Without equitable access to Covid-19 vaccines, even those nations that have achieved wide vaccine coverage within their respective populations will continue to be at risk. SARS CoV-2 variants that could render vaccines ineffective will mean rich nations getting caught in a vaccine-innovation/redundancy trap—large unvaccinated populations in poor nations make emergence of these likelier as circulating strains mutate in immuno-compromised hosts. So, the US joining the call at the WTO for waiving IPR protection for vaccines temporarily is without doubt a big fillip for vaccine equity. The US’s decision comes after months of opposing this—the proposal, spearheaded by India and South Africa, was first mooted last year in October. By itself, this won’t be enough to swing the WTO towards the waiver; a much wider consensus is needed given many rich nations and blocs oppose this, but this will undoubtedly have a salutary effect since the US has pumped large sums into deals with pharma giants for expedited vaccine research, development and commercial supply. Indeed, the EU, after the American decision, has indicated willingness to discuss the waiver again, if a concrete proposal is tabled, though there was enough caution also voiced on IPR waiver not being a “magic bullet” for vaccine equity. The US decision has also helped convince the Gates Foundation, one of the largest donors to the WHO-GAVI-CEPI initiative, Covax, that aims to give vaccine-access to 92 low and middle income nations.
At present, of the 1.28 billion doses administered globally, 40% is accounted for by just five nations rich nations/blocs, including the US and the EU; bear in mind that this stems from the vaccine supply contracted in advance from top vaccine-makers—high income nations hold 4.7 billion of the 8.9 billion confirmed doses purchased globally, and low-income nations just 0.77 billion. As a result of this yawning disparity in access, as per the Bloomberg Vaccine Tracker, high-income countries are getting vaccinated nearly 25 times faster than low income ones. And, at the current pace of nearly 20 million doses administered a day (with the bulk of this happening in high-income nations that have a low overall share in the global population), inoculating the global population is going to take years. Meanwhile, the Covax pipeline—which has increasingly found its role as a supply window for rich nations to be at cross-purposes with its mission to provide vaccine access to the most economically vulnerable people in poor nations—has been suffering because of its reliance on supplies contracted from manufacturers in India. With the second surge in the country, and the clamp down on vaccine exports, Covax had shipped only 54 million doses in April (or less than a fourth of its target for the month). With G7 countries voicing willingness to share a large chunk of the surplus with them, some of the immediate inequity will hopefully get addressed.
For more sustained, widespread vaccine coverage, however, waiving IPR for a few years is an imperative. Some have argued that there may not be existing capacity in the developing world that can be diverted to vaccine-production so that supplies get ramped up at affordable costs. But, that isn’t a big hurdle; as the example of the yellow-fever vaccine production facility in Senegal, or India’s indigenous vaccine-producing capabilities, show, this is not a big challenge. The WTO needs to move on this early so that vaccine production and supply is adequate to cater for the needs of all countries. It is important to keep in mind that “no one is safe till we all are safe”.