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Ahead of a key World Trade Organization meeting at which ministers are being urged to finally back a temporary intellectual protection waiver proposal on coronavirus-related technologies, a new report highlights ongoing vaccine inequity and a situation in which global health has been “left hostage” to Big Pharma.
Released Monday and entitled Losing Time: End this pandemic and secure the future, the publication comes from the Independent Panel for Pandemic Preparedness and Response, a body established by the World Health Organization (WHO).
“The idea that a poor health worker is unprotected while the healthy and wealthy receive booster doses should present a deep moral quandary. To this there is only one solution—vaccine equity.”
The report addresses progress on a suite of reforms the panel recommended six months ago regarding the current pandemic as well as future ones.
“There is progress, but it is not fast or cohesive enough to bring this pandemic to an end across the globe in the near term, or to prevent another,” panel co-chairs Helen Clark, former prime minister of New Zealand, and Ellen Johnson Sirleaf, a Nobel Peace Prize laureate and former president of Liberia, wrote in the report’s preface.
“Waves of disease and death continue,” they said, “as people in the Northern Hemisphere move indoors, fatigue with restrictions sets in, vaccine coverage and other countermeasures remain uneven, and people in the poorest countries have almost no access to vaccines.”
“We ask: if this pandemic cannot catalyze real change, what will?” wrote Clark and Jonhson Sirleaf.
While 67% of the population of all high-income countries are fully vaccinated, it’s a vastly different situation for low-income countries, where less than 5% of people have received a single dose, the report notes.
The dire impact of that disparity is clear, the report adds, as deaths have increased fastest in the regional groups with the lowest vaccination rates. Since December 2, 2020, high-income countries have seen a roughly 167% increase in Covid-related deaths. In low-income countries, by contrast, there’s been a 339% increase.
Driving that inequity is richer nations having gobbled up doses, while their promises of donated vaccines have fallen short. According to the report:
The independent panel called for high-income countries with an adequate supply pipeline to redistribute at least one billion vaccine doses to [low- and middle-income countries] by 1 September 2021. They did not meet that target. As of 16 November, 1,494 billion doses have been committed through the Advance Market Commitment (AMC) window of the COVAX Facility, of which 256.5 million had been delivered. Meanwhile, the capacity of low- and middle-income countries to purchase vaccines is squeezed by confidential high-cost deals between manufacturers and wealthy countries as they add booster doses to their immunization programs, despite powerful arguments against this on equity grounds.
The contrast between doses promised and doses delivered is clear.
“In low-income countries especially, actual delivery of doses is running at only 15% of the expected or secured number of doses,” the report adds, referencing promised doses for the upcoming year lacking transparent delivery plans.
“Inconsistent delivery, including dumping large shipments at the last minute, is a potential waste of vaccine,” the report states, “and therefore a wasted opportunity to protect people.”
Losing Time also takes issue with the broader problem of who maintains control of Covid-19 vaccine know-how and called for the “desperately needed” transfer of technology “to decentralize production and repair broken supply chains.”
“While wealthy countries have made public pledges, just a fraction of redistributed doses have actually been delivered.”
Echoing calls from global social justice campaigners, the report states: “Global health cannot be left hostage to a pharmaceutical industry which buys up patents for promising products (often originally developed with significant public monies in universities and research institutions) and develops them in the interest of making profits. This system does not achieve the right balance between innovation and global public goods.”
A “vaccines-plus strategy” is needed, the panel adds, suggesting a global treaty could be a useful tool. Such an international agreement, according to the report, would help “secure collective interests across the spectrum of pandemic preparedness and response, from preparedness capacity building to alert and investigation obligations and fair access.”
In a statement, Johnson Sirleaf bemoaned global vaccine inequity and referenced rich nations like the U.S. that are already administering booster doses to the general population.
“Our panel calculated that there were at least one billion doses available to redistribute to low-income countries by 1 September this year. Yet while wealthy countries have made public pledges, just a fraction of redistributed doses have actually been delivered,” she said. “The idea that a poor health worker is unprotected while the healthy and wealthy receive booster doses should present a deep moral quandary. To this there is only one solution—vaccine equity.”
The report’s release came a week before the WTO’s ministerial meeting (MC12) beginning November 30 and where, according to humanitarian group Doctors Without Borders, countries can “get on the right side of history” by adopting a widely backed proposed waiver of some Trade-Related Aspects of Intellectual Property Rights (TRIPS) rules—a plan seen as key to expanding global access to Covid-19 vaccines as well as related tests and treatment.
First proposed by South Africa and India in October 2020, the proposal is opposed by some wealthy countries including Germany, the United Kingdom, Canada, and Switzerland; in the U.S., the Biden administration has expressed support for waiving vaccine-related property protections.
“If this was done when proposed a year ago, how many would now have access to vaccines and treatments?” Public Citizen’s Global Trade Watch asked in a tweet last week. “If not now at MC12, how many millions more will die?”