Vaccine Nationalism — The Case for the Global Pooling of IP via CTAP

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Across the world, countries are beginning to roll out the COVID-19 vaccine. Of the three approved in the UK — Pfizer/BionNTech, Moderna and Oxford/Astrazeneca — the Pfizer vaccine is currently being distributed, and AstraZeneca are on track to produce 2 million doses a week by the end of March 2021.

However, according to a recent study by Duke University, it is clear that there will be a global deficit of vaccines until at least 2024. Faced with limited supplies, rich countries have been quick to make deals with vaccine producers, offering public funds in return for guaranteed doses.

AstraZeneca, the firm scaling up production of Oxford University’s vaccine, has promised the UK roughly 100 million doses in exchange for £65.5 million of funding, with larger pledges to the EU, US, China and Japan exceeding 300 million doses each for large and sometimes undisclosed sums. In addition, governments have offered product liability indemnification in return for the firm keeping costs at a non-profit rate, substantially “de-risking” investment in the vaccine.

The fact that production of the vaccine has fallen to large pharmaceutical companies is unsurprising. An effective global vaccine supply requires speed, capacity and money. Giants like AstraZeneca can implement economies of scale, producing the vaccine cheaply and efficiently.

Issues arise regarding how poorer countries will get access to the vaccine. As was the case with HIV treatment, developing countries have been up to 7 years behind richer nations in terms of drug supply because patented retrovirals were so expensive. We have already seen how patents have restricted the provision of COVID-19 treatment drugs: as the pandemic began to worsen last May, Gilead was restricted from supplying remdesivir to over 70 countries due to patent limitations.

Most developing countries lack the production capacity of pharmaceutical giants to manufacture the virus themselves and rely heavily on international aid. Given the significant supply agreements between producers and wealthier countries, concerns have been raised about so-called “vaccine nationalism” causing global inequality as low-income populations struggle for immunity. It would create, in the words of Wendy Chamberlain MP, a “two-tiered planet”.

Rather than opening up their IP so smaller producers can make the vaccine themselves, companies like AstraZeneca have instead opted to grant licences to other large producers through global initiatives like COVAX. This WHO initiative brings together governments and manufacturers to establish fair vaccine distribution across the globe. Countries can pool their resources and spread risk through collective investment in a transparent and coordinated approach.

Through the COVAX initiative, both AstraZeneca and Novavax have issued licenses for 1 billion doses to the Serum Institute of India, the world’s largest vaccine manufacturer by number of doses it can produce. Other companies such as Johnson & Johnson and GlaxoSmithKlein have issued similar amounts.

On the face of it, this is entirely laudable. But COVAX’s effectiveness is potentially fairly limited. It relies hugely on the SII as the biggest manufacturer for developing countries, and as the Institute’s chief executive, Adar Poonawalla, has pointed out, India is currently enforcing a ban on drug exports. Such a block will prevent vaccines from leaving India for “several months”, severely limiting COVAX’s main channels for timely vaccine distribution. Once again, vaccine nationalism is hindering global transmission.

Given such difficulties with distribution, nations turn towards their own domestic producers. Yet, for these companies to gain efficiency, they need access to useful vaccine IP. To get this, they require state-sanctioned mRNA patent waivers in developed countries and transparent, horizontal data sharing from large companies to small.

At a WTO conference in November, India, South Africa, Pakistan and others called for exactly this. Despite the UK government dismissing their concerns as “hypothetical”, Moderna did go on to announce that it will not enforce vaccine related patents for the duration of the pandemic. Pharmaceutical companies have also been quick to point towards other existing channels for IP sharing: there is currently a blockchain system in the industry whereby companies can search rival companies’ data without revealing commercial secrets.

But critics have pointed out that for small producers to benefit from fewer IP restrictions, there would need to be a much more substantive transfer of know-how, trade secrets and cell-lines between international vaccine producers. Smaller producers need to know more than simply how to create a vaccine, but how to produce it cheaply and on large enough scales to meet domestic demand. This information is not locked up in mRNA patents but protected processes central to the operation of large-scale drug manufacturing, hence the reluctance of firms to give such information away.

Rather than rely on global distribution agreements and the goodwill of pharmaceutical companies, it would be more effective to open up IP channels to small producers in low-middle income countries. This would bypass restrictive nationalist policies, such as India’s drug ban. It would also allow developing nations to keep production within their own markets and minimise debt to foreign firms and international organisations.

There is an existing initiative to facilitate this: C-TAP, short for COVID-19 Technology Access Pool. This data pool allows for crucial intellectual property assets — from patentable processes to R&D and technical production knowledge — to be distributed to vaccine producers. It would function in the same way as the Medical Patents Pool gathers IP surrounding anti-HIV drugs to improve production efficiency. It is a clear solution to the roadblocks of vaccine nationalism, granting a wider range of global producers equitable access to health technologies.

At present, C-TAP is voluntary and lacks the support of most wealthy nations and large pharmaceutical companies, hence poorer nations have made direct appeals for international patent waivers. Its potential, however, is great. In the face of such a global catastrophe, it is frustrating, if perhaps inevitable, that institutions and governments are wary of lowering IP exclusions for a serious health imperative. Existing channels for vaccine IP distribution are ineffective and this needs to be made clear to those resisting initiatives like C-TAP. If we are to achieve an equitable global vaccine provision, more must be done to spread knowledge to domestic producers in less-developed nations.