Synthesis and Conclusions: Securing technology transfer in the Pandemic Agreement

This guest blog draws from the discussions at a 27 January 2025 expert workshop organised by the Geneva Graduate Institute entitled Technology Transfer in Practice: Implications for Pandemic Agreement Negotiations. The background paper for the meeting, which includes interviews with the experts, was originally published here. One of the invited experts was ML&P’s Ellen ‘t Hoen.

Introduction

Technology transfer has been one of the more politically and technically difficult issues on which to forge consensus in the Pandemic Agreement negotiations. In the wake of the Covid-19 pandemic—which was characterized by shortages of health products, widespread trade barriers and highly-unequal and inequitable access to pandemic products—there is widespread agreement on the importance of diversifying production capacity by strengthening it in low and middle-income countries (LMICs). All countries stand to benefit if the world can produce sufficient volumes of products to get a pandemic emergency under control as quickly as possible, by reducing the risk of ongoing spread and ending the emergency faster.

The “greening” (indicating consensus in ongoing Pandemic Agreement negotiations) of Article 10 Sustainable and geographically diversified local production, reflects strong support for this objective, which is also reflected in many new local production initiatives launched worldwide over the past several years.¹ Achieving this objective will require the transfer of technology from actors in one country to another. However, there remains significant disagreement on how to do so, particularly on what is the appropriate mix of voluntary and compulsory measures.  Countries that have historically been technology-holders tend to prefer that such transfer only take place on “voluntary and mutually-agreed terms (VMAT)”, whereas those that want access to technology tend to favor also adopting compulsory measures. The question remains, what is needed to ensure effective technology transfer for strengthening local production capacity?

The Geneva Graduate Institute’s Global Health Centre organized a workshop on technology transfer in January 2025 to solicit experts’ views on this complex topic and to facilitate understanding of real world challenges from experienced practitioners with backgrounds in industry, intergovernmental organizations and non-governmental organizations. The main ideas from each speaker are summarized in interviews earlier in this report. This synthesis article draws out implications of the workshop discussions for the draft Pandemic Agreement. They reflect the views of the author, and do not necessarily represent the views of the Global Health Centre or Geneva Graduate Institute.

For which products is technology transfer most needed?

Expert speakers largely focused on biologics – particularly vaccines – as the technology for which transfer is most essential. For small molecule drugs, compulsory licensing may be a sufficient measure including in emergencies, as many companies can manufacture these without requiring technology transfer. Diagnostics tend to be relatively low-cost to develop and manufacture, with multiple platform technologies available, and therefore also rely less heavily on technology transfer. In contrast, manufacturing of biologics such as vaccines or monoclonal antibodies (mAbs) requires both access to specific starting materials, such as cell lines, and to specialized know-how on complex, multi-step production processes. Therefore, most of the challenges discussed relate specifically to more complex pharmaceuticals such as new vaccines. 

Clashing interests between technology-holders and -recipients

Workshop speakers made clear that successful technology transfer for the production in LMICs of complex biologics such as vaccines requires many different pieces of the puzzle to be in place: e.g. infrastructure, trained human resources, regulatory capacity, sufficient international supply chains, long-term investment, public purchase commitments, a sustainable business model, and years of intensive collaboration, among others.  All this requires long-term political and financial commitment from home governments. They also noted that technology transfer for vaccines in normal times usually takes several years to arrive at a successful product that can receive regulatory approval and reach people. That said, timelines can be accelerated considerably when pre-existing production capacity is in place, as demonstrated during the Covid-19 crisis when technology transfer for contract manufacturing of vaccines took place within months.² Nevertheless, capacity to manufacture must be built during interpandemic times to ensure production facilities are ready and available when emergencies strike – a so-called “warm base.”  Sustaining the warm base requires a business model that makes products for sale every day, not only during crises. The implication is that technology transfer is required as early as possible, and that technology recipients should be able to use platform technologies (e.g. mRNA or protein sub-unit for vaccines) to produce other products outside of emergency periods.

Unfortunately, commercial technology-holders face incentives to do the opposite – that is, not to transfer technology outside the firm during inter-pandemic times, and if they do so, to restrict as tightly as possible the potential use of platform technologies for other products, as both measures would enable market competitors. When transfer does occur, it can vary in depth from enabling only production of the last stages (e.g. fill-and-finish), which limits autonomy of the recipient, to a full end-to-end transfer.

During the Covid-19 emergency, technology transfer practices varied widely, but overall was not sufficient to enable rapid supply to LMICs.³ Businesses had little incentive to enable competitors to meet demand, which would have reduced the high revenues they were earning. Training others also requires significant human resources, and diverting production personnel away from manufacturing would have been commercially costly at a time when scaling up production to meet ballooning global demand was the business priority.

