The COVAX initiative as a patch for true solidarity
A commentary on the ill-concealed vaccination nationalism of industrialised nations
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A very small percentage of people can have seizures when exposed to certain visual stimuli, such as letters whose composition reflects the failure of global policies to the detriment of many people. Even people with no history of seizures can have an undiagnosed condition that causes what are called „tantrums“ when reading such texts.
If you experience any of these symptoms, stop reading immediately and see a doctor or your constituency representative.
Symptoms of these seizures include dizziness, altered perception, eye or muscle twitching, trembling in the arms or legs, disorientation, confusion and brief loss of consciousness. During a seizure, there may also be a feeling of fainting or convulsions, which can lead to hopelessness and despair.
What COVAX is supposed to do
What has become of it
Already in the implementation of these ideas one can read that some countries will be more equal than others:
Self-financing countries will be guaranteed sufficient doses to protect a certain proportion of their population, depending upon how much they buy into it. Subject to funding availability, funded countries will receive enough doses to vaccinate up to 20 per cent of their population in the longer term.4
Dr. Seth Berkley
CEO of Gavi
It seems, our solidarity is only lasting for 20% of the people from the poorest countries. Financially strong countries, i.e. those that pay for their COVAX doses themselves and do not receive donations, on the other hand, are not capped in the delivery of goods for the time being. Later in the same text, these industrialised nations are even promised a 10-50% vaccination quota, the doses of which they can order through COVAX.
20% is a good start, one could say, if there were no direct reference to the expected delay, which is not mentioned for the rich countries. Besides, the German Health Minister Spahn said in November that about 30-40% of the german population are considered to be in the risk group for severe disease progression in case of infection.5 Nevertheless, we expect that in other countries this may be a maximum of 20%.1 So the doses still to be donated are not enough to protect all the most vulnerable people, and certainly not enough to establish herd immunity with a vaccination rate of around 80%. But isn’t that exactly what we need to defeat the pandemic, and to do so everywhere? If we assume that some countries cannot afford 20% of the required vaccines, where are they supposed to get the other 60% for the assumed herd immunity?
Also, ideally, countries should not enter into parallel bilateral supply contracts with the vaccine manufacturers, as these compete with COVAX, i.e. increase demand in the market with limited supply, thus driving up the price. The manufacturers can sell their few products more expensively when demand is diversified. So COVAX could buy even fewer vaccine doses for the money it has painstakingly collected. Well, we all know that is exactly what happened. The EU, collectively for its members, and other rich countries buy their own vaccines past COVAX, and the initiative remains empty-handed. The industrialised nations are supplied first, the invisible hand lies protectively over us.
The idea of a fair and cooperative community joining forces to defeat the virus globally has in the end turned into another hierarchical aid project with familiar power imbalances and without sufficient effective resources.
Incidentally, the insightful quote on the misplanning of the initiative is dated 03/09/2020, written by Dr Seth Berkley, CEO of Gavi, the vaccination alliance that co-manages COVAX. Their biggest fan and lobbyist, and even he admits to these inequalities. On the 3rd September last year, not a single vaccine had been licensed in the EU, and it is easy for me to indict mistakes today from the perspective of history afterwards. But even at that time, there were already many actors who drew attention to these and other problems. And even better: they proposed solutions!
How it should have gone
These extraordinary times and circumstances of call for extraordinary measures.— Ambassador Katherine Tai (@AmbassadorTai) May 5, 2021
The US supports the waiver of IP protections on COVID-19 vaccines to help end the pandemic and we’ll actively participate in @WTO negotiations to make that happen. pic.twitter.com/96ERlboZS8
An up-to-date overview of the countries‘ positions and much more information can be found on the action page of Médecins Sans Frontières (and on the very top of this commentary), which, unsurprisingly, is also in favour of enforcing the proposal. After all, there are historical examples that would speak to the success of such a measure, such as the polio vaccine, on which there has never been a patent, and AIDS treatments and tests, which have become enormously cheaper and more available since patents were suspended. Despite broad civil society support and overwhelming arguments against the profits of the pharmaceutical industry and for the health of the world’s population, this path will not be taken as things stand, because Germany and all the rest of Europe (except the Vatican and Ukraine) continue to oppose it. At least, after the US gave in, the EU holds out the prospect of introducing a compromise proposal in June that could provide for a simplification of licensing. Radical help is undesirable: the focus is on licensing, the so-called transfer of technology under the control of the patent-owning companies. The main arguments that politicians have adopted from lobbyists (and my responses to them) are:
We must be able to ensure the enduring quality of vaccines
So far, most vaccines of any kind have been produced outside the industrialised nations; India is referred to as the pharmacy of the world.
