Needed: A fellowship of countries to fight Covid-19
Find a way to incentivise innovators developing medicines and vaccines, yet ensure access to the innovation is for all
One ring to rule them all, One ring to find them, One ring to bring them all and in the darkness bind them”.
In JRR Tolkien’s story Lord of the Rings, a “Fellowship of the Ring” was formed to destroy the one ring and its evil powers. The fellowship comprised of representatives of different races of Tolkien’s middle earth: Hobbits, wizards, elves, dwarves and men, who were united in their quest, despite their differences. Tolkien’s remarkable story is about how they succeed by acting together.
The coronavirus disease (Covid-19) is clearly the ring binding humanity in its darkness. Sadly, however, there is no fellowship in sight. On the contrary, the dark powers of the ring appear to be dividing countries more than ever before, with increasing protectionism and the decline of globalisation.
The 73rd World Health Assembly of the World Health Organization (WHO), at its virtual meeting on May 18-19, adopted a resolution that recognised the unprecedented challenges posed by the pandemic, and called for “equitable access to and fair distribution of” all essential health technologies and products to combat the virus. It also recognised that extensive immunisation against Covid-19 is a “global public good”. Ahead of the World Health Assembly, more than 140 world leaders and experts made an unprecedented call that all vaccines, treatments and tests be patent-free, mass-produced, distributed fairly and made available to all people, in all countries, free of charge. The WHO assembly, however, failed to achieve consensus on ensuring how this “global public good” of extensive immunisation will be achieved.
The WHO Assembly was preceded by a United Nations General Assembly resolution emphasising on the need for “equitable, efficient and timely” access to any future vaccines developed to fight the coronavirus, as well as a virtual meeting of G20 countries which emphasised that people’s health and well-being are at the heart of all decisions taken to protect lives, tackle illness and strengthen global health security. None of these initiatives, however, addressed how equitable access to medicines or vaccines for addressing Covid-19 can be achieved.
India and the United States (US) were nowhere to be seen in the May 4 virtual summit, co-organised by the European Union (EU), Britain, Norway, Saudi Arabia, Japan, Canada, South Africa and several other countries and non-governmental organisations which collectively pledged $8 billion to research, manufacture and distribute possible vaccines and treatments for Covid-19. The geopolitical tensions between the US and China are threatening any coordinated multilateral response, as well as the continued existence of multilateral institutions which are central to a global effort to find a vaccine. President Donald Trump has announced a freeze on funding to WHO, on the allegations of mismanagement of the Covid-19 pandemic and bias towards China. There are also calls in the US to abolish the World Trade Organization (WTO) whose role in enforcing trade rules have in any event been rendered ineffective by US actions to scuttle the WTO’s appellate body. The US government’s Operation Warp Speed (a partnership between private pharmaceutical companies, government agencies and the military) is focused on the availability of a vaccine, but only for the US while Chinese biotech companies are engaged in similar efforts with their government and the Peoples’ Liberation Army.
Outrage from the French government and the EU has reportedly resulted in the French pharmaceutical company Sanofi withdrawing its plan to give the US priority access to its potential Covid-19 vaccine. Reports on the EU-supported May 4 virtual initiative quote EU officials as stating that while pharmaceutical companies that receive the funding will not be asked to forgo Intellectual Property Rights on the new vaccine and treatments, they should commit to making them available worldwide at affordable prices. This hortatory statement, however, falls flat in the absence of a definitive plan of action necessary to address equitable access.
Who will own, who will have access and on what terms, to the medicines and vaccines that are being developed — this lies at the heart of any real and effective solution to tackle Covid-19. Patents, rights over test data, and know-how, are important economic mechanisms for incentivising innovation and development of new technologies. While dealing with a pandemic of such large dimensions, however, there is a crucial need to balance private profit and the larger public good. In the mid-20th century, both inventors of the polio vaccines — Jonas Salk and Albert Sabin — declined to patent their inventions, an act which ensured widespread access and neareradication of polio worldwide. This stood in stark contrast with one of the largest lawsuits in 1998, when 39 pharmaceutical companies sued South Africa, alleging patent violations resulting from it importing cheaper anti-AIDS drugs and other medicines. While public pressure led to the lawsuit being dropped after three years, it exemplified the complexities and significant litigation risks that can accompany any effort to implement affordable access to patented medicines.
Covid-19 needs an innovative solution, and this is necessary at the stage of research and development and clinical trials, rather than something which can be addressed after a cure is found. The virus has bound our globally interconnected world like no other, and the utility of any vaccine to fight it can succeed only if there is rapid universal access to the cure. That can happen only if governments across the world develop a pragmatic approach that recognises and rewards innovators, while ensuring that access to the innovation is held in trust for the benefit of humankind. We urgently need a fellowship of countries that can fight off, arguably, the 21st century’s greatest challenge.