While companies came under political pressure to transfer technology during the crisis, that pressure is considerably lighter in inter-pandemic times. Companies that control valuable platform technologies are already developing potentially lucrative products for other diseases that can be sold day-to-day, not only during emergencies (e.g. Moderna’s candidate vaccines for cancers or respiratory syncytial virus (RSV)⁴. Enabling competitors to manufacture competing products both for pandemic emergencies and in interpandemic times runs directly counter to business logic.

It therefore seems highly unlikely that a purely voluntary approach to technology-holders will result in the technology transfer that is needed in inter-pandemic times. Even if such transfer can be induced, it is likely to be narrowly restricted to pandemic products, which is not enough to sustain the warm base through day-to-day sales. It may also be restricted to late-stage fill-and-finish, which allows the technology holder to retain considerable control since the recipient must still rely on them to supply critical inputs.

One answer to this conundrum in the past has been relying on non-commercial technology transfer projects. Following the 2009 H1N1 influenza pandemic, WHO worked with the Netherlands Vaccine Institute and International Vaccine Institute to transfer technology to potential influenza vaccine producers in LMICs. This was possible because the relevant technology was well-established, with non-commercial actors holding sufficient knowledge to train others. Similarly, two non-commercial entities – the WHO and Medicines Patent Pool – are coordinating the mRNA technology transfer hub, which is largely financed with public and philanthropic funds. Therefore, one path to facilitate technology transfer in the future is to invest public funds in R&D for pandemic products (as called for in Article 9.2(a)⁵) and to ensure the resulting technologies can be controlled and transferred by non-commercial actors.

However, relying on non-commercially-controlled technology is unlikely to be sufficient –commercial actors hold valuable technologies likely to be needed to address pandemics. So the question remains, how can commercial actors be induced to transfer technology when it seems to go directly against their business interests?

Compulsory and voluntary approaches to disembodied vs embodied aspects of technology

The low likelihood of commercial actors transferring technology voluntarily is a key rationale for compulsory measures. For ‘disembodied’ aspects of technology—such as technical documents, patents, data, regulatory filings, starting materials—governments could require private firms to share these for pandemic-related purposes. In other words, a compulsory approach is possible. However, practitioners emphasized that successful technology transfer in inter-pandemic times requires cooperation sustained over several years, with parties that are not only able but also willing to share ‘embodied’ aspects of technology, such as know-how. ‘Embodied’ here refers to the knowledge of skilled, experienced practitioners that is not always written down or captured on paper in disembodied form. It is difficult to imagine how one could compel one team of practitioners, against their will, to effectively and efficiently teach another a complex manufacturing process. Practitioners emphasized that trust and goodwill facilitate effective cooperation. In recognizing the disembodied and embodied aspects of technology, it becomes apparent that technology transfer may encompass both compulsory and voluntary elements. Might both be needed to ensure effective technology transfer for pandemic products?

Inducing technology transfer from commercial actors

In the face of countervailing incentives, how could commercial actors be made more willing to transfer valuable technology?

One possible approach is to make the benefits of transfer outweigh the costs of not transferring technology, using carrots and sticks, such that it becomes rational for the commercial actor to willingly engage in such transfer. This approach sits along a spectrum between purely voluntary, on the one end, and purely compulsory, on the other. At first glance, voluntary and compulsory approaches may seem to be polar opposites. But this is a false dichotomy. In practice, one often complements the other, as when private firms voluntarily adopt certain practices to avoid compulsory measures. For example, in 2016 the government of Malaysia negotiated with pharmaceutical company Gilead for a voluntary license on the hepatitis C drug sofosbuvir, but the parties did not reach agreement. In 2017, the government subsequently announced it would issue a compulsory license on Gilead’s sofosbuvir patents; shortly thereafter Gilead added Malaysia, Thailand, Ukraine and Belarus to its voluntary license⁶. 

Greened text in the draft Pandemic Agreement already provides some carrots and sticks. Articles relevant for technology transfer include not only Article 11. Transfer of technology and know-how for the production of pandemic related health products, but also other articles such as those on R&D (Art. 9), production (Art. 10), pathogen access and benefit-sharing (PABS) (Art.12) and procurement (Art.13).

First, the text establishes the norm that regionally-diversified production is important for addressing pandemics (Article 10), and that technology transfer is expected behavior for pandemic products. That is, technology transfer is articulated and agreed as the right thing to do. Firms that engage in such transfer could be rewarded with reputational benefits. Such soft norms are important for setting expectations and a benchmark for subsequent accountability efforts, even if they lack the enforceability of harder rules.

