The Biden administration’s announcement that it would support waiving patent protections for Covid-19 vaccines to help spur production and access, especially among low-income countries, was a welcome step for increasing global access for these drugs at a time when they are desperately needed.
In justifying the move, Katherine Tai, the U.S. trade representative, said in a statement, “This is a global health crisis, and the extraordinary circumstances of the Covid-19 pandemic call for extraordinary measures.”
But the United States and its fellow counterparts in the World Trade Organization shouldn’t stop there. They should also directly engage drug companies in addressing the lack of access to vaccines through their existing and potential networks of public and private partners.
The experience in the 1990s with HIV medications offers lessons for why they should do this.
In the mid-1990s lower-income countries and activists exerted mounting pressure on high-income countries and big pharmaceutical companies to ease access to expensive antiretroviral medications that treat HIV/AIDS. This came after the United States and other Western countries had been successful in codifying their restrictive approach to patent protection in the WTO’s Trade-Related Aspects of Intellectual Property Rights agreement, also known as TRIPS, that effectively outlawed “compulsory licensing” — the generic copying of patented drugs.
After these pressures intensified, the TRIPS agreement was modified to allow countries to suspend patent enforcement when facing public health crises.
In practice, few countries took advantage of this provision. Some lacked domestic manufacturing capability (the policy was later clarified to allow for importation from other countries), some viewed the rules as overly complicated and burdensome, and some feared invoking the wrath of the United States.
Partly to blunt the negative fallout on their reputations for denying access to low-cost HIV/AIDS drugs, large drug companies like GSK and Pfizer began negotiating arrangements directly with partners in lower-income countries, contract manufacturers, and international health organizations such as the World Health Organization; the Gates Foundation; and the Global Fund to Fight AIDS, TB and Malaria.
Under these arrangements, HIV/AIDS medications were distributed at cost, below cost, or for free in some cases. Those medications became much more widely available in places such as South Africa, where more than 60% of those with HIV/AIDS were able to receive these medications. Sadly, the emergence of the Covid-19 pandemic has disrupted distribution of these medications, making access to Covid-19 vaccines all the more urgent.
The advantages of these arrangements are that they alleviate concerns among pharmaceutical companies that their patents on these and potentially other drugs will be rendered worthless and they allow the companies that developed the drugs to have more control and oversight over their manufacturing processes, ensuring greater quality control. Given some of the problems already encountered with production quality, efficacy, and distribution, this could also be advantageous for the beneficiaries.
The vaccine rollout in the U.S. has shown that pharmaceutical companies can rapidly scale up production — or help their partners do so. BioNTech’s recent announcement that it would establish manufacturing capacity in China through a joint venture and locate an Asian-based headquarters in Singapore, and Moderna’s agreement to provide 500 million doses of its vaccine to Gavi, the Vaccine Alliance, on behalf of the COVAX facility, could be the first among many similar initiatives to follow.
The global Covid-19 pandemic is a grave public health crisis, especially in countries such as India, Brazil, and South Africa that are struggling to contain it. Wealthy countries should do everything in their power to make vaccines more wildly available and at reasonable cost. Drug companies, sometimes rightly vilified for some of their policies and practices, can be partners — as opposed to adversaries — in this effort and should be encouraged to move aggressively to strike deals such as those reached over HIV/AIDS drugs in the 1990s and 2000s.
Jonathan Doh is the associate dean of research and global engagement, professor of international business, and faculty director of the Moran Center for Global Leadership at the Villanova School of Business.