Manufacturing is complex and requires challenging supply chains.
The supply chains are only challenging because various intermediate products are patented and protected. Most of it could be produced anywhere in the world, if only you were allowed to.
A release of the patents will not lead to a single dose more on the market.
It takes only 6 months in the prioritised procedure to set up and approve a clean laboratory with production, as has already been done.
Without profit incentives, research will no longer be carried out in the future.
The research on mRNA vaccines was carried out at universities with a lot of dedication and little money. The pharmaceutical industry only jumped on board when it came to production, this is where greed comes into play.
The funniest thing about the waiver is the following:
It is a CAN formulation. The TRIPS Agreement obliges ratifying countries to provide patent protection for the respective products for at least 20 years. The waiver proposes that states no longer have to apply this rule. So they CAN suspend patent protection if they WANT to. Germany, or anybody else for this matter, would not have to do this at all if they did not want to, even if the waiver were adopted. This is because patent rights apply nationally, whereas the WTO has no legislative power. All existing laws continue to apply until they are changed. The waiver only offers permission to change them without having to fear WTO sanctions. By refusing to negotiate on this, however, the German government is also preventing this voluntary solidarity for all other states that would like to suspend their patents. That is absolutely absurd.
Hey, but how does the Federal Foreign Office put it so nicely? „Germany is committed – to multilateral solutions instead of vaccine nationalism“.9 Meaning the reality certainly can’t be that bad, can it? In the paragraph under this heading it says „[Germany] advocates for a fair, transparent and affordable access to Covid 19 vaccines, medicines and diagnostics worldwide in all international bodies.“ Maybe the German WTO delegation and our Chancellor should be informed of that statement, surely they just didn’t read it yet. After all, they have a lot to do with self-portrayal all day long; something as substantive as this can sometimes get lost; it’s not a shame.
What we are left with
- The first injections were administered in Germany on 27.12.2020. The first COVAX jab did not enter an arm until 01.03.2021, 9 weeks later.11
- COVAX only signed a contract with Pfizer/BioNTech in January. It provides for the supply of 40 million doses, which is only 3% of the planned 2021 production.12
- At the time I am writing this post (02.06.2021), Germany, as a single country, was administering about 51.5 million jabs,13 COVAX was allowed to deliver just 77 million to 127 participating countries.14 By June, it was probably going to be 330 million doses to 145 countries (at least according to original plans). Even that would only have been enough to vaccinate 3.3% of the recipient populations.12 By that time, Germany will have lifted vaccine prioritisation and people like me, who are not at increased risk, will already be getting their second jab. In most countries around the world, not even essential health workers will be fully protected by the same date.
- Because our states have been so incredibly selfish, solidarity is being re-shouldered onto the population: for a donation of 6 euros on gogiveone you can buy a single vaccine dose for the COVAX initiative. This definitely helps, but in the end these funds go to pharmaceutical companies who, without the blocking attitude of the industrialised nations, would no longer have any right at all to take the lives of the poorest on our planet hostage for their profit.
Solidarity can perhaps only be shown by those who have power. Maintaining the power imbalance was and is an active decision of the industrialised nations by not supporting the waiver.
The current circumstances in India, Southeast Asia and South America are hardly the result of the rejection of the waiver. But one can state that every aid mission now brings in symbolic solidarity capital to the governments of said countries, based on a gap in ability to industrially fight pandemics through the availability of medical products, which the waiver wanted to equalise. Similar capital should be brought in by the COVAX initiative, if it were to work. These handouts would not have been so profitable for the upcoming elections if the entire capacity of the world was really used to fight this pandemic. For as hard as it seems to be for some to believe, these capacities also exist outside Europe and the USA.