Second, Article 9.5 Research and development commits States Parties to develop and implement policies regarding conditions on publicly-funded R&D that promote equitable access, including through technology transfer, among other provisions⁷. Governments can implement this commitment by requiring commercial actors that conduct publicly-financed R&D on pandemic products to transfer technology as a condition of such funding. Firms are not required to accept public funding. If and when they do, they would also be voluntarily accepting a legally-binding commitment to transfer technology.  Preferably, technology transfer would be required as early as possible and for as wide a use as possible, but the exact terms of funding contracts will be determined at national level and, to some extent, case-by-case. Transparency of such contracts will help to monitor implementation and push for improvement where needed.

Third, greened sections of Article 11 (focused on technology transfer) include commitments to promote, facilitate or incentivize technology transfer; publish the terms of licensing agreements; encourage patent-holders to forgo or charge reasonable royalties during pandemic emergencies; promote technology transfer to regional or global technology transfer hubs; support capacity building; reaffirm the right to use TRIPS flexibilities and to respect their use; strengthen or develop mechanisms for technology transfer, and consider amending national legislation to implement this article. After painstaking negotiation, much has been agreed.

Keeping this in mind, there are a number of clauses still under negotiation where additional carrots and sticks could be included. For example:

1. Parties could commit to mandate private firms to share disembodied aspects of technology (e.g. documents, data, regulatory filings) in Article 11.
2. Parties could commit to make available licences on government-funded or government-owned technologies in a transparent, non-exclusive manner worldwide (as reflected in draft Article 11.1(b) which is “yellowed” text as of Dec 2024, reflecting widespread agreement if not yet consensus).
3. Parties could commit to provide technology transfer, or finance or offer other incentives for such transfer, as a benefit under the PABS system in Article 12. For example if revenues are generated through the PABS system, some could be used to pay technology-holders that engage in transfer. Other public funds could also be allocated for this purpose, unrelated to PABS.
4. Parties could commit to make technology transfer a condition of publicly-financed procurement contracts for stockpiling (in interpandemic times) and for supply (during pandemics) in Article 13. (Licensing is envisioned in Article 13(bis).2 as a potential condition in public procurement contracts, but not technology transfer more broadly.)

These are non-exhaustive illustrations for how States Parties can use the Pandemic Agreement as a vehicle to commit to use carrots and sticks to induce technology transfer for pandemics.

What role for a treaty?

International legally-binding obligations on technology transfer serve several functions. First, they set norms for expected behavior by both state and non-state actors. Second, they structure cooperation between states for mutual benefit. States can commit to each other through a treaty that they will ensure technology transfer to the best of their ability, with the understanding that enabling all states to control potential and actual pandemics increases health security for all. Such state commitments are important because private firms are not directly bound by public international law. It is up to states to regulate private firms in their territories. If a private firm in Country A holds a technology needed to combat a pandemic emergency in Country B, it is the government of Country A that has the authority to mandate actions by that firm. A treaty gives Country B greater confidence that Country A will take the steps that will facilitate cross-border technology transfer. Historically, vaccine technology has been concentrated in a few advanced industrialized countries. But a number of middle-income countries demonstrated their growing vaccine R&D capacity during the Covid-19 crisis⁸. In future, international rules that ensure cross-border technology transfer for pandemic emergencies could spur South-South cooperation, and/or provide for technology transfer to high-income countries as well. Finally, a treaty binds states to other commitments that increase the likelihood that technology transfer will successfully deliver improved access to pandemic products. Practitioners emphasized that technology transfer alone is not sufficient to sustain local production, but that a conducive ecosystem is required. Provisions in Article 10, for example, commit states to support skills development and capacity building, promote investments in production facilities including through purchasing arrangements, and Article 14 commits states to strengthening their regulatory systems. A full package of commitments in the Pandemic Agreement could help deliver on the promise of local production.

Conclusion:

Full agreement on technology transfer has not yet been achieved in Pandemic Agreement negotiations, but ensuring effective provisions is critical for achieving the broader objective of geographically-diversified production capacity. Governments may wish to fund and ensure they retain sufficient control of non-commercial technology, and commit to transferring it for pandemic products, as they have in the past. For commercially-controlled technologies, governments could mandate the sharing of disembodied aspects of technology (e.g. documents, data, regulatory filings), but full technology transfer for the complex process of manufacturing biologics seems also to require the voluntary participation of the technology-holder, particularly for embodied aspects of the technology that require one person to teach another. However, that willingness need not only rely on the charitable impulses of the technology holder, which are likely to be insufficient in the face of strong business incentives not to transfer at all. Governments can commit through the treaty to use all the legal, financial and political means at their disposal to push and pull technology holders to share technologies needed to address pandemics. The sum total of such measures—carrots and sticks—should make technology transfer the rational choice for commercial actors, and could include: mandates to share disembodied aspects of technology  combined with reputational benefits, conditions on public funding (e.g. for R&D and procurement contracts), PABS-related conditions, and financial incentives (e.g. direct payments). Taken together, these could push and pull commercial actors so that technology transfer becomes the expected, accepted and likely course of action for pandemic products.

