"Can the sun be patented?" This is what New York virologist Jonas Salk, considered the father of the polio vaccine, said in an interview when asked why he didn't want to patent it. Now humanity is on the verge of eradicating this disease, as it did with smallpox and rinderpest. However, Salk did not become rich, because he put health first as a public good. Seventy years later, this is not the criterion that prevails with the covid-19 remedies. A few weeks ago WHO Director-General Tedros Adhanom Ghebreyesus warned that "Having safe and effective vaccines against a virus that was totally unknown just a year ago is an exceptional scientific milestone. But it would be even more so to ensure that all countries enjoy the benefits of science equally".
The World Trade Organization (WTO) will meet this month to discuss once again the proposal made by South Africa and India to temporarily suspend patents, intellectual property provisions and monopoly on vaccines and covid-19-related treatments, tests and technology for the duration of the pandemic. Since discussions began last October, 100 countries have supported the proposal, which faces outright opposition from the wealthiest players: the United States, the European Union, Switzerland, Norway, the United Kingdom, Japan and Australia. Spain is also advocating that patents be maintained.
While leaders such as the President of the European Commission, Ursula von de Leyen, the German Chancellor, Angela Merkel, the French President, Emmanuel Macron, and the Spanish President, Pedro Sánchez, are making speeches proclaiming that vaccines against covid must be a public good of universal access, their governments have launched an unprecedented race to buy the existing and future production of all vaccines that are being developed. Europe has bought doses to immunize 800 million people, when its population is 450 million. Canada has guaranteed vaccines for six times its total population.
The result, according to a study published two weeks ago in the British Medical Journal, is that rich countries have taken more than half of the doses that have been or will be produced in 2021, although they have only 14% of the world's population. This blows the Covax mechanism up, which was supposed to ensure that all countries in the world had vaccines for at least 20% of the population this year, which would make it possible to cover the groups that everyone agrees have to be a priority: health workers and people who, because of their age or because they suffer from other diseases, are more vulnerable to the virus. "It has been scientifically proven that vaccination will have more impact if we vaccinate all countries at once, starting with the priority groups, than if we try to create bubbles of immune countries", Miriam Alía, a vaccine expert from Doctors Without Borders explains. "The same countries that monopolize vaccine production are the ones blocking the initiative to override patents, which would allow the vaccine to be manufactured at prices affordable to all countries and not depend on the charity of others".
There are precedents, such as the legal victory in 2001 of Nelson Mandela's government against the pharmaceutical companies in order to universalize antiretroviral drugs for HIV at the height of the AIDS epidemic in South Africa. "We are not calling for a coup d'état against capitalism, but for laws to be applied which provide that in exceptional situations everyone should be allowed to make vaccines to cover the entire world population as soon as possible", Alía adds.
Lack of transparency
From Médicins du Monde, Ave Mari Aburto recalls that there has been a great public and philanthropic investment in the development of the vaccines and that the pharmaceutical companies "are not subject to control and transparency mechanisms to know how much the research and production of the vaccines has cost and thus be able to set reasonable prices". Pharmaceutical companies' agreements with countries are also secret. According to the price table leaked by Belgian politician Eva de Bleeker - in a tweet that she erased thirty minutes after publishing it - the European Commission has agreed to pay 14.68 euros for each dose of the Moderna vaccine and 1.78 euros for the Oxford/AstraZeneca vaccine.
Rafael Bengoa, a former WHO executive, also warns that "saying that you will give the leftover vaccines after vaccinating your population sounds good, but it is not so humanitarian and in the end it responds to a logic of security, because the north needs the south to slowly return to normality". He adds that we also need to ensure that the South receives the means for training, and not just the vaccines, to avoid being dependent on the North every time there is a health problem. Bengoa assumes that next year only Europeans and North Americans will have herd immunity and that "in 2021 Africa will explode epidemologically", so he favours vaccinating in line with the global evolution of the pandemic and ensuring that the WHO has an epidemiological surveillance mechanism in place.
And then there are the ethical considerations. For Begoña Roman, professor of bioethics at the UB, we are playing with a double standard: "Here we talk about the most vulnerable and that is why we give priority to older people, but when we talk on a global scale we change. We have to change the patent system, which applies to drugs a law that comes from the industry sphere, and a zipper is not the same as a vaccine. We will have to manage inconsistencies. The states and Europe will be partial in favour of their own, but we have to assess what level of partiality can be assumed. We need international institutions that stand above states, and this is true both for health and for environmental problems. It is unthinkable to say in the 21st century that if you are Senegalese and not European, bad luck".