It’s Time for the U.S. to Step Up and Help Get the World Vaccinated
When the Biden administration, in a surprise reversal, announced this week that it would support the waiver of intellectual property rights connected to Covid-19 vaccines, the announcement was hailed as a huge step in the fight to contain the global Covid pandemic, with the head of the World Trade Organization (WTO) calling it a “monumental moment in the fight against Covid-19.”
For many, it sparked hopes that vaccine manufacturers around the world would soon be able to begin making copies of the various Covid vaccines, expanding supply at a time when the vast majority of the world’s population remains unvaccinated and the virus is ravaging countries like India and Brazil.
Yet while Biden’s support for the intellectual property waiver was symbolically important, it’s unlikely to have any material impact on the course of the pandemic over the rest of the year and will be of no use to India as it tries to bring its current outbreak under control. What the world needs instead is a strategy that will vaccinate as many people as possible as quickly as possible. And the simplest, most obvious way to do that is for the world’s wealthiest countries to step up and foot the bill for vaccination on a global scale.
Why isn’t an intellectual property waiver the solution? In part, it’s because any such waiver has to be approved by all 164 members of the WTO, and many European countries remain opposed to the idea. (Yesterday, Germany — home to BioNTech, which is partnering with Pfizer to make one of the two mRNA vaccines — came out publicly against a waiver.) And even if they were eventually to change their minds the way the U.S. has, it’ll require lengthy negotiations to come up with a plan every WTO member will sign off on.
There’s also a bigger problem: Waiving intellectual property rights is not likely, on its own, to be enough to spur a boom in vaccine production. Consider that even under current global intellectual property rules, countries are able to issue what are called compulsory licenses in times of “national emergency.”
These licenses allow a country’s drugmakers to make copies of patent-protected drugs or vaccines without the patentholder’s permission. (India and Brazil, most famously, used compulsory licensing to produce drugs to fight HIV/AIDS.) In addition, certain poorer countries, including Bangladesh (which has a robust pharmaceutical industry), are already exempt from global intellectual property rules — they’re free to copy the vaccines without fear of being sued. Yet so far, no country has issued a compulsory license for vaccines, nor has any drugmaker in Bangladesh tried to make vaccines on its own.
What that suggests is that even if the WTO agrees on an intellectual property waiver, it’s not going to be enough to expand vaccine production any time soon — and soon is when we need it. An intellectual property waiver might help ease the supply bottleneck of certain key ingredients that go into these vaccines. But manufacturing Covid vaccines, particularly the mRNA ones, is not as simple as manufacturing your typical generic drug. Simply having the patent isn’t enough.
It’s not that mRNA vaccine factories are especially hard, in a physical sense, to scale up or expensive to build. But because mRNA vaccines are new — Pfizer’s and Moderna’s are the first ever approved — making them requires technical manufacturing know-how that not many people, or companies, have. Compulsory licensing or waiving intellectual property rights doesn’t give you automatic access to that know-how.
The former director of chemistry of Moderna, for instance, recently said that if manufacturers had the vaccine blueprint and technical advice, they could set up an mRNA plant in a few months. The problem is that while the intellectual property waiver would get manufacturers the blueprint, there’s no obvious way to force Pfizer or Moderna to give them technical advice. Given time, of course, drugmakers would figure out how to produce these vaccines even without the patentholders’ help. But time is precisely what we don’t have.
What we do have, though, is money. At least the United States and the other members of the G7 do. And right now, those countries are not using their wealth to help vaccinate the world — they’re only using it to help vaccinate their own citizens.
That needs to change.
The G7 countries should commit to paying for enough vaccine doses to vaccinate people in developing countries across the world. This is both the right thing to do morally, but it’s also an economically rational thing to do, since as long as the pandemic continues, the global economy’s prospects will be constrained, and we’ll have to worry about the prospect of mutant Covid variants emerging.
There are a variety of ways to implement this strategy, but the simplest would be to simply tell Pfizer, Moderna, and other drugmakers that we’ll buy every extra dose of vaccine they can make this year, at the price the U.S. is paying for its doses, and then allocate those doses to developing countries. The reason drugmakers are focused on making vaccines for the U.S. and Europe, after all, is that those countries will pay higher prices for vaccines. So if we, in effect, set one global price for each vaccine, there will be no incentive for drugmakers to hoard them for consumption by rich countries. And there will be an incentive for drugmakers to ramp up production, either on their own or by licensing and transferring their technology to manufacturers around the world — precisely what the intellectual property waiver is supposed to accomplish.
There are other options, as well. The organization PrEP4ALL, for instance, has come up with a proposal for the U.S. government to build its own massive mRNA manufacturing facility and then license Moderna’s vaccine. PrEP4All claims that if the U.S. were to do this, it could build a facility capable of making enough doses to vaccinate the whole world for less than $15 billion. (This option would have the ancillary benefit of giving us permanent manufacturing capacity to make vaccines against future pathogens.) The $15 billion price tag seems improbably low, but even if it cost three times that it would still be cheap. And the principle underlying the proposal is exactly right— the U.S. needs to step up and “hit hard, hit fast, and hit globally.”
Now, countries like the U.S. have talked a good game about helping vaccinate the world, especially via the World Health Organization’s Covax initiative, which is meant to improve global access to Covid vaccines. But they have not matched their words with dollars. The U.S. commitment to Covax has been $4 billion, which is ludicrously small, given the scope of the problem. And that commitment is actually big relative to what other countries have been willing to spend.
What wealthy countries need to recognize is that if there were ever a time when money was no object, it’s now. That’s especially true because the cost of global vaccination — even paying full price for vaccines — is trivially small relative to the benefits, and that’s the case even if you only count the economic benefits and ignore the more important human ones (lives saved and hospitalizations averted). If we could get, say, an extra 5 billion doses this year, that would cost less than $100 billion total. That’s an incredible bargain when you consider that the U.S. alone has already spent $5 trillion countering the economic fallout from Covid.
It’s true, of course, that following this strategy would mean that pharmaceutical companies making these vaccines would reap big profits. But those profits would be a tiny fraction of the value created by the vaccines, and the intellectual property waiver proposal can still move forward in the meantime. And if drugmakers are going to get rewarded for anything, better it be lifesaving vaccines, rather than lifestyle drugs or another statin.
More to the point, even if you think letting Pfizer and Moderna make a lot more money is galling, there is no good alternative if the option is getting as many people as possible vaccinated quickly. And in the grand scheme of things, it would be far more galling if rich countries were to let the pandemic kill thousands of people a day around the world simply because they wouldn’t step up and spend the money needed to stop it.