TECHNOLOGY TRANSFER IN PRACTICE: IMPLICATIONS FOR PANDEMIC AGREEMENT NEGOTIATIONS
A January 2025 discussion paper from the Geneva Graduate Institute

Endnotes

1. See, for example, the 2021 World Health Assembly resolution on local production (https://www.who.int/publications/i/item/WHA74.6-Strengthening-local-production-of-medicines-and-other-health-technologies-to-improve-access), the annual World Local Production Forum (https://www.who.int/initiatives/world-local-production-forum), and the African Union-Africa CDC Partnerships for African Vaccine Manufacturing (https://africacdc.org/download/partnerships-for-african-vaccine-manufacturing-pavm-framework-for-action), among other initiatives. ↩︎
2. O’Sullivan C, Rutten P, Schatz C. 2020. Why tech transfer may be critical to beating Covid-19. McKinsey and Company. Available:  https://www.mckinsey.com/~/media/McKinsey/Industries/Pharmaceuticals%20and%20Medical%20Products/Our%20Insights/Why%20tech%20transfer%20may%20be%20critical%20to%20beating%20COVID%2019/Why-tech-transfer-may-be-critical-to-beating-COVID-19-vF.pdf ↩︎
3. Alonso Ruiz, A., Bezruki, A., Shinabargar, E. et al. Which roads lead to access? A global landscape of six COVID-19 vaccine innovation models. Global Health 20, 25 (2024). https://doi.org/10.1186/s12992-024-01017-z ↩︎
4. Reuters. 2024. Moderna jumps as vaccine shows benefit in head and neck cancer in early study. April 9. https://www.reuters.com/markets/us/moderna-jumps-personalized-cancer-vaccine-shows-benefit-early-study-2024-04-09/ ↩︎
5. Pandemic Agreement, text as of 6 December 2024, 17:23 CET, Article 9.2(a): “To this end, the Parties shall promote, within means and resources at their disposal, and in accordance with national and/or domestic law and policy: (a) sustained investment and support for research institutions and networks that can rapidly adapt and respond to research and development needs in the event of a pandemic emergency…” ↩︎
6. Saez, C. 2017. Malaysia grants compulsory licence for generic sofosbuvir despite Gilead licence. Health Policy Watch. 15 September. https://healthpolicy-watch.news/malaysia-grants-compulsory-licence-generic-sofosbuvir-despite-gilead-licence/ ↩︎
7. Pandemic Agreement, text as of 6 December 2024, 17:23 CET, Article 9.5: “Each Party shall develop and implement national and/or regional policies, adapted to its domestic circumstances, regarding the inclusion of provisions in publicly funded research and development grants, contracts and other similar funding arrangements, particularly with private entities and public-private partnerships, for the development of pandemic-related health products, that promote timely and equitable access to such products, particularly for developing countries, during public health emergencies of international concern including pandemic emergencies, and regarding the publication of such provisions. Such provisions may include: (i) licensing and/or sublicensing, particularly to manufacturers of developing countries and for the benefit of developing countries, preferably on a non-exclusive basis; (ii)affordable pricing policies: (iii) technology transfer; (iv) publication of relevant information on clinical trial protocols and relevant research results; and (v) adherence to product allocation frameworks adopted by WHO. [NOTE: Pending final discussion of Article 11 regarding licensing and tech transfer].” ↩︎
8. Alonso Ruiz, A., Bezruki, A., Shinabargar, E. et al. Which roads lead to access? A global landscape of six COVID-19 vaccine innovation models. Global Health 20, 25 (2024). https://doi.org/10.1186/s12992-024-01017-z ↩︎

Suerie Moon

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Guest author Suerie Moon is the co-director of the Global Health Centre at the Geneva Graduate Institute and a professor of practice, interdisciplinary programmes and international relations/political science. Prior to joining the Graduate Institute in 2016, she was Lecturer on Global Health at the Harvard T.H. Chan School of Public Health. She is widely published and has served on a number of expert advisory panels and boards.

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