Vaccine anniversary imperatives
Tuesday, Dec. 14 marks the one-year anniversary of the first COVID-19 vaccine given out in the United States. Since that time, over 8 billion doses have been administered around the globe. And yet only about 7% of those doses have been given out in low-income countries. The recent omicron variant, first reported in South Africa at a time when it was already spreading in other continents, emerged in the face of this global vaccine inequity; South Africa had a 25% vaccination rate in the country at the time of the variant’s discovery.
Essential new treatments for those stricken with COVID may be being denied to those living in poorer nations. Wealthy countries alone will soon have access to new oral antiviral therapeutics, one of which, Paxlovid, has the potential to protect the unvaccinated at risk for severe disease at a rate of approaching that of vaccination (89% protection from hospitalization and death). The world has not committed yet to expanding their use to low-income countries.
Advocacy to resolve these deeply immoral inequities can’t be left to the World Health Organization and Doctors Without Borders alone. And so a collective of health care providers, researchers and students at academic medical centers around the United States — of which we are a part — has formed to work toward the goal of global equity in COVID-19 vaccines and treatments. We call ourselves White Coats for Global COVID Equity, and we believe that by urgently taking the following six steps we can immediately help end one of the greatest threats to global health in more than a century.
Waive patents for vaccines
Waiving patent rights temporarily on vaccines allows countries with limited resources to manufacture vaccines on their own. This is currently not happening. Instead, pharmaceutical companies that hold patents on COVID-19 vaccines continue to reap billions of dollars in profit. A World Trade Organization provision to waive patents during medical emergencies has existed since 1995. The U.S. government has indicated its support to temporarily waive patents. In October 2020, India and South Africa formally proposed to the WTO General Council that intellectual property provisions for vaccines be temporarily waived.
This request was denied.
Waiving patents for COVID-19 vaccines needs to happen now, with additional support for technology transfer. Patent waivers, especially for Moderna, which benefited from NIH vaccine experts and taxpayer money, are a moral, ethical and public health imperative.
Increase vaccine manufacturing capacity in high-income countries
Pharmaceutical companies are not producing vaccine to sufficiently supply the entire world. The U.S. could encourage public-private partnerships through voluntary licensing agreements or invoke the Defense Production Act to increase manufacturing capacity. Equally important is increased production of materials like the lipid particles encasing the mRNA in the mRNA vaccines.
Donate surplus vaccine doses
The World Health Organization estimates that countries in the G7 are hoarding at least 600 million doses of vaccine. Doctors without Borders estimates that 241 million doses will be wasted in these countries by the end of 2021 due to reaching expiration dates. Just in the U.S. alone, millions of doses have been thrown out after reaching expiration. Donations have been slow and far below promised volumes.
Support coordinated vaccine distribution strategies to maximize impact
The U.S. should work with COVAX — a global initiative to make COVID-19 vaccine access universal — and with other relevant agencies and authorities to distribute vaccine doses in a way that responds to evolving local needs and maximizes impact. The U.S. should also provide resources to support the health infrastructure needed to provide vaccines.
Encourage philanthropy from the corporate world
We need to better encourage vaccine donations from high-income countries and pharmaceutical companies. A key component of this effort will be facilitating donations from wealthy companies to purchase vaccine supplies needy nations. The five Big Tech companies — Apple, Amazon, Google, Microsoft, Facebook — had a combined income of $1.2 trillion during the first year of the pandemic. Even a $25 billion investment ( just 2% of that revenue) for Moderna doses would massively boost supplies for the world.
Avoid international travel bans and instead support early detection
Travel bans offer only short-term public health benefits — and only if they are applied universally to all places where variants of concern have been identified. More often they result in inappropriate blame and devastating economic effects and effectively punish scientific cooperation. The most appropriate strategy to mitigate the impact of new variants is to expand COVID-19 testing at ports of exitand entry and in high-risk communities; redouble efforts to improve global vaccination rates to prevent the emergence of future variants; and support global surveillance for new variants.
The points above aren’t temporary fixes: They will be applicable as future COVID-19 variants, vaccines and treatments emerge. As we celebrate the anniversary of the COVID-19 vaccine being given out in the United States, we are faced with the stark reminder that the world is little closer to its goal of ending the pandemic worldwide than it was a year ago.
U.N. Secretary General António Guterres said in February that “vaccine equity is the biggest moral test before the global community” at this time. Doctors, researchers and public health experts like us across the country are uniting to lend our voices to that fight. We hope you’ll join us.