As Joe Biden backs waiving intellectual property rights for COVID-19 vaccines, what other steps can the United States take to promote fairer vaccine distribution?
By Matthew Lavietes
NEW YORK, May 6 (Thomson Reuters Foundation) - President Joe Biden has thrown his support behind waiving intellectual property (IP) rights for COVID-19 vaccines, potentially paving the way for other countries to make their own.
Wednesday's announcement comes amid growing concern that India's escalating COVID-19 crisis could lead to more vaccine-resistant strains of the deadly virus, undermining worldwide efforts to tackle the pandemic.
Biden's top trade negotiator said the "extraordinary circumstances of the COVID-19 pandemic call for extraordinary measures", but pharmaceutical companies said the move would undermine their response to the crisis and could compromise safety.
More than 100 countries, led by India and South Africa, have supported a temporary waiver of IP rights on COVID-19 vaccines at the World Trade Organization (WTO), but the proposal has been blocked by the European Union, Britain and some other countries.
With nearly 150 million Americans having received at least one COVID-19 vaccine dose, Biden has faced calls to promote equitable vaccine distribution around the world.
By July, the country could have an oversupply of 300 hundred million coronavirus vaccine doses, according to a report by the Duke Global Health Innovation Center, while developing countries face a long wait to vaccinate the majority of their populations.
Washington said last month it would start sharing up to 60 million doses of AstraZeneca's vaccine with other countries as they become available, but should the White House be doing even more to improve access to COVID-19 vaccines globally?
"The short answer is: 'yes it should, like now, immediately,'" said Ruth Faden, a Johns Hopkins University bioethicist and vaccine policy expert.
"The harder questions are the 'how questions.' That's when things start to get more complex."
The easiest way for the United States to contribute would be to pledge money to the global immunization effort, Faden said.
In February, Biden's administration pledged to give $4 billion to COVAX, a global scheme by the World Health Organization (WHO) to distribute coronavirus vaccines to low- and middle-income countries, more than any other country.
The country has already distributed $2 billion of those funds, but is waiting on other countries to fulfill their own pledges before distributing the second half.
Even if COVAX were fully funded this year, it would be able to vaccinate only a quarter of the populations in the world's 92 poorest nations, according to the Duke paper.
"I know that many countries are asking for the United States to do more, some with growing desperation because of the scope and scale of their COVID emergencies," U.S. Secretary of State Anthony Blinkin told a virtual fundraising event for COVAX in April.
Blinkin acknowledged pressure on the United States to help.
"We hear you. And I promise, we're moving as fast as possible."
SHARING INTELLECTUAL PROPERTY
The head of the WHO, Tedros Adhanom Ghebreyesus, hailed Wednesday's White House announcement as a "monumental moment" in the fight against COVID-19.
The statement, which followed mounting pressure from scores of countries and aid groups, paves the way for what could be months of negotiations to hammer out a specific waiver plan. WTO decisions require a consensus of all 164 members.
Besides angering the pharmaceutical industry, some experts argue that breaking vaccine monopolies with a temporary waiver of WTO intellectual property rules is unnecessary and could prove chaotic.
But Arthur Caplan, the head of the Division of Medical Ethics at New York University Grossman School of Medicine, said the pandemic will likely yield further opportunities for big pharma to boost revenue and profit.
"Maybe some companies are nervous if you share, but I think we'll be back with boosters and other ways for them to make their money anyway," Caplan told the Thomson Reuters Foundation.
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Some aid groups and international leaders have urged wealthier countries such as the United States to share their vaccine surplus.
A letter backed by the Center for Strategic and International Studies, a Washington-based think-tank, called on the United States to donate 10% of its excess doses over the summer, and to bump it up to 50% by the end of the year.
The pledge to start sharing up to 60 million doses of the AstraZeneca vaccine - which has not been authorized for use in the United States - would go some way to meeting such demands.
French President Emmanuel Macron in February also called on the United States and Europe to donate 5% of their supplies to the global effort.
Two public health experts said, however, that donating doses prematurely would be "flawed".
"We should start thinking about sharing vaccines with Michigan before we start sharing with Mauritius," Caplan said.
The state of Michigan has faced a surge in coronavirus cases.
"Morally it's right to try to assist your town, community, your neighbors, your country, before turning to others."
Once hospitalization rates stabilize and herd immunity, when roughly 70% to 90% of a population is resistant to the virus, is reached, the United States can start a "serious sharing program", Caplan added.
Alternatively, some experts have called on the Biden administration to "loan" vaccines out to other countries, which it has already done by shipping roughly 4 million AstraZeneca vaccine doses to its neighbors, Mexico and Canada.
The vaccines were given under a deal by which the United States expects to be paid back with doses in return later this year.
"That doesn't actually reduce our overall supply, it's more an issue of timing," said Krishna Udayakumar, founding director of the Duke Global Health Innovation Center.
And timing is key, Udayakumar added, as the virus continues to mutate and new variants emerge.
"Even our health and our lives are not going to be protected unless we really take a global approach to turning a corner on the pandemic."