African nations have welcomed news that the U.S. supports a proposal to waive intellectual property protections for COVID-19 vaccines. But, they warn, the road ahead is long and full of obstacles.
Health experts and activists say the decision, announced this week by the U.S. trade representative, could save lives in parts of the world where the coronavirus pandemic continues to rage and vaccines are in short supply.
Fatima Hassan is director of the Health Justice Initiative, a South African group that advocates for equitable health care.
While Hassan said she welcomes U.S. support of the so-called “TRIPS” waiver — it stands for “Trade-Related Aspects of Intellectual Property” — she worries that the process is moving too slowly.
“Obviously ... we welcome the Biden administration's announcement — and really its giving effect, partially, to a promise he made when he was campaigning to be the president of the United States," he said, but added that it is only a "small step to be able to go forward in terms of the TRIPS waiver, but also in terms of other initiatives to scale up manufacturing not just in Africa, but in the global South, particularly in Latin America and Asia as well.”
The waiver idea came from two nations that have suffered greatly during the pandemic: South Africa and India. South Africa is the continent’s worst-hit country, with nearly 1.6 million confirmed cases and a vaccination program that has been plagued by fits and starts. Health officials are now bracing for a third wave of infections.
Hassan stressed that the waiver alone won’t immediately produce a bounty of locally produced vaccines. The Africa Centers for Diseases Control has identified about six facilities on the continent that are capable of manufacturing vaccines — hardly enough to quickly meet the needs of more than 1.2 billion Africans.
And, says Yuan Qiong Hu of global aid group Doctors Without Borders, the U.S. does not have the final word here. The World Trade Organization meets in June to hammer out the conditions, and there are a number of high-profile opponents, including the European Union, Canada, Switzerland, Japan, Germany, Brazil and Australia.
While more than 100 countries support the waiver proposal, countries that oppose the waiver, says Hassan, may fear that it sets an irreversible precedent.
Industry groups also have weighed in. In a statement late last year, the International Federation of Pharmaceutical Manufacturers & Associations said diluting intellectual property rights would be “counterproductive” and would risk “undoing” the very system that generated life-saving vaccines in record time in the first place.
Despite such opposition, Hassan remains upbeat.
“Maybe this statement from the U.S. trade office is actually the first of a long journey, where over the next few decades we’ll finally be able to have a real reckoning around the impact of intellectual property on access to healthcare services, in particular medicine,” she said. “The fact that medicines are still commodified, that they are subject to a trade regime and subject to the quite excessive and quite protectionist rules of the World Trade Organization is a key concern for many organizations and many health advocates and activists.
"I think that we shouldn't underestimate the statement and the move by the U.S. government," she added. "It's certainly going to create a ripple effect.”
Umunyana Rugege, director of South African advocacy group Section 27, certainly hopes that is the case. Her group campaigns for social justice in South Africa. Before COVID-19 appeared, their health advocacy focused on another pandemic: HIV. South Africa carries the world’s heaviest burden of that virus. Rugege said her country’s lengthy experience in that battle enabled them to act quickly when COVID-19 first appeared.
“Early in the pandemic, what we did was to call for a number of things,” she said. “The first thing was a moratorium on any new patents on COVID-related technologies. So that's before we even had vaccines, before we knew what treatments were going to work. We said, let's make sure that we're not giving out new patents on these technologies. The second thing we demanded was for automatic compulsory licenses where there are health technologies that are found to be effective against COVID, but that have patents."
This is familiar ground for African health activists. From the mid-90s, activists lobbied hard for the World Trade Organization to issue a similar waiver for lifesaving antiretroviral medications. A final agreement was inked in 2001.
According to the United Nations, as many as 42 million people have died from AIDS-related illnesses since counting began more 40 years ago. Since COVID was first recognized in early 2020, the World Health Organization says it has killed 3.2 million people.