COVID-19 is a global problem, and therefore can only be solved at the global level. While the recent debates in Germany and the European Union have mainly focused on local vaccine distribution, an essential element in defeating the pandemic has been overlooked: we need a global immunisation strategy.
At the moment, we are still far from having an efficient and comprehensive global vaccination strategy. The world is in danger of splitting into two vaccination camps: the camp of industrialised countries in which a small portion of the world’s population has secured the bulk of the vaccine. A camp in which– despite all difficulties – the economy is showing signs of recovery, travel corridors are being created and the social recovery of exhausted societies can begin. And another camp lacking a sufficient amount of vaccines. Here, the pandemic weakens already fragile health systems even further in their fight against other diseases while the pandemic’s indirect consequences are particularly threatening, since many people work and live without any social security.
Health is a global public good and a human right. Once again, however, it is clear that the task of securing public health cannot be entrusted to the unequal power relations of the market. It is not only inhuman but also dysfunctional when money and power decide who gets vaccinated first and who gets vaccinated last. The mantra that has been circulating since the border closures last year is as true as ever: viruses do not respect borders. If certain countries and regions do not receive vaccines, mutations will spread, undermining existing vaccine protection and further restricting the lives of all.
The Covid-19 Vaccine Global Access Initiative (COVAX) launched by the WHO aims to ensure access to vaccines to low- and middle-income countries that cannot afford them on their own. This is a correct and important initiative, but it has got off to a very slow start. At the G7 meeting in February, additional funding for COVAX was pledged once again by the EU and Germany, among others. Nevertheless, a funding gap of USD 22 billion remains. The member states did not move swiftly enough to support the initiative with adequate funding, while individual countries had already signed contracts with pharmaceutical companies. Almost all of the OECD countries have procured more doses than their populations need. Now, the massive production bottlenecks mean that COVAX, like other latecomer countries, is finding it difficult to mobilise vaccines.
At the same time, the geopolitical implications are becoming apparent. Russia and China, in particular, have already begun to engage in ‘vaccine diplomacy’. Both countries already began to produce and export vaccines before the final test results of the crucial phase 3 trials became available. Since then, China, itself a member of COVAX, has entered into bilateral agreements with countries in Latin America, Africa and Southeast Asia, offering loans for the purchase of vaccines. Even the EU state Hungary, bypassing the approval procedure of the European Medicines Agency (EMA), has recently joined Serbia in approving Russian and Chinese vaccines. These arrangements ensure that the countries in question get the necessary vaccines, while China and Russia enhance their reputations and political influence. Therefore, the European Union has an urgent geopolitical interest in finally implementing a functioning global vaccination strategy.
For this to work, it must address financing, production and distribution.
COVAX’s funding gap must be closed so that the initiative can distribute the missing two billion vaccine doses to 92 low- and middle-income countries.
At the same time, we must work with the countries to rapidly build infrastructure that will enable that the vaccine is distributed promptly.
Finally, whether pharmaceutical companies should waive patent protection, at least temporarily, and pass on the technical knowledge required to produce vaccines must be opened up to discussion.
The relaxation of patent protection for HIV drugs twenty years ago has saved many lives in the fight against AIDS. If patent protection is removed, prices will fall and COVAX will need less money to fund vaccines on the scale required. Whether the voluntary licensing system favoured by the industrialised countries is adequate must be carefully examined as a matter of urgency. Priority can be given to voluntariness, but if this is not sufficient, temporary relaxations of patent protection must be considered.
At a time when fundamental rights of individual citizens are being restricted worldwide, patent protection cannot be treated as sacrosanct, especially in view of the fact that the development of the vaccines has also been supported with billions in public funds. Germany’s constitution, the Basic Law, states under Article 14, paragraph 2: ‘Property entails obligations. Its use shall also serve the public good.’ This appeal to the primacy of the public good not only applies to us in Germany, but certainly throughout the world in this pandemic.
The pandemic has already taught us that health must not be a privilege.
Access to high quality healthcare for all human beings is a key element in the sustainable improvement of health worldwide. This calls for a well-trained and well-paid healthcare workforce, a comprehensive basic social safety net and a strong system of public funding and organisation of research and production. Countries that lack sufficient resources to build a healthcare system on their own must receive support through funds to establish basic health protection. Furthermore, good development cooperation can enable both state and civil society actors to guarantee adequate healthcare.
This commentary is a pre-print of an article to be published in the journal accompanying the Global Solutions Summit on May 27-28, 2021.
See the German version here.