A truly “Global Britain” must stop blocking global solutions to end the COVID-19 pandemic

Victorine de Milliano, Policy Advisor - UK, MSF Access Campaign

In 2015, right before I started as an intern at Medecins Sans Frontieres (MSF), I wrote an opinion piece in a Dutch newspaper in response to the thousands of people who were losing their lives in the Mediterranean Sea as they tried to reach Europe. Europe’s discriminatory migration polices, I wrote, determined who deserved to live and who did not. Now, six years later I’m back with MSF and seeing the same story of lethal discrimination playing out again, this time in the context of the COVID-19 pandemic. Lives are once more being lost because of decisions taken by governments that don’t seem to care about the human cost of their policies.

As COVID-19 rages around the world, there is a dire lack of international responsibility and accountability for global vaccine rollout, resulting in millions of preventable deaths. Early on in the pandemic, world leaders loudly proclaimed their solidarity with people around the world — they said we all stood together against the virus. But that hasn’t been reflected in reality. Take the UK government as an example. As vaccines started emerging from the pharmaceutical pipeline, the UK government claimed that they championed the importance of rapid, equitable access to safe and effective vaccines.” Yet, this same government is today shamelessly blocking the various measures needed to deliver that equitable access to vaccines, medicines and diagnostics.

The UK government has excessively hoarded vaccines, buying up enough vaccine for seven doses for every UK citizen. They continue to oppose the proposal at the World Trade Organization (WTO) TRIPS council to temporarily waive intellectual property (IP) rights on COVID-19 medical tools, including vaccines, and refuse to demand the pharmaceutical industry to openly share its technology. These actions — or inactions — will define the legacy of the UK’s pandemic response. In order to prop up their damaging positions, the government has adopted a series of false arguments.

Let’s test the validity of three claims made by the UK government in a WTO meeting on the TRIPS IP waiver while defending their opposition to it. We are at a critical juncture with the waiver process as the WTO General Council is meeting this week to decide a way forward. Opposition from governments including the UK continues to derail the process, depriving the world of a valuable tool to increase production and supplies of lifesaving COVID-19 medical tools.

Claim #1: “We have not seen evidence demonstrating intellectual property as a limiting factor in either the production or the supply of COVID-19 goods.”

Truth: Hundreds of organisations, academics and governments have supported the waiver and provided evidence of IP being a barrier to access to medicines.

This claim is simply not true. MSF and many others have provided numerous examples in which IP rights have limited access to various COVID-19 medical tools.

In the 10 months since the TRIPS waiver proposal was tabled, hundreds of IP scholars, experts and organisations, and many governments, have lined up to present evidence and express their support for it amid concerns over inequitable distribution, rising cases and deaths, and emerging variants.

And this is in no way a new phenomenon, or one unique to COVID-19. History is littered with examples of pharmaceutical monopolies impeding access to medicines, from TB and HIV to hepatitis C and cancer, limiting supply and driving up prices for essential medicines.

Claim #2: “The UK has worked with the WHO on developing C-TAP”

Truth: The UK has led the opposition to the development of C-TAP and not a single company has yet shared its technology with the pool.

In May 2020, the COVID-19 Technology Access Pool (C-TAP) was launched by the World Health Organization (WHO) to encourage the pharmaceutical industry to pool its knowledge and technologies so that multiple manufacturers could be empowered to increase the production and supplies of new COVID-19 products. However, in direct contradiction to the UK’s claim that they supported the development of C-TAP, it was reported in the media they actually led the push against the development of C-TAP.

Now, more than one year later, C-TAP remains empty, with UK-based GlaxoSmithKline and AstraZeneca choosing to share their vaccine technology on a confidential and bilateral basis, retaining control over the terms, conditions and capacity of the global vaccine production and supply.

The UK government has invested huge sums of public money into the development of new tools to fight the pandemic — including the Oxford-AstraZeneca vaccine. It has a duty to prevent such bilateral and confidential licensing agreements, and push companies to commit to open, unrestricted, and transparent agreements to accelerate broad and affordable access to the final products.

Claim #3: “Voluntary licensing and technology transfer partnerships are making real, positive impact on vaccine delivery, as exemplified by the Oxford-AstraZeneca vaccine with its numerous partnerships around the world.”

Truth: Only 1.3% of people in low-income countries have received a first dose, while nearly 70% of adults in the UK are fully vaccinated.

The UK-funded Oxford-AstraZeneca vaccine has become the centrepiece of the UK’s defence for its opposition to the IP waiver. Indeed, the Oxford-AstraZeneca vaccine has been relatively more accessible in low- and middle-income countries than other vaccines, but when looking at overall vaccine equity, the reality is less rosy. AstraZeneca, which obtained an exclusive license from Oxford, has partnered with the Indian vaccine producer the Serum Institute, which is now the backbone to supply the COVAX Facility.

However, the restricted vaccine production capacity and vaccine export bans during the surge of domestic needs in India contributes to the reality that only 1.3% of people in low-income countries have received at least one vaccine dose, compared to 50% in high-income countries, with COVAX having distributed only 6.8% of its committed two billion doses so far. At this rate, it will take 57 years for everyone to be fully vaccinated, according to one study.

The licensing model and technology transfer partnership model adopted by the Oxford-AstraZeneca vaccine precisely show the limits of restrictive and bilateral voluntary licenses, which put a cap on potential production capacities.

We should also not forget that this waiver proposal extends beyond the Oxford-AstraZeneca vaccine and vaccines in general, and covers ALL COVID-19 medical tools. As long as vaccines are not arriving in sufficient quantities in poorer countries, access to affordable and available diagnostics and treatments is especially crucial. The existing manufacturing monopolies extend beyond vaccines, limiting the scale-up of diagnostics and treatments. Several medicines recently recommended by WHO for COVID-19 treatment remain under monopoly, causing shortages of supply and high prices.

The UK government must stop using the Oxford-AstraZeneca vaccine as a justification for blocking all other solutions for increasing the production and supply of urgently needed medical tools.

What’s next for “Global Britain”?

Under the UK’s leadership, the G7 promised to “vaccinate the world” by 2022, yet the UK chooses to counter the exact measures needed to do so. Taking every possible step to ensure equitable access to vaccines, treatments and diagnostics is essential to ending this pandemic. Currently, we see outbreaks happening across the world with a 40% increase in mortality in Africa over the course of one week. At this rate, new variants will arise making the fight against this pandemic even more difficult.

The waiver will not be the panacea for ending this pandemic, but it’s a critical step in the process. With the text-based negotiations ongoing at the WTO on the IP waiver, the UK must acknowledge the key access challenges related to IP and the importance of the waiver to overcome these. If Britain truly wants to play a global role in this pandemic and other global challenges, following its exit from the European Union, here is now the opportunity to do so.

If not, in the words of WHO Director-General Dr Tedros Adhanom Ghebreyesus: “there is one word that can explain it, and that is greed.”

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This blog is a place to reflect on our experiences working for access to medicines. For the official MSF Access Campaign website please visit msfaccess.org.