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The inequality in accessing vaccines to tackle the Covid-19 pandemic is growing. Since the invention of the vaccines, there was apprehension regarding the accessibility of the vaccines by the citizens of poorer countries. The supply of vaccines is also far less than the demand. And whatever is being manufactured are being purchased by developed countries in advance and in plenty, leaving low and lower middle-income countries far behind in the vaccination drive. Many high-income countries have already managed to vaccinate a large number of their population. Whereas, most people in the least developed countries (LDCs) are still waiting for their shots and struggling to recover from the pandemic, both in terms of health and economy.

The world needs 11 billion doses of Covid-19 vaccines, given that 70 percent of the global population has to be vaccinated, with two doses per person. The Duke Global Health Innovation Centre indicates that as of March 19, 2021, high and upper-middle-income countries have secured about 6 billion out of 8.6 billion doses of vaccines. These countries have only one-fifth of the total population of the world. Low- and lower-middle-income countries could secure only 2.6 billion doses, even though four-fifths of global population lives in these countries.

Since the rolling out of the vaccines in December 2020, the number of vaccinated people has varied across countries. As of July 8, 2021, only 0.2 percent of the people in low-income countries and 4.1 percent people in lower middle-income countries have been fully vaccinated. Bangladesh has been able to fully vaccinate 2.6 percent of its population while India has vaccinated 5.1 percent of its people fully during the same time. The USA vaccinated 47 percent and the UK vaccinated 51 percent of their respective populations till July 8, 2021. So, the world average of fully vaccinated people now stands at 12 percent. However, with such unequal access to vaccines for Covid-19, the world cannot recover from the pandemic fully even if some countries are vaccinated fully—because we do not live in isolation in this day and age. Therefore, rapid scaling up of vaccine manufacturing and distribution is crucial.

In order to increase the supply of Covid-19 vaccines and reduce the vaccine inequality, there have been proposals to provide opportunities to developing and least developed countries to manufacture generic versions of Covid-19 vaccines. Several countries have expressed their desire to manufacture vaccines to fulfil domestic needs and for supplying to other countries. But the Trade Related Aspects of Intellectual Property Rights (TRIPS) of the World Trade Organisation (WTO) has been a barrier preventing this. The TRIPS Agreement, which was negotiated during the Uruguay Round negotiations of the WTO and came into force in 1995, protects creations and innovations using patents, copyrights and trademarks. Pharmaceutical companies enjoy such patents by investing in innovation and producing medicines. This has given some companies the monopoly of producing certain medicines due to which they can also charge high prices.

To overcome the vaccine crisis, India and South Africa made a submission to the Council of TRIPS on October 2, 2020 requesting a temporary "waiver from certain provisions of the TRIPS Agreement for the prevention, containment and treatment of Covid-19." In their communication, the two countries urged the WTO Members "to work together to ensure that intellectual property rights such as patents, industrial designs, copyright and protection of undisclosed information do not create barriers to the timely access to affordable medical products including vaccines and medicines or to scaling-up of research, development, manufacturing and supply of medical products essential to combat Covid-19."

On May 25, 2021, a revised proposal was submitted by 62 co-sponsors including India, South Africa and Indonesia, which requests a waiver for three years "in relation to health products and technologies including diagnostics, therapeutics, vaccines, medical devices, personal protective equipment, their materials or components, and their methods and means of manufacture for the prevention, treatment or containment of Covid-19."

Naturally, pharmaceutical companies are not happy about the idea of transferring intellectual property to countries for making Covid-19 vaccines. They feel the waiver on patenting of pharmaceutical products will take away their freedom to decide the prices of medicines. According to them, since they invest on the research and development of vaccines, it is their exclusive right to put a price on pharmaceutical products. Many opponents have also raised the issue of quality and safety of the vaccines to be manufactured in other countries. But supporters of manufacturing generic versions disagree, saying that manufacturers have adequate experience of supplying high quality medicines and vaccines.  The proposal by India and South Africa has received support from about 120 countries. Though, the USA is agreeable to waive patent rights only for Covid-19 vaccines. Several countries, including Australia, Japan, the EU, the UK, Singapore, Brazil and South Korea, are unwilling to discuss the revised proposal. But on June 9, 2021, the WTO Members agreed to begin text-based negotiations on the proposal. By the end of July 2021, the WTO Members are expected to reach an agreed text for negotiation.  

If temporary waiver of patent is negotiated and agreed upon by the WTO Members, it will be an unprecedented decision during this unprecedented time. However, the waiver is not enough for increasing vaccine supply and reducing vaccine inequality between rich and poor countries. We are aware that there is already some flexibility in the WTO with regard to TRIPS. As such, the decision should expedite the production and export of generic versions at an affordable price—more so than what is allowed in the existing WTO rules. It may be recalled that the 2001 Doha Declaration of the WTO on the TRIPS and Public Health reaffirmed the flexibility of TRIPS member countries in bypassing patent rights for better access to essential medicines. As per the Doha Declaration, the WTO Member states may grant compulsory licensing for patented drugs, allowing for quicker and more affordable production of generic versions. The 2005 decision of TRIPS included that countries without manufacturing capacity or inadequate demand for pharmaceuticals may import generic equivalents with the assistance of producing or exporting countries.

Therefore, while patent waiver under the TRIPS Agreement is a critical move towards generic manufacture of vaccines, this is only the initial step. What's most important is the know-how and technology transfer for the generic manufacturer. Article 66.2 of the TRIPS agreement refers to promotion and encouragement of technology transfer by developed countries to LDC members. The 2003 and 2005 decisions on TRIPS and Public Health have also emphasised the implementation of Article 66.2. However, there is clear reluctance on the part of developed countries and pharmaceutical companies to share technology with LDCs.

Bangladesh, which is a lower middle-income country as well as an LDC, has an active interest in the proposal for the patent waiver for Covid-19 vaccines and medicines. With only 2.6 percent of our population fully vaccinated so far, we still have no clarity regarding how and when 120 million vaccine-eligible people will be fully vaccinated. However, Bangladesh has a better capacity to manufacture pharmaceuticals compared to other LDCs. It has a few world-class pharmaceutical factories which have been supplying low-cost medicines to other countries, particularly to poorer countries. As an LDC, Bangladesh can export its pharmaceutical products under compulsory licensing. And with an improved technological capacity, Bangladesh can improve its production capacity and manufacture Covid-19 vaccines for meeting both domestic and international demand.

Therefore, Bangladesh should actively work alongside other struggling countries towards the successful completion of the negotiation on patent waiver to deal with the ongoing Covid-19 crisis.

Dr Fahmida Khatun is the Executive Director at the Centre for Policy Dialogue. 

This article was originally published on The Daily Star.
Views in this article are author’s own and do not necessarily reflect CGS policy.