Getting trade policy right is crucial to global COVID-19 vaccination

Author: Ken Heydon, LSE The death rate in India from COVID-19 has reached alarming levels and that’s intensified attention on trade in the provision of vaccines to help. Trade is a crucial element in the fight against the pandemic. Some countries, such as China, have sought credit for providing vaccines to others, while cooperation via […] The post Getting trade policy right is crucial to global COVID-19 vaccination first appeared on East Asia Forum.

Getting trade policy right is crucial to global COVID-19 vaccination

Author: Ken Heydon, LSE

The death rate in India from COVID-19 has reached alarming levels and that’s intensified attention on trade in the provision of vaccines to help.

Trade is a crucial element in the fight against the pandemic. Some countries, such as China, have sought credit for providing vaccines to others, while cooperation via the COVAX initiative has seen vaccines shipped from India’s Serum Institute to some of the poorest countries in the world.

But trade policy has also been a serious impediment to the free flow of vaccines, vital vaccine inputs and the knowledge behind their production.

At critical times, several countries — including the United States, the European Union and more recently India — have placed embargoes or administrative impediments on the export of vaccines. Perversely, India has also had a 10 per cent customs duty on imported vaccines.

Restrictions have also been placed on the materials needed for vaccine manufacture. In February, the invocation by the United States of the Defense Production Act — which requires US suppliers of materials and equipment for vaccine production to seek approval to export — put global access to 37 critical vaccine inputs at risk.

Adar Poonawalla, the head of India’s Serum Institute, has linked the global shortage of bioreactor bags — critical in the vaccine supply chain — to the US policy of prioritising domestic production. The potential for supply disruption through policy interference is stark: the Pfizer vaccine needs 280 components from 86 suppliers in 19 countries.

Within the ongoing debate about intellectual property rights, the United States has now expressed support for the proposal initiated at the WTO by India and South Africa to temporarily waive them on COVID-19 vaccines, including on the messenger RNA technologies used in the Pfizer–BioNTech and Moderna vaccines and on those used in the adenovirus vaccines produced by Oxford–AstraZeneca. Nevertheless, even if the waiver receives the necessary support of all 164 WTO members, this will not prevent intellectual property right restrictions from stopping developing countries from acquiring knowledge on new techniques to design vaccines and to develop the cell lines needed in vaccine manufacture.

Ensuring the free flow of necessary inputs within the supply chain is vital to fostering global vaccine production. On 14 April 2021, WTO Director-General Ngozi Okonjo-Iweala met with government and industry representatives to discuss ways of strengthening supply chains. A guiding principle in facilitating trade will be the provision in GATT Article XI that any restrictions on export be temporary, noting that even a ‘temporary’ restriction can be highly disruptive within a complex global supply chain.

More ambitiously — with a focus on facilitating cooperation rather than just avoiding restrictions — there may be scope to build on the Trade and Health Initiative proposed by a group of WTO members in late 2020. This would involve the establishment of an internationally coordinated program of fragmented and subsidised production of vaccine components.

The key here would be the need to overcome the reticence of countries that do not have the public health incentive to provide subsidies at the scale required to satisfy global demand. Those countries would only enjoy the ‘externality’ benefit of solving their own public health crisis if they were guaranteed access to other countries’ vaccine output through trade.

Further ahead, the trade regime will need to be better aligned with the pursuit of knowledge to deal with future pandemics, including those arising from variants of SARS-CoV-2, against which current vaccines are likely to be less effective.

Notwithstanding the complexities arising from the paradox of patents — namely, restricting knowledge now to increase it in the future — action is still possible that would go beyond a temporary waiver.

More should be done within the WTO to implement changes to the Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement, intended to improve developing countries’ access to medicines. In 2010, India and Brazil initiated WTO dispute settlement actions and argued that repeated seizures on patent infringement grounds of generic drugs — originating in India and transiting through the Netherlands to reach other developing countries — were inconsistent with the TRIPS Agreement. The case has languished but there is still scope via TRIPS Article 31 to clarify the issue of seizure of drugs in transit.

More should also be done within preferential trade agreements to facilitate developing country access to medicines. The Trans-Pacific Partnership is a case in point. When the United States was actively involved in the negotiations, it sought a 12-year period of data exclusivity for biologic drugs, some of which are used in COVID-19 therapy.

Even with the departure of the United States from the agreement, CPTPP provisions on data exclusivity protection for biologic drugs – which many health authorities consider a significant deterrent to research and a source of increased public spending on medicines — still hang in a state of suspension.

To be fully effective, action on the trade front needs to be combined with public health reform within developing countries. The impact of COVID-19 in India for example has been accentuated by decades of underinvestment in public health infrastructure. The shortage of personnel, beds and oxygen dramatically demonstrates this. As always, trade cannot carry all the load.

Ken Heydon is a Visiting Fellow at the London School of Economics. He is a former Australian official and senior member of the OECD secretariat. He is author of The Political Economy of International Trade: Putting Commerce in Context (Polity, 2019).

