Asian, African, and European states got near unanimous backing for a resolution calling for the pooling of patents and affordable access for any vaccine against the cororonavirus, after winning some critical diplomatic and practical arguments in favour of global cooperation.
#WHA73 adopted the EU-led COVID19 response resolution by consensus: Recognising a COVID19 vaccine as a global public good, an unprecedented number of >140 @WHO members co-sponsored the text, demonstrating overwhelming solidarity and a multilateral global response to the pandemic! pic.twitter.com/2J4VYm2Kq6
— EU at the UN – Geneva (@EU_UNGeneva) May 19, 2020
Their resolution at the World Health Organisation’s assembly in Geneva on 18-20 May committed all member states to work collaboratively for the development of therapeutics and vaccines for the COVID-19 response and “voluntary pooling and licensing of patents to facilitate equitable and affordable access to them”.
Theory VS Reality
On paper, this would allow cash-strapped countries to override patents to get access to new therapeutics and vaccines against the virus. Its reference to the Doha Declaration on Intellectual Property and Public Health, means the backers of this resolution could draw on the authority of the World Trade Organisation to implement it.
Just how that might work was thrown into doubt at the Geneva summit when the United States delegation disassociated its government from those commitments. US diplomats, led by Washington’s ambassador to Geneva, Andrew Bremberg, a close ally of President Donald Trump, were trying to win support from African and other delegations for a condemnation of Tedros Adhanom Ghebreyesus as Director General of the WHO.
They were also seeking a dilution of the resolution’s call for a ‘people’s vaccine’.
“A puppet of China”
Washington’s case wasn’t helped by President Trump’s calling the WHO a “puppet of China”. He followed that up with a threat to withdraw the US from the WHO within 30 days unless it implemented unspecified reforms.
“Trump’s use of the WHO Assembly to pursue his campaign against China played into Beijing’s hands,” said one delegate at the meeting. “The mood was that we have to work together now to tackle the pandemic … then do the analysis and the investigations later.”
Responding to Trump’s statements, China’s President Xi Jinping rejected what he called bids to politicise the WHO, then offered $2bn in fresh funding to compensate for the loss of the US contributions, which Trump suspended last month.
Xi added that China would also support the calls for a vaccine to be classed as a global public good. This is an important statement, given that China is a key competitor, along with Europe and the U.S., in the race to produce a safe and effective vaccine.
One of the African ambassadors in Geneva told The Africa Report that there had been no support for the US position. “They tried to organise some meetings but there was no interest in that … in the end the US officials spoke only to the Cameroonian ambassador.”
US gets no support
Bremberg and his team, despite brandishing a four-page letter from President Trump lambasting the WHO and Tedros, failed on all counts. They could not get any other member states to back them.
Under current conditions there was no guarantee that logic would prevail over political interests.
The Cameroonian Embassy, which represents the Africa group at the UN in Geneva, had put out a statement calling for universal access to the vaccine and commending Tedros’s handling of the pandemic.
In the end, the US delegates argued that the assembly’s decision on access to the vaccine would take away the profit incentive from pharmaceutical companies to develop a vaccine. They went on to argue that doing so was a “misinterpretation of international trade obligations” which would discourage companies from “new drug development and expand[ing] access to medicine.”
No place for rich country domination
This debate followed an open letter on 14 May from South Africa’s Cyril Ramaphosa, Senegal’s Macky Sall and Ghana’s Nana Akufo-Addo, and another 40 international public figures arguing that a vaccine was the world’s best chance of “putting a stop to this painful global pandemic.”
This reflects a concern that just as rich countries have dominated the market for medical technology, such as ventilators and oxygen machines, even for personal protective equipment, they would marginalise poorer countries in the distribution of vaccines.
The letter says “we cannot afford for monopolies, crude competition and near-sighted nationalism to stand in the way” of universal access to a vaccine.
“New space race”
There are over 70 candidates for an effective vaccine in research currently. Some liken the rivalry to a new space race.
The prize would be the national kudos of having got there first. But many public health experts are sceptical that producing the vaccine will be a unilateral project. “The Ebola vaccine was ‘discovered’ in Canada, tested in the United States and then manufactured in Germany,” said one of the industry delegates in Geneva.
Before any proposed vaccine gets international acceptance, there will have to be extensive clinical trials. Regulators will have to approve each stage in the development and manufacturing of the vaccine.
Getting a vaccine past stringent international safety and quality controls will test the resources of the biggest pharmaceutical conglomerates, even in the middle of a global health emergency.
That could give the WHO a gatekeeping role in managing the production and distribution of the vaccine. It also fits in with the aims of other international partnerships to raise money for vaccine development – the Access to COVID-19 tools (ACT) Accelerator and the Coalition for Epidemic Preparedness Initiatives.
Last month, the European Commission raised €7.4bn for the development and distribution of vaccines against coronavirus, saying it was committed to make it available to the poorest countries.
But representatives from some of the biggest pharmaceutical-producing countries, such as Argentina, Brazil, India, Russia and the United States weren’t there and have shown no interest in backing the initiative. That raises the spectre of vaccine nationalism.
Perhaps the organisation best placed to fight that is the WHO itself but if the US quits and ploughs ahead unilaterally, it will weaken both the organisation and prospects for global health cooperation, say officials in Geneva.
“In the end, I think the US will probably cut a deal and stay in the WHO,” said a diplomat in Geneva. “If you look at all the US officials working at [the] WHO headquarters and its collaboration with the Center for Disease Control in Atlanta, it’s in the interests of global health security.” But, he added, that under current conditions there was no guarantee that logic would prevail over political interests.
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