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Pressure mounts on rich countries and big pharma to act on global vaccine inequity

Differences between Western states on patents and exports are likely to persist after Rome summit

Accusations of 'vaccine apartheid', voiced by South Africa and Kenya in recent months, and repeated again earlier this week by World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, appear to have pushed Western states into action.

The latest calls for action come as concerns grow that the second wave of coronavirus infections cutting across India could be repeated in Africa. 

Already, India's ban on vaccine exports due to its own emergency – its Serum Institute was to be the main supplier of vaccines to developing economies – has cut the availability of vaccines to Africa. By the middle of May, only 2% of Africa's 1.3 billion people had got Covid-19 vaccinations. French President Emmanuel Macron's target that 40% of Africans would be vaccinated by the end of this year would require a radical change in vaccine policy and practice.

But there is little agreement on how to make those changes. Sharp differences are likely to emerge at the Global Health summit hosted in Rome on 21 May by the European Union and the WHO. 

With United States President Joe Biden having joined the campaign led by India and South Africa to waive patents on Covid vaccine manufacture earlier this month, the EU, which has long opposed lifting patent protection, was under pressure to set out an alternative plan (AC Dispatches 10/05/2021, Health chiefs salute progress in lifting patents on Covid-19 vaccines but say India's crisis shows risks to Africa). 

That plan, likely to be tabled at the Rome summit, will include several measures to support vaccine-manufacturing capacity, setting up three production hubs in Africa. EU officials might also moot the additional possibility of a time-limited patent waiver, although this was not included in the draft declaration reported by Reuters. Primarily, the European Commission is calling for the US and Britain to join in easing export restrictions and for working vaccine developers to step up supplies. Pfizer and BioNTech are to make new pledges on boosting production at the Rome meeting, and another two big pharma companies are expected to follow suit.

The EU also argues that there is sufficient flexibility in the existing World Trade Organization rules. Any moves to increase the capacity of African states to mass produce vaccines are likely to be useful only in the next pandemic or the later stages of this one.

WTO Director-General Ngozi Okonjo-Iweala, who has sought to stay neutral on the issue, told the European Parliament's International Trade Committee on Thursday that 'getting the Intellectual Property rights waiver for vaccines will not be enough'.

'We need more flexibility and automatic access for developing countries, and at the same time, we have to protect research and development,' she added.

Just as frustrating as the inability to produce vaccines in Africa has been the slow pace of promised vaccine supplies arriving. Pledged vaccines from the EU, France and the UK, among others, are still yet to arrive as exporting countries continue to prioritise getting jabs to their own populations. Meanwhile, the international vaccination programme Covax, instead of being a forum to coordinate supplies equally, has become an emergency tool of last resort for developing countries.

The EU points out that it has exported over 200 million vaccine doses, while the US and UK have not exported any. The UK is the second-largest contributor to Covax after the US. 'The current situation is not sustainable. It is both unfair and inefficient,” President Macron said in Paris on 18 May.

Changing that will require leaders to agree on a policy regime that moves away from vaccine nationalism. So far there is little evidence of that happening.

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