As the world waits for the arrival of a vaccine that may end the spread of COVID-19, an urgent advocacy campaign has kicked off in Australia to ensure poor countries have fair access to the vaccines.
Medecins Sans Frontieres (MSF) Australia and New Zealand is in the midst of a high-level campaign to help shift the Federal government’s opposition to an international waiver that, if implemented, could ensure vaccines will soon be available for developing countries. With the waiver, drug companies could begin producing vaccines, treatments and any other medical tools used to fight the virus without fear of being sued or prosecuted on patent or intellectual property grounds.
The campaign’s goal might be simple, but it is linked to a complex set of international trade conventions and rulings that will help ultimately determine just who gets the vaccine, when they get it and what price they pay for it. And no one is under any misapprehension about the urgency or the importance of the campaign.
“This is such a unique moment …we know this virus will not be eliminated until everyone has access to the appropriate medical tools. That’s our bottom line,’’ Nicolette Jackson, a member of MSF’s COVID-19 Access Campaign Advocacy team, explains.
“What’s so unique about COVID is that this is so urgent, it’s so global it’s so complex and the urgency about scaling up access is so pressing, that it’s one of those moments when all of those flexibilities [in trade rulings] that are there should be enacted.’’
The parameters of the debate are clear: 13% of the world have already reserved 50% of the new vaccines in development. The US and the UK have signed advance purchase agreements with pharmaceutical companies that cover their population by 400 per cent – or create potentially four doses of the vaccine for every person in the population. In addition, Oxfam research on the five potential vaccines currently in clinical trials found that nearly two-thirds of the global population would not be vaccinated until 2022.
In October, India and South Africa asked the World Trade Organisation (WTO) to activate a waiver to its Intellectual Property rules that impact design and patents, as they relate in this instance to COVID vaccine development, Put simply, the application of the temporary waiver would help ensure developing nations had timely access to a vaccine.
Australia joined seven other countries, including the USA, UK, Canada and Brazil, to argue that the waiver didn’t need to be activated because there were flexibilities within WTO rules that could be used to ensure developing countries were not disadvantaged. The problem is that these “flexibilities’’ are often too challenging for under-resourced poorer nations to implement. The wealthier nations also pointed to a new organisation, called the COVAX (COVID-19 Vaccine Allocation Plan) facility – that they, including Australia, helped to fund as a bulwark against the rise of so-called “vaccine nationalism’’ and to ensure that developing countries would have access to a vaccine. The hope is that through this scheme there will be a billion doses made available to the 92 least developed countries by the end of next year.
All well and good, but MSF has seen some of these arguments before, and knows there are real risks for developing countries. More than 20 years ago, MSF was part of the campaign to help reduce the price of drug treatments for the HIV virus. The campaign was vital to ensuring developing countries could afford the treatment.
Nicolette says the 2001 Doha declaration made it clear that the public health had priority over the intellectual property behind the creation of any drug treatment. “That was a really critical moment in making HIV treatments affordable - prices went from $10,000 to $100 because of competition by generic drug manufacturers in India. It became possible with support from the Global Fund to fight AIDS, TB and Malaria for people living with HIV in poor countries to receive life-saving HIV treatment for the first time.’’
MSF established its Access to Essential medicines campaign at the time. The campaign identified that access to drugs wasn’t just about price, but also about the lack of commercial incentive for pharmaceutical companies to research potential cures for diseases that were prevalent only in developing nations in Latin America or Africa.
This campaign, however, has a far quicker turnaround time, as the momentum builds with the promise of several vaccines becoming available next year.
“Right now, our priority for the next few weeks is to organise as many high level bilateral briefings as we can with people from Australian and New Zealand governments,’’ Nicolette says. “Australia is critical at this point because it’s one of only eight countries to come out and say they object to the waiver.’’
“For us right now, other than trying to organise those bi-lateral briefings, …we are also trying to mobilise our supporters, and getting some kind of petition online that people can support, getting some kind of open letter that again we can share with our supporters,’’ she says.
There has already been the highly effective EndCovidForAll campaign, started by Micah Australia with the Australian Council for International Development (ACFID) and Campaign for Australian Aid. More than 150 organisations joined the campaign to lobby the Australian government to increase financial support for countries in the region and help developing nations to get access to a vaccine.
In a joint statement with Health Minister Greg Hunt, Foreign Affairs Minister Senator Marise Payne announced five weeks ago that Australia was going to support access to a vaccine in the South Pacific and south-east Asia.
The announcement outlined how the Australian government would spend $500m over the next three years to provide support for supplying vaccine doses and technical support to nations within the regions.
But according to MSF, Australia has also set aside $3.3 billion through five separate agreements with pharmaceutical companies to look after our own vaccine needs.
The decisions around the Intellectual Property waiver are set to be debated again this month when WTO representatives meet. And while the debate may seem dry and abstract, the consequences most certainly are not.
“The risk is that developing countries will be pushed to the back of the line and if you can pay more, you are going to get prioritised,’’ Nicolette says.
“There hasn’t been enough transparency around these advance purchase agreements these rich countries have made with drug companies, so if they’re offering higher prices than say the COVAX facility can pay, then obviously the temptation will be for these drug companies to prioritise these rich countries first. Developing countries will have to wait.’’
Not only that, but MSF has particular concerns about the humanitarian element to the vaccine debate. “We are really concerned about the implications of addressing the humanitarian needs when it comes to COVID,’’ Nicolette says. “MSF right now is calling on the rich countries to ensure that with any COVID vaccines that they are able to get access to that they can set aside some of them to create a humanitarian stockpile of vaccines – this is something the World Health Organisation (WHO) has talked about. When we’re talking to Australian and New Zealand governments one of our big asks is to ensure that there is some kind of humanitarian allocation.’’