The Daily Star newspaper recently featured on its front page: “COVID Vaccines. A shot from Lakh Pfizer is coming next month ”(May 19, 2021). This news obviously comes at a good time for Bangladesh as it struggles to find more vaccines for the nation of 160 million people. As is known, Bangladesh and Beximco Pharmaceuticals Ltd signed an agreement last year with the Serum Institute of India (SII) to procure 30 million doses of the Oxford-AstraZeneca vaccine, but SII halted the administration of these. doses after providing only 10.2 million. units, due to its strong domestic demand amid severe Covid-19 infections in India.
A legitimate question to ask: why couldn’t Bangladesh have procured millions more of these vital jabs from other countries or on the open market to meet its growing demand? A related question is: if Bangladesh, India, South Africa and other developing countries have installed pharmaceutical manufacturing facilities but are inactive, what is preventing them from mass-producing drugs? vaccines created by Pfizer, Moderna or AstraZeneca, and why do they have to wait months for a response from COVAX on this?
The answer to these questions is complex, but the simplest way to look at it is this: Covid vaccines are private property and are sold to the highest bidder or only to those who can afford the list price. More on this topic in a minute.
It has been known for some time that many third world companies, including pharmaceuticals in Bangladesh, already locally manufacture vaccines for hepatitis, influenza, meningitis, rabies, tetanus and measles. Abdul Muktadir, CEO of Incepta, said he fully appreciates the extraordinary scientific achievement involved in creating the Covid vaccines this year, but wants the rest of the world to share it and is willing to pay a “fair price” for plans and technical know-how.
Like Muktadir, a few others around the world, including the WHO, have called on pharmaceutical companies to voluntarily share or pool the knowledge gained to facilitate universal and rapid access to vaccines.
On May 24, WHO Director-General Dr Tedros Adhanom Ghebreyesus told health ministers of its 194 member states that more than 75 percent of all vaccines had been administered in just 10 countries. At the current rate of vaccination, only 30 of the world’s population would have been vaccinated by the end of 2021. He warned that no country should assume it is “out of the woods”, as long as the virus and its variants spread elsewhere. WHO data shows that high- and high-income countries, which account for 53 percent of the world’s population, have secured 83 percent of the world’s vaccine supply. Low-income and low-income countries, meanwhile, represent 47 percent of the population and have received only 17 percent of the vaccine supply.
So the 64 billion dollar question is: how do you speed up immunization in the face of a global vaccine shortage? If we have idle vaccine factories around the world, what is standing in the way of increased production and supply? The shortest answer, as stated earlier, is that vaccines are private products. Then one might ask why the vaccine cannot be considered a “global public good”? A public good is a good like air and national defense that allows each of us – often within a geographic border – to enjoy the product for free and without excluding anyone else.
UNESCO first called for COVID-19 vaccines to be considered a global public good (GPG) last year in February 2020. Earlier, in 2006, the International Public Goods Working Group Global presented a list of six potential BPG candidates, but did not do so. include vaccines. In contrast, Ursula Von der Leyen, head of the European Commission, used the expression “global common good” to describe vaccines.
The technical conditions for “public goods” were first formulated by Nobel Prize-winning economist Paul Samuelson, who in the 1950s clearly spelled out two necessary conditions. First, the consumption of the article is not concurrent and, second, it is not excludable. Let me clarify. Non-competing consumption implies that the use of one consumer does not prevent the use of another. “Non-exclusion”, on the other hand, means that the cost of preventing non-payers of the good from enjoying the benefit of the good is prohibitive. The sun is a good example of public good.
At first glance, the Covid vaccines developed by Moderna, Pfizer or AstraZeneca are not public goods because each of these suppliers makes these products for commercial use and billions of people are excluded because there are not enough supplies. Therefore, they are not public goods in the sense that Samuelson or other modern economists use this concept. However, it could be argued that in the current pandemic situation, vaccines can be classified as “global” public goods, as immunization benefits everyone and the social cost of exclusion is very high. In addition, excluding the vaccine could be costly and could mean the difference between life and death.
The concept of BPM focuses on public goods in the broadest sense. One BPM used by one person in Bangladesh does not reduce how much someone else in the United States can consume, or the positive externalities are so great that private companies cannot expect to capture or receive all of them. social benefits. Here are some examples of global public goods that have been discussed in the literature: Biodiversity and the natural environment.
For Covid-19, it would be overkill to consider a biomedical innovation such as a diagnostic test, drug or vaccine as GPG. In practice and in the context of this pandemic, there are good reasons to create policies to facilitate the diversity of manufacturers and to provide for the open licensing of intellectual property rights for effective drugs and vaccines against the disease. viruses, because “the world has a very strong interest in ensuring that they are available everywhere and at low cost.”
The obstacles that stand in the way of implementing a policy that views vaccines as GPGs are numerous, but two of them stand out: i) patent or intellectual property (IP) rights of the developers of vaccines; and ii) lack of technical know-how for vaccine production and distribution. Vaccines and all drugs and technologies related to Covid are protected under the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). A patent waiver was jointly proposed by India and South Africa at the WTO meeting in October last year for a temporary TRIPS waiver, and objections were swift and furious. BioNTech, partner of Pfizer, is a German company, and Angela Merkel, German Chancellor, said: “The protection of intellectual property is a source of innovation and it must remain so in the future”.
In addition, securing adequate raw materials and supplies is critical to increasing vaccine production, but global Covid-19 vaccine supply chains are complex and fragile and have experienced shortages as production has increased. The United States has invoked the Defense Production Act more than a dozen times in the past year to increase access to raw materials and capacity for domestic manufacturing.
India and South Africa are both large producers of generic drugs, but they have less expertise and capacity to manufacture complex biologics like mRNA vaccines. A recent incident at a US plant in Baltimore has raised alarm bells about the potential risk of licensing vaccine manufacturing facilities in an unregulated environment. “And above all, patient safety must always come first,” said a spokesperson for AstraZeneca.
Governments and health experts have come up with two potential solutions to the vaccine shortage: one, backed by the WHO, is a patent pool inspired by a platform created for treatments for HIV, tuberculosis and hepatitis for the voluntary sharing of technology, intellectual property and data. But no company has offered to share its data.
Another proposal that has yet to gain popularity is to ask President Biden to move towards a government purchase of patent rights under “eminent domain,” after which the United States, as owner, would coordinate the process. worldwide distribution.
In the meantime, some countries and companies are planning to make their own bilateral vaccine donations, bypassing COVAX. “These bilateral agreements risk fueling the flames of vaccine inequity,” said the director-general of the WHO.
Dr Abdullah Shibli is an economist and works in the field of information technology. He is also Senior Research Fellow, International Sustainable Development Institute (ISDI), a think tank based in Boston, USA.