Public
excitement prevailed at the arrival of the first batch of Covid-19
Pfizer-BioNTech vaccine yesterday, probably more as a sign of relief and hope
for ending the pandemic soon.
Some 312,390 doses of vaccine were reportedly
received, and the National Covid-19 Immunisation Programme will be kicked off
in phases from February 26 with Prime Minister Muhyiddin Yassin due to receive
his first dose under public scrutiny on the first day of the programme.
The challenge has just begun, aiming to vaccinate more than 80%
(> 26 million) of the population residing in Malaysia within a year, with
the first shipment of doses representing merely 0.6% of the doses required (all
except one vaccine candidate in the Malaysian vaccine basket requires two
doses).
The world is not equal, worse during the pandemic. More than 80%
of the population were immunized in Israel by February 18, about the target our
government sets for our own country, albeit one year earlier.
Globally, as of February 20, more than 199 million doses have been
administered, with 87 countries (45% of the 195 in the world) having received
their first vaccines, before Malaysia officially gets its very first dose.
The current projections for global vaccine rollout suggest that
many will have to wait at
least three – and up to five – years to cover 75% of the
population with a two-dose vaccine, leaving many low-income countries behind.
Due to the growing inequality among countries during the
pandemic, the global economy will get hit hard through supply chain disruptions
and travel restrictions; the economic impacts are estimated to cost around US$9.2 trillion (RM36.8 trillion).
Developed economies would pay, too, shouldering half of the burden of the hefty
cost, if they let poorer countries go unvaccinated for longer periods.
Given that the acute global demand for vaccines far outstrips
the current production capacity and supply from a limited number of manufacturers,
“vaccine nationalism” exacerbates the global inequality.
The world map of vaccine contracts shows exactly
that: a small group of wealthy nations has procured the bulk of the global
vaccine supply, reserved more than enough vaccine doses for their own domestic
use (eg, the UK 3.4x, Canada 3.35x and the European Union 2.3x). Out of the
9.59 billion doses booked by February 12, if redistributed evenly, that would
be enough to cover more than half the world’s population.
Such “vaccine nationalism” coupled with limited manufacturing
has caused an “artificial scarcity” that prevents vaccines being shared
equitably among countries.
The shortage is not only in vaccines, some countries also find
it difficult to obtain adequate Covid-19 related medical products, such as
personal protection equipment (PPE), diagnostics, medicines and other medical
devices like ventilators.
Artificial scarcity and high demand for such products create a
situation where the goods go to places where they can be sold at higher prices,
thus resulting in some medical products priced out of affordability at adequate quantity for
low-income countries.
Intellectual property (IP), such as patent, trade secret,
industrial design and copyright, has been identified as a major barrier for
competent manufacturers and suppliers all over the world to ramp up the
production of Covid-19 medical products to meet global demand during this
period.
Many patent-holding multinational corporations have shown
insufficient plans, lack of willingness or no plans at all to openly license or
transfer technologies to competent manufacturers globally.
Even if some of the corporations did offer voluntary licences,
they set the conditions for their chosen partners to determine where to supply
and at what price.
At the beginning of the pandemic, American biopharmaceutical
company Gilead Sciences already set a negative precedent: excluding nearly half
of the world’s population (including Malaysia) from accessing alternative
suppliers at a lower price for an early potential Covid-19 drug treatment
(remdesivir), which has now been delisted by the WHO for lack of efficacy.
Plenty of evidence has shown that the IP
barrier to access to medical products and tools is real.
Malaysia is vulnerable to such patent-barrier induced medical
products shortage. Malaysian-owned patents comprise only 4% out of the total
number of patents granted for pharmaceutical products in
Malaysia from 2003-2018.
The top 10 foreign countries whose companies and other entities
took control of nearly 80% of all pharmaceutical patents in Malaysia were the
US, Switzerland, Germany, Japan, France, the UK, Belgium, Sweden, Italy and
South Korea.
This corresponds to 56.1% share or RM22.8 billion worth of
all pharmaceutical
imports from these 10 countries alone for the past five years
(2016-2020).
This shows the degree of high dependency Malaysia has on
imported medical products, given that the trade deficit in the pharmaceutical
sector is widening year-to-year to the tune of RM1.06 billion in 2020.
What is more concerning is that the pharmaceutical imports for
2020 dipped significantly by 18.6% compared to the preceding year. Perhaps this
is caused by pandemic-driven supply chain disruptions and global shortages (due
to acute high demand).
Given these circumstances, South Africa and India put forward a
proposal to the Trade-Related Aspects of Intellectual Property Rights (TRIPS)
Council at the World Trade Organisation (WTO) on October 2, 2020, requesting
a temporary waiver to be granted to WTO members so that they do not have to
implement, apply or enforce certain IP obligations related to Covid-19 products
and technologies for a certain period of the pandemic.
The TRIPS Agreement requires all WTO members to grant 20 years
of patent monopoly for products (including medical products) if they satisfy
certain criteria and conditions.
This “waiver proposal” that now has support of nearly 100 member countries would empower
countries to do their best within their policy space to scale up manufacturing
capacity, engage in R&D collaboration to develop new treatment and tools,
allow transfer of technology, and have access to the increased supply of
Covid-19 products and tools from other competent manufacturers, without the
fear of expensive litigation.
This proposal would be also useful to provide expedited legal
certainty and clarity to the competent manufacturers, especially those in
developing countries like Malaysia, to effectively leverage their unutilised
capacity or invest in new capacity to ensure sufficient and affordable global
supply of such life-saving products.
Given the glaring global failure of fair distribution of Covid-19
related resources, some countries have come into the painful realisation that
relying on the mercy and limited voluntary actions from the pharmaceutical
corporations is perhaps not the solution in a global pandemic.
While a growing number of countries have voiced their support
for the waiver proposal (with the co-sponsors now including the entire group of
African countries and a few others in addition to South Africa and India), not
surprisingly, the opposition to the proposal mainly consist of the top
patent-holding developed countries including the US, the UK, Japan, the EU, and
Switzerland.
This pandemic is unprecedented in human history in terms of the
number of people infected and who have died from the disease. So, delivering
universal, affordable and timely access to vaccines and critically important
medical treatments should not be left to monopolistic market forces.
In fact, several corporations have received enormous amounts of
public funding and investment supporting the Covid-19 R&D.
Moreover, governments, health care workers, patients, and
healthy volunteers have also contributed substantially to clinical trials and
other scientific research to advance the knowledge and significantly enhance
the R&D activities on different therapeutics and vaccines.
Therefore, it is completely legitimate to ask for Covid-19
related IP to not be enforced during this pandemic period.
The current flexibilities in the TRIPS Agreement, including
government issuance of compulsory licence, is a piecemeal solution at best and
would not provide timely responses during the global health emergency for the
government to obtain the necessary access to Covid-19 products, treatments and
vaccines.
Thus,
it is high time to urge our government to unconditionally support the waiver
proposal come the next scheduled TRIPS Council meeting on Feb 23. It is the
right thing to do for the country (especially if we all care to get our vaccine
shots within a year), and everyone in the world will benefit from it.
