Patently unfair: when climate justice aligns with access to medicines

Guest blogger: Rebecca Hotchkin, Co-National Coordinator, Universities Allied for Essential Medicines (UAEM) UK, and medical student at King’s College, London University

Climate change has been described as the biggest threat to global health in the 21st century. Last year’s UN Climate Change Conference in Glasgow, COP26, saw large-scale mobilisation in the UK across a wide range of civil society and led to the creation of the COP26 coalition. This coalition included environment and development NGOs, trade unions, grassroots community campaigns, faith groups, youth groups, migrant and racial justice networks — to name a few. The unifying ambition has been to highlight the intersectionality of climate justice and how this issue shows the need for systemic change in our current political and economic systems.

Universities Allied for Essential Medicines (UAEM) UK members supported some of the work of the COP26 coalition, and joined a group of healthcare professionals warning about the impacts of climate change on health. These are of course multiple, and have been clearly summarised in a report from Medact, explained in the graphic below.

The impact of climate change on global health. Creative Commons

We reflect on the intersection between climate change and access to medicines through two angles: global solidarity and intellectual property.

How the COVID-19 pandemic has demonstrated the limits of ‘global solidarity’

The first angle is vaccine inequity. Many parallels have been drawn between the climate crisis and the COVID-19 pandemic. The pandemic has shown the world what it means to face a direct existential threat. We have seen the measures we are able take, and the resources we are able to mobilise to face such a crisis.

However, the pandemic has also shown the world that it is not enough to just tackle the immediate crisis. Centuries worth of systemic inequalities have been highlighted by this common threat as they are by the challenges posed by climate change.

This has been seen most clearly through the inequity in the rollout of COVID-19 vaccines. As UAEMers we are acutely aware of vaccine inequity, with less than 16% of people in low-income countries having received at least one dose of COVID-19 vaccine.

What this means is that countries with higher vaccination rates, like the UK, have been able emerge from the pandemic earlier, and open up their economies once more, while many countries around the world are still in the midst of the crisis. Their vulnerable populations and healthcare workers remain at risk, while we are offering booster shots and ending restrictions.

Despite saying we would work together at the beginning of the pandemic, rich countries have chosen to hoard vaccines and prioritise their own populations while others have been forced to depend on promises of donations and charity. The UK and European Union (EU) countries have also been refusing to support a TRIPS waiver on COVID-19 intellectual property at the World Trade Organization, that could help boost supplies of all COVID-19 medical technologies — instead putting corporate profits before public health needs.

This crisis has highlighted how our global systems are built and how power structures play out in a way that hinders our ability to tackle the pandemic, as seen with the emergence and spread of new variants of COVID.

There are a number of direct impacts of this global vaccine inequity on the climate crisis. First, the failed global response and refusal to work together has led to a lack of trust in global solidarity, as highlighted by Tasneem Essop, Executive Director of Climate Action Network: “If this is the way rich countries conducted themselves in a global crisis — where they took care of their own needs first, took care of companies, did not recognize that this is an opportunity to reach out and demonstrate solidarity — then there’s no good track record for how they will conduct themselves in the face of other global crises, such as the climate crisis, where poorer countries will bear the highest burdens.”

We have seen promises to vaccinate the world and dose pledges that are then not met. These broken promises are all too familiar in the response to the climate crisis, with promises to cut emissions and support lower-income countries to deal with the impacts of climate change and transition to greener economies through climate finance not being met.

Furthermore, despite COVID vaccine doses donated by the UK to some COP26 attendees, the ongoing pandemic restricted the ability of delegates from low-income countries who are those most affected by the climate crisis to attend the climate talks last November. The pandemic is also limiting low-income countries’ ability to take much-needed climate action both through the economic effects — vaccine inequity is set to cost the world $2.3 trillion, as well as through restricting the policy space as countries are still in the midst of the public health crisis.

Overall, as a ‘dry run’ for the climate crisis, the COVID pandemic has illuminated the truth behind the slogan “system change not climate change”.

© Shutterstock

How intellectual property is blocking access to greener technologies to fight climate change

The second example of links between the challenges we face in lack of access to medicines and climate change is the impact of intellectual property (IP) in accessing technology. The same laws that underpin the access-to-medicines crisis around enforcing patents through TRIPS apply to innovative green technologies, which are concentrated in rich countries, yet are urgently needed by all countries to adapt their economies and reduce carbon emissions. Green technologies include renewable energy sources; transition technologies to limit the environmental impact of existing sources of emissions; hydrogen cell devices; medicines for new illnesses that arise due to climate; and new crops needed for changing weather patterns.

Patents have been seen as key to sparking innovation in this new area, through providing incentives for rapid development. However, their use has been debated at previous COP meetings as to whether patents act as a barrier to access to green technology. Patents also impede swift action in this area as they can take as long as 18 months to be granted and will restrict access for 20 years. As we are facing a global crisis, there have been calls for more international collaboration and sharing of know-how, so innovators can build off each other’s work.

Debates around this at previous COP meetings have led to agreements around technology transfer. For example, the Kyoto Protocol obliges sharing of green technology if held in the public domain, and the creation of an enabling environment for private mechanisms to share, such as know-how pathways and patent pools. There has also been the implementation of initiatives such as WIPO Green, an interactive marketplace that encourages innovation and the diffusion of green technology.

It is unfortunately unclear how effective these interventions have been, and the impact of IP law has not been addressed directly through this. Other solutions proposed have included compulsory licensing to enable countries to override patents for the sake of public interest, for example in the Republic of Korea and Poland.

It is clear that, as with access to medicines, our urgent need to share innovative green technologies to address the climate crisis, requires us to explore fully the impact of IP law on our research and development (R&D) system and how it impacts on access to these vital technologies.

Injustices based on existing rooted power structures

These two case studies provide some insight into the links between access to medicines and the climate crisis. Much remains to be explored in the interaction of these two issues, what we can learn from the responses to both crises, and how the many injustices stem from common causes rooted in the way global systems and power structures are built.

Rebecca Hotchkin

To stay in touch with the work of the Access Campaign to ensure fair access to medicines for all, visit our website and sign up to our newsletter.

Find out more about UAEM and how to engage here.

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MSF Access Campaign — Medicines Are Not a Luxury

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.