As the race towards a Covid-19 vaccine continues – with 11 leading candidates in phase 3 clinical trials, 14 more in phase 2 and 35 entering phase 1 – the question of how and to whom an eventual vaccine will become available remains largely unanswered.
A new report released yesterday from Human Rights Watch calls answering this question “urgent and central” to pandemic recovery, and makes a series of recommendations to governments and UN agencies to ensure equitable access to vaccines.
Chief among them is the recommendation to support the World Health Organization (WHO) Covid-19 Technology Access Pool (C-TAP), an initiative launched in May to share intellectual property, technology and know-how related to fighting the pandemic. Called “a visionary decision of great humanity” by Carlos Alvarado Quesada, the President of Costa Rica, C-TAP is designed to accelerate innovation and ensure equal access to any technology.
“All governments should take concrete steps to endorse the C-TAP Solidarity Call to Action and develop a collective strategy to implement it.” — Human Rights Watch
The moment a vaccine is approved, the demand for it will be instant, global, and pressing. No one company will be able to supply the world. And if prices are high, billions could be left in the cold “There is no point in achieving amazing technological developments if we cannot guarantee affordable access to technology,” said Quesada.
“All governments should take concrete steps to endorse the C-TAP Solidarity Call to Action and develop a collective strategy to implement it,” said Human Rights Watch.
To-date, however, precious few WHO member states have bought into the vision: at the time of writing, only 40 had endorsed the Solidarity Call to Action on C-TAP. And countries leading the financing of research and development have thus far been reluctant to require technology sharing as a condition of receiving public monies, such as the $15.9 billion pledged towards a global recovery.
And bilateral deals between wealthy nations and the pharmaceutical companies with leading candidates have sparked concerns of ‘vaccine nationalism’ in which distribution will be determined by countries’ ability to pay rather than by need. An Oxfam International analysis of available information about 5 leading vaccine candidates concluded that 51% of future doses had already been promised to High Income Countries representing 13% of the global population.
Vaccine nationalism is short-sighted, as in a global pandemic all are as vulnerable as the least protected populations. It is also, Human Rights Watch argues, a betrayal of the human rights commitments made by governments to safeguard the rights to life and health.
Human Rights Watch: Affordability, transparency and knowledge-sharing are essential to save billions of lives and livelihoods
HRW’s key recommendations underline the need for both affordability and transparency, noting “the lives and livelihoods of billions of people are on the line.”
While many companies have made vague promises of ‘non-profit’ pricing while the pandemic lasts, it is unclear precisely what that means. Pricing, HRW notes, range from $3 – $72 a dose, and it is likely that at least two doses a person will be necessary. These prices beg the question of how they will be made available to the 9 percent of the global population living on less than $1.90 a day. And documents from leading candidate manufacturer AstraZeneca show that the question of when the pandemic is over, at least for pricing purposes, may be a matter of contract negotiation rather than a WHO declaration.
“Whoever finds the vaccine must share it. This is a global responsibility and it’s a moral responsibility for a vaccine to be shared far and wide.” — Scott Morrison, prime minister, Australia, September 26, 2020, 75th United Nations General Assembly
Transparency, too, has been an issue. The COVAX Facility, for example, is an international cooperation mechanism led by Gavi, the Vaccine Alliance, aiming to achieve equitable access to vaccines. However, it has not published the details of its agreements with companies or countries, nor details of how its target prices are being calculated. It should do so. HRW also recommended the COVAX Facility be better aligned with C-TAP. One way is to encourage responsible licensing of any vaccines supported by the facility.
Greater transparency is also needed on how public funding is contributing to vaccine candidates, and under what terms and conditions, HRW notes. It recommends a public database of all contracts related to Covid-19 research, and for concrete conditions to be attached to all public funding for such research. This is clearly a task the WHO research & development observatory should take on.
Finally, a global pandemic must be fought at a global level. Countries must take steps to ensure knowledge developed to fight Covid-19 is knowledge that is accessible to all. This means, HRW said, pledging not to sign deals that corner future doses of vaccines. It also means supporting moves to share technology, both through C-TAP and by supporting a recent proposal of South Africa and India to waive intellectual property protection during the pandemic.
The report can be read in full here.