The accelerating vaccine rollout has nurtured growing hope for the end of the COVID-19 pandemic. Ending this unprecedented challenge will require an unprecedented effort. Science and medicine continue to do their parts but the full potential and impact of those efforts now rests on the World Trade Organization to waive intellectual property rights and licensing of technology for COVID vaccines.
So far, the hope of the COVID vaccines is one still held by a privileged few. Canada, with a GDP of $46,000 per capita, has purchased enough doses to vaccinate its people five times over. In contrast, Jordan, with a GDP of $4,400 per capita and a profound COVID-19 burden, has secured doses for only 5 percent of its population. In Africa, the disparity is particularly dire. Of the approximately 400 million people vaccinated globally, only 1.9 percent are on the African continent — though it’s home to almost 17 percent of the global population and 24 percent of the world’s disease burden.
A year after COVID-19 has erupted, stalling the global economy, ravaging countries and exposing our collective vulnerability, wealthy countries are finally shifting their attention and investment to global vaccination efforts. In an act of solidarity and self-preservation G7 leaders recently committed $4.3 billion to finance the underfunded COVAX initiative — a global collaboration to source and fairly distribute COVID-19 vaccines to the most high-risk people in every country. In addition, some countries have committed to sharing a fraction of their surplus vaccines (an estimated 1.2 billion doses) with poorer ones.
While such donation-based models for global vaccination are necessary, they are far from sufficient in ending the pandemic. COVAX aims to vaccinate 20 percent of the population in 92 lower income countries by the end of this year — a goal far below what is needed for pandemic control. The current crisis of global vaccination is driven by vaccine nationalism but more fundamentally by slow supply. At the current global vaccination rate of approximately 10 million doses daily, it would take an estimated 3 years to cover 75 percent of the population with a two dose vaccine (the estimated need for herd immunity). Maximizing global vaccination rates is multifaceted, but a current bottleneck is production, as intellectual property regulations have restricted vaccine manufacturing to a small number of corporations.
There are effective paths to boost the vaccine production necessary in a pandemic of this scale, but they require collaboration, including sharing of IP and technological know-how. In October 2020, South Africa and India submitted a proposal to the WTO to temporarily waive IP rights for COVID-19-related technologies during the course of the pandemic in order to facilitate the necessary emergency vaccine production among manufacturers. Although this waiver has been welcomed by nearly 100 countries, the WTO has not reached a consensus on the proposal due in part to opposition by several wealthy countries and regions — including the United States, European Union and Japan.
Policymakers opposing the waiver argue that existing IP flexibilities, such as voluntary or compulsory licensing, will suffice in expanding production. But these flexibilities have limited real-world results. Many COVID-19 vaccine developers have not taken any steps to voluntarily license or transfer technologies or share IP with the WHO COVID-19 Technology Access Pool. When they have taken steps, it has been restricted; AstraZeneca licensed its vaccine to India, but its agreement is limited to the Serum Institute of India, ignoring multiple capable vaccine manufacturers across South Asia. Government-led compulsory licenses also require a slow, case-by-case approach and their use has been previously undermined by wealthy countries with large pharmaceutical industries, such as the United States and Switzerland.
Merck recently announced that it will help produce the Johnson & Johnson vaccine. A temporary IP waiver coupled with technology transfers could catalyze similar collaborations with currently under leveraged manufacturers worldwide, boosting vaccine production and speeding up global herd immunity. This would save the lives of countless older and medically high-risk individuals in poorer countries, who at the current rate may not be vaccinated until 2024. Achieving global herd immunity as quickly as possible is also critical to prevent new variants from emerging and potentially reducing the efficacy of current vaccination efforts.
Our economies hinge on expanded vaccine production. The International Chamber of Commerce estimates that the global economy may lose as much as $9.2 trillion if poorer countries are not ensured access to COVID-19 vaccines. While sharing of IP will challenge the scale of pharmaceutical profits in this particular moment, we must prioritize a return on investment in lives saved, global health, and ultimately our global wealth and social responsibility.
The IP system is designed to protect research and spur innovation, but its value is quickly eroded when only some get to benefit from technological breakthrough, while billions remain at unnecessary risk. We are undertaking the largest global vaccination effort in human history. To be truly successful, it will require an urgent shift in IP law for this moment that prioritizes human lives.
A temporary sharing of IP will not forever disband the IP system, as some claim. Rather, it will show the full potential of the industry, innovation and science.
And it will unite nations in collaborative action to end a catastrophe that has taken 2.7 million lives. We can prevent there being millions more.
Dr. Vanessa Kerry is a critical care physician at Mass General Hospital, an associate professor at Harvard Medical School and CEO of Seed Global Health which partners with governments to invest in health care capacity for national, economic and human security. Parsa Erfani is a Fogarty Scholar at the Harvard T. H. Chan School of Public Health.