So the next time you hear someone talking about how the EU has bought too few vaccines and how Germany is vaccinating terribly slowly, please draw the attention of the person you are talking to to these circumstances. As has been the case for a long time, our welfare means the suffering of others. Because true solidarity would also have required sacrifice.
- deutschland.de: Covax – eine Initiative für alle (11.03.2021), retrieved from https://www.deutschland.de/de/topic/politik/deutschland-unterstuetzt-covax-2-milliarden-euro-fuer-impfstoff. Last accessed on 25.05.
- e.g. press conference 19.2.2021, retrieved from https://www.bundesregierung.de/breg-de/themen/buerokratieabbau/pressekonferenz-von-kanzlerin-merkel-nach-der-g7-videokonferenz-1860056. Last accessed on 28.04.
- WHO: The Access to COVID-19 Tools (ACT) Accelerator (2020), retrieved from https://www.who.int/initiatives/act-accelerator. Last accessed on 28.04.
- Gavi: COVAX explained, abgerufen unter https://www.gavi.org/vaccineswork/covax-explained. Last accessed on 28.04.
- ZDF: Spahn: 30 bis 40 Prozent sind Risikogruppe (09.11.2020), retrieved from https://www.zdf.de/nachrichten/politik/coronavirus-spahn-risikogruppen-100.html. Last accessed on 28.04.
- ONE: Wie steht es um die globale Verteilung der COVID-19-Impfstoffe? (02.03.2021), retrieved from https://www.one.org/de/blog/verteilung-covid-19-impfstoffe/. Last accessed on 28.04.
- WTO: Council for Trade-Related Aspects of Intellectual Property Right, IP/C/W/669, retrieved from https://docs.wto.org/dol2fe/Pages/SS/directdoc.aspx?filename=q:/IP/C/W669.pdf&Open=True. Last accessed on 28.04.
- WTO: TRIPS — Trade-Related Aspects of Intellectual Property Rights, retrieved from https://www.wto.org/english/tratop_e/trips_e/trips_e.htm. Last accessed on 28.04.
- German Federal Foreign Office: Corona gemeinsam und solidarisch bekämpfen: Deutschland unterstützt weltweite Pandemiebekämpfung mit weiteren 1,5 Mrd. EUR (19.02.2021), abgerufen unter retrieved from https://www.auswaertiges-amt.de/de/aussenpolitik/themen/gesundheit/covax/2395748. Last accessed on 25.05.
- Wall Street Journal: Why Covid-19 Vaccination in Poorer Nations Has Slowed, Posing Global Risks (19.04.2021), retrieved from https://www.wsj.com/articles/why-covid-19-vaccination-in-poorer-nations-has-slowed-posing-global-risks-11618826934. Last accessed on 28.04.
- TIME: The First COVID-19 Vaccines Shipped Through COVAX Were Administered in the Ivory Coast (01.03.2021), retrieved from https://time.com/5942715/ivory-coast-covax-first-shots/. Last accessed on 28.04.
- euronews: Was ist COVAX und hilft es armen Ländern an Corona-Impfstoffe zu kommen? (26.02.2021), retrieved from https://de.euronews.com/2021/02/26/was-ist-covax-und-hilft-es-armen-landern-an-corona-impfstoffe-zu-kommen. Last accessed on 28.04.
- RKI: Tabelle mit gemeldeten Impfungen bundesweit, data status 02.06. 8:00 o’clock, retrieved from https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Daten/Impfquotenmonitoring.html. Last accessed on 02.06.
- Gavi: COVAX vaccine roll-out, Dashboard data status 02.06., retrieved from https://www.gavi.org/covax-vaccine-roll-out. Last accessed on 02.06.
- UNICEF: The COVAX Facility will deliver its 65 millionth vaccine dose this week. It should’ve been at least its 170 millionth. The time to donate excess doses is now (17.05.2021), retrieved from https://www.unicef.org/supply/press-releases/covax-facility-will-deliver-its-65-millionth-vaccine-dose-week-it-shouldve-been. Last accessed on 25.05.
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