This article is part of an  on the COVID-19 crisis and its impact.

The post Getting trade policy right is crucial to global COVID-19 vaccination first appeared on East Asia Forum.
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No end to COVID-19 pandemic absent international cooperation

Author: Jeremy Youde, University of Minnesota Duluth India is in the grips of a massive COVID-19 outbreak, with the total number of cases now numbering more than 24 million sick and more than 250,000 deaths (though the number of COVID-19 deaths is likely significantly higher). The country is setting records for the number of new […] The post No end to COVID-19 pandemic absent international cooperation first appeared on East Asia Forum.

No end to COVID-19 pandemic absent international cooperation

Author: Jeremy Youde, University of Minnesota Duluth

India is in the grips of a massive COVID-19 outbreak, with the total number of cases now numbering more than 24 million sick and more than 250,000 deaths (though the number of COVID-19 deaths is likely significantly higher). The country is setting records for the number of new cases nearly every day. Arundhati Roy, the world-renowned Indian author and activist, has called the situation a ‘crime against humanity’.

The rapid surge of cases in this second wave of COVID-19 has quickly overwhelmed India’s health care system. Medical oxygen, a vital tool for treating patients whose blood oxygen levels are too low, is in such short supply that some hospitals are asking patients to bring their own oxygen with them. Hospitals have even sued the government to force it to devise a plan to supply oxygen. Patients who can’t get a hospital bed are being forced to lie outside because there is no space inside.

Compounding the situation is the sheer lack of vaccines to stop further spread of the virus. In late April, Mumbai, home to roughly 20 million people, had to stop all vaccination campaigns for three days because it had no more vaccines. Though India is the world’s biggest producer of vaccines and has been engaged in an active vaccine diplomacy program, the country is now importing doses of Russia’s Sputnik and the AstraZeneca vaccine, along with the locally-produced Covaxin vaccine, to resume its vaccination program The country was able to resume vaccinations thanks to donations of Russia’s Sputnik vaccine and locally-produced supplies of the AstraZeneca and Covaxin vaccines.

Despite widespread acknowledgement that viruses do not respect borders, India’s devastating experience with COVID-19 calls into question the degree to which the international community is willing to translate idea into practice. Programs like the COVID-19 Vaccine Global Access (COVAX) are supposed to ensure a more equitable distribution of COVID-19 vaccines, but the reality seems instead to reinforce the inequalities around vaccine distribution.

While shipments of the AstraZeneca vaccine from the United States will be helpful, there is more that it could do to ameliorate the shortages in India—and the inequitable access to COVID vaccines more generally. A program like COVAX or donations from the United States can only do so much to resolve structural inequalities that limit access to pharmaceuticals and vaccines; it addresses the immediate issues but not the underlying root causes that give rise to maldistribution in the first place. If world leaders want to make pharmaceuticals more accessible, they need to change the intellectual property rights system governing therapeutic drugs.

Intellectual property rights grant creators the right to control who gets to produce a product and under what conditions through the granting of patents. This control is supposed to reward innovation by allowing creators of intellectual property to reap the rewards from their discoveries.

This might make sense in the case of a car or a computer, but what happens when the people who need access to a drug to protect public health are the very people who lack the money to purchase it? When commerce takes precedence over public health and prevents people from getting the drugs that can protect their own lives and those of others, the risk increases for everyone.

This tension between commercial interests and health is not unique to COVID-19. When antiretrovirals were developed to prolong the lives of those living with HIV, the annual cost was more than US$10,000 — making them completely unaffordable for the majority of people in the countries with the highest rates of HIV infection. This led to the adoption of the Doha Declaration in 2001, allowing countries to ignore patent protections for pharmaceuticals when there is a public health emergency. This includes allowing countries to manufacture their own generic versions of patented drugs.

Both India and South Africa have called on the World Trade Organization (WTO) to declare a public health emergency. Wealthy states resisted these pleas for months, but the United States and China have both announced that they would support a waiver in this instance, though pharmaceutical manufacturers and a number of European governments remain opposed. Drug companies argue that the move would stifle the innovations that allowed them to develop the vaccines so quickly, and European governments argue that the move will do little to ease the shortage. Even with American and Chinese support, though, the WTO’s consensus-based decision-making process means that it is entirely unclear when (or if) a waiver will be granted — while India’s COVID-19 outbreak continues to explode.

Stopping the global COVID-19 pandemic requires meaningful international cooperation. The outbreak in India shows what happens when that collaboration is absent or slow in coming. Action is needed that requires a willingness to change the rules about pharmaceutical intellectual property rights to match the scope and scale of the challenge from the disease that the global community faces.

Jeremy Youde is Dean of the College of Liberal Arts at the University of Minnesota Duluth.

This article is part of an  on the COVID-19 crisis and its impact.

The post No end to COVID-19 pandemic absent international cooperation first appeared on East Asia Forum.
Source : East Asia Forum More   

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