If it is up to the pharmaceutical industry, this pandemic will last much longer

“Every aggressive new variant could be enough to bring us back to square one in the fight against the virus. Europe must break the deadlock on intellectual property rights,” write Belgian Federal Minister for Development Cooperation Meryame Kitir and MEP Kathleen Van Brempt. 

Scientists have been warning for some time that unequal access to vaccines increases the risk of variants such as Omicron. Barely 2% of adults in developing countries have received at least a first jab. That is less than half the number of third jabs that we have already administered in the West today. Former British Prime Minister and Ambassador of the World Health Organization Gordon Brown recently put it this way: “Our failure to put vaccines into the arms of people in the developing world is now coming back to haunt us. We were forewarned – and yet here we are.”

Ironically, the Omicron variant will dramatically increase inequality in vaccine access if we don't take action. The vaccines based on mRNA technology are the most adaptable to new variants, but at the same time they are also the most expensive ones. They are made by European and American companies that have little interest in supplying vaccines to developing countries. As a result, we risk ending up in a vicious circle: in the West, vaccination campaigns will have to be launched again and again against new variants, while the South will have less and less access to effective vaccines. Not only is that completely unacceptable ethically, it's also very stupid. The vaccine disparity gives free rein to mutations. Any aggressive new variant could be enough to bring us back to square one in the fight against the virus.

The industry decides

Today, it is de facto the pharmaceutical sector that decides who gets the vaccine and who doesn't. Vaccine inequality has become a revenue model. Moderna, Pfizer and BioNTech - the three companies that currently hold a monopoly on mRNA vaccines - have made $34 billion  in profits this year alone. That's $1000 profit per second. That income may double next year. Record amounts, even for the pharmaceutical industry.

As a result, the vast majority of mRNA vaccines will go to the richest countries - also in 2022. Those sales yield the highest profit margins. The EU pays three times as much for the Pfizer/BioNTech vaccine as developing countries (€19.50 compared to €6 per dose). The Financial Times has reported on how the African Union was unable to purchase 2 million vaccines from Pfizer/BioNTech for the 5 million health workers in Africa. At the same time, the EU signed contracts with the same company for 2.4 billion doses - four times the amount needed. This dynamic makes low and middle-income countries dependent on less effective Chinese vaccines and donations from the West. 

That stark inequality has led to months of acrimonious conflict over intellectual property rights. The World Health Organization and developing countries advocate waiving patent protections and the free use of knowledge of medicines and vaccines against Covid-19. International trade rules limit the rights of countries to market generic products. In addition, they prohibit governments from sharing trade secrets about the production process or the data from the clinical trials. A proposal (the so-called TRIPS waiver) to eliminate these legal restrictions is on the table at the World Trade Organization, but despite the European Parliament's support for the idea, Commission President Ursula von der Leyen continues to say no. The reason? Once knowledge of the technology is widespread, it will be hard to stop the development of generic, cheaper products - even after the pandemic. 

There is an alternative model

While the international debate about pharmaceutical monopolies has reached an impasse thanks to the EU, the World Health Organization itself has taken steps to effectively make the vaccines a public property. It is currently working with a South African start-up to decipher the formula of Moderna's vaccine. The organization hopes to start up a learning centre (the WHO mRNA technology transfer hub) within four years. If Moderna cooperates, that period could be reduced to two years. But of course, that is not happening.

In the tech transfer hub, other vaccine manufacturers will be able to acquire the production rights and scientific know-how of the copied mRNA vaccine, in order to subsequently be able to produce vaccines or vaccine components themselves. This will allow new manufacturers, also in Africa, to compete on the market. In doing this, the WHO is treading on thin ice, legally. Moderna has never granted contractual permission to copy its vaccine. A solution to the patent issue is therefore crucial for these hubs, along with greater funding and scientific support, including from our country.

Which side will Europe take?

We won't be safe until everyone is safe. That is the biggest lesson we should learn from the emergence of the Omicron variant. And that can only be done by learning from the mistakes of the past year. Efforts have already been made. For example, Belgium has shared more than five million vaccines with vulnerable countries, we are committed to logistical support via COVAX and we support initiatives to voluntarily share knowledge and technology.

That is hugely important, but in the meantime the reality is simple: if we leave the keys to the vaccination campaign in the hands of the pharmaceutical industry, the pandemic will last much longer. It is high time for Commission President von der Leyen to face up to this reality and collaborate with the Biden administration, which does support a temporary suspension of patents and is also taking action within the US to this end. The US and the EU are the largest producers and consumers of mRNA vaccines. If they would put their full weight behind supporting the World Health Organization, a lot would be possible.

The paths for cooperation are clear: the deadlock around intellectual property rights must be broken and the WHO technology transfer hub must be provided with funding and scientific cooperation. There must be joint agreements on mandatory technology sharing and licensing clauses in our purchase contracts and the funding of scientific research. The longer we postpone these logical steps, the greater the inequality will become. And we will all pay a very high price for this inequality.