for all from June 21.
World is worried
Due to the huge potential of vaccine manufacturing in India and the efforts made, since the beginning, by the government, the speed of vaccination in India has been higher than that in other countries, but due to the large population of the country, the target to vaccinate the entire population is a bit distant. It may be true that by the end of the year we should be able to complete our target of vaccinating the entire population. But if we talk about the rest of the world, we find that, except for a few countries of the world, including India, most of the countries do not have the capacity to manufacture vaccines. India has been a major source of vaccines for the world. These countries would be dependent on select companies of the world to buy vaccines.
Due to the ongoing patent system and other types of intellectual property rights (IPRs) in the world, most of the global companies are selling vaccines at very expensive prices. It is worth mentioning that whereas, in the initial phase in India, vaccination was mostly done free of cost by the government after procuring vaccines at a price of nearly Rs 150 per dose and the private sector was administering the vaccine at Rs 250 per dose, global companies like Pfizer and Moderna are selling the vaccine at US$ 20 to 50 (1500 to 3750 rupees) per dose. Governments or people of poor countries cannot afford such an expensive vaccine. Price is the biggest barrier to universal access to vaccines. One can understand that patents and IPRs are the biggest reasons behind the high price of vaccines.
To overcome this obstacle, India and South Africa have urged the World Trade Organization to grant Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver for a limited period. In October 2020, the two countries jointly proposed in the World Trade Organization (WTO) that in view of the corona pandemic, vaccine and essential medicines should be exempted from the provisions of TRIPS for a certain time period (to be determined) to ensure adequate production and availability of vaccine and medicines at reasonable prices. This effort has already got the support of more than 120 member countries. At the end of May, a meeting of the proposer countries was held for this, in which these countries finalized a proposal that demands exemption from the provisions of TRIPS for Covid vaccine and medicines for at least 3 years. This proposal also demands ensuring of essential raw materials for the production of vaccines and medicines, technology transfer and freedom from trade secrets.
It has to be understood that while the TRIPS Agreement provides for the protection of IPRs, it provides for numerous flexibilities as well, whereby, in the event of a health emergency, pandemic etc., the provisions of TRIPS can be relaxed to work for humanity. In addition, more clarifications were given on this subject in the Doha Declaration on the TRIPS Agreement and Public Health at the Ministerial Conference of WTO held in Doha in 2001. It has been clarified in the Doha Declaration that in the event of a public health crisis, pandemics, serious diseases like HIV-AIDS and others, the member countries will have the right to make medicines available in sufficient quantities and also export them at affordable prices by issuing compulsory licences for medicines.
It is observed that due to subjects like patents and other IPRs, monopoly on technology and raw materials, trade secrets etc., there are obstacles in the access to vaccines and medicines to poor countries. Unfortunately, European countries and some other developed countries are creating obstacles in the way of these efforts of India and South Africa for TRIPS waiver for humanity. But it is a matter of satisfaction that the US administration has changed its earlier stand and now they have supported the proposal of TRIPS waiver of India and South Africa for the vaccine (not so far for medicines). On June 8, there was a pleasant development that member countries resolved to go for a text-based discussion on the issue despite some reservations shown by the European Union and a few other countries.
It will become clear in the months to come whether humanity will win in the face of corporate profits. Will patent-free vaccines and medicines really become a reality? Or will poor countries have to buy expensive medicines from the companies, thereby forcing people to die without medicines and vaccines if they are unable to buy them? The need of the hour is that the humane forces of the society ensure the victory of the human race by creating public pressure to ensure patent-free vaccines and medicines.
(Dr Ashwani Mahajan is a Professor at PGDAV College, University of Delhi and National Co-Convenor of Swadeshi Jagaran Manch)