Are vaccines a commodity or a basic human right?

This author indignantly denounces the commodifying of vaccines for profit and as a mechanism for international diplomacy, penning these thoughts in the name of human dignity and the right to life. Will vaccines and global health continue to be governed by the market and foreign policy concerns or will we assume them as a universal human right?

Fernando Soto Baquero

Looking beyond our altruistic wishes and the speeches of politicians and world leaders, we thought the pandemic’s terrible consequences on health, the economy and human rights would jolt our consciences. We believed it would realign our thinking toward a better world, a more mutually supportive and equitable new normality, a renewed Utopia in which we would revalue humanity.

This scenario, however, is elusive and unattainable by most people. Instead, we are seeing with the vaccines how ideological and political tensions between States are being exacerbated and the pharmaceutical companies’ excessive profit motive is being imposed.

A soft genocide

In theory, humanity is now capable of mass producing enough vaccines to immunize everyone and has the money to acquire them and the health systems to apply them. If that’s the case, it should also have what’s essential to stop the pandemic’s trail of death, economic collapse and impoverishment. But in practice, the pandemic is prevailing due to the challenge of inequality. Nothing reveals as much about our societies today as the unequal distribution of vaccines around the world: their stockpiling and geopolitical use is deepening the obscene magnitude of the unequal access to health these medicines could help offset.

The Economic Commission for Latin America and the Caribbean (ECLAC) has already warned that the pandemic will reduce Latin Americans’ life expectancy by half a year, but no one dares to point out that with foreign interference in the domestic affairs of “weaker” countries, a veritable soft genocide is underway behind vaccine stockpiling that doesn’t distinguish between ideologies. Everyone pretends not to see it, like in Hans Christian Andersen’s story The Emperor’s New Clothes, where only an innocent child voiced what everyone saw: the emperor is naked.

Nothing can be more illustrative of vaccine stockpiling than the confirmation that the United States reportedly has available almost 2.1 billion doses—with which it could vaccinate its entire population more than three times over—but exporting them is forbidden. The New York Times reports that the US has about 30 million doses of the AstraZeneca vaccine in its West Chester, Ohio, facility, as they haven’t yet been approved by its health authority. It is also reported that an additional 15 million doses of this same vaccine were damaged at an Emergent BioSolutions facility in Maryland. This is a cruel paradox in light of the desperation of more than 70 countries that have already authorized its use and could be applying it immediately but lack the vaccines.

For its part, the European Commission has reserved about 2 billion doses of vaccine and 2.6 billion euros to purchase them from the respective laboratories. Its difficulties in immunizing its population lie in accelerating the vaccination rate and overcoming some of its population’s distrust regarding the effectiveness of certain vaccines.

A vaccine apartheid

What we are finally seeing with this stockpiling of vaccines is that while 10 countries have applied 75% of all vaccines worldwide, 130 countries haven’t received a single dose. The US, Canada and the UK have ordered enough doses to vaccinate their entire populations more than once. In contrast, Latin America and Africa have only vaccinated 3% of their populations.

According to the University of Oxford’s database, Our World in Data, the number of single doses of anti-COVID-19 vaccine applied per 100 inhabitants by March 31 of this year was 116 in Israel, 52 in the UK, and 45 in the US. In contrast, with the exception of Costa Rica, fewer than 1 inhabitant per 100 has been vaccinated in Central America as of the same date… a figure only arithmetically possible.

This is how the deep rift of inequality is opening up a kind of vaccine apartheid between the vaccinated and unvaccinated countries. Vaccinated countries will restore their economies sooner and the unvaccinated ones will become poorer and more isolated from the rest of the world, with the risk of new, resistant and more transmissible variants of the virus appearing, which will eventually “threaten” the immunity of those already vaccinated.

Vaccine diplomacy

Stockpiling and market control of vaccines have resulted in their use for geopolitical purposes, a kind of vaccine diplomacy through which political influences and/or favors, migratory restrictions or trade benefits are exchanged, using the power asymmetries between countries.

Examples abound. On March 18, the United States announced a “loan” of 2,700 vaccines to Mexico, which responded that same day by closing its borders with Guatemala and Belize to Central American migration: a give-and-take transaction whose bargaining chip is the human rights of migrants.

The European Union blames its difficulties on the failure of supplies from the British company AstraZeneca and threatens to forbid the export of vaccines to the UK, a country that has vaccinated 40% of its citizens.

On a visit to China in February of this year, the Brazilian communications minister made the unusual request to the Huawei telecommunications company that it intercede for vaccine supplies. Until then, the company was excluded from participating in bidding for Brazil’s 5G network. Two weeks after the visit, new rules were announced for bidding on that network in Brazil, this time with Huawei’s participation.

China, which has the world’s third largest vaccine production capacity, is one of the first countries to take diplomatic initiatives with its vaccines. It has pledged to set aside a US$1 billion vaccine fund for Africa and offered loans of up to that amount in Latin America, where it is positioning itself in the vaccination strategies of several countries: Argentina, Brazil, Chile, Peru and Mexico.

More than 50 countries, including Argentina, Bolivia, Mexico and Venezuela, have asked Russia for 1.2 billion doses of the Sputnik V vaccine and financing to acquire them through the Russian Direct Investment Fund. In April, Russia pledged 300 million doses of its vaccine to the African Union, thus helping to increase its influence on that continent.

Vaccines have also been used by countries such as India and the United Arab Emirates to make donations and curry favor with countries where they have strategic or trade interests.

The universalizing of hypocrisy

Anticipating that the rich countries would be the first to monopolize vaccines at the cost of leaving the poorest without supplies, the World Health Organization (WHO) and Gavi, the Vaccine Alliance (previously called the Global Alliance for Vaccines and Immunization) promoted a global alliance for the distribution of vaccines (COVAX) with the altruistic aspiration of supplying them to poor countries. Its objective, designed with more good intentions than deeds and becoming increasingly unattainable, is to distribute 2 billion vaccines by the end of 2021, which would immunize only 20% of the population in the 200 countries that have lined up for it. Needless to say, this deadline will already extend into 2022, optimistically speaking.

In a supreme display of universal hypocrisy, the G-20 countries pledged at their November 2020 meeting to “spare no effort to ensure affordable and equitable access for all people to COVID-19 vaccines.” Reality runs contrary to these speeches, however, and COVAX is moving very slowly, between promises and “treading water,” because although the rich countries have promised US$6 billion to finance COVAX, they have at the same time bought up vaccines and are not sharing them. According to the WHO, only 5 Latin American countries have received vaccines: just 728,000 doses, far below the needs.

No one is safe until everyone is safe

Time marches on. New outbreaks of contagion are appearing in unexpected places and it’s becoming progressively clear to the rich countries that “no one is safe until everyone is safe.” This phrase is increasingly moving from being a bureaucratic mantra to a real threat.

It’s already resonating around the world that the later the poor countries are vaccinated, the more exposed the rich countries will be to the emergence of new coronavirus variants, which will be immune to the vaccines that have been administered. Apparently very alarmed, the rich countries meeting at the G-7 summit this March 19 restated the challenge of getting more vaccines to poor countries, urgently calling on global charity. France’s President proposed, as a matter of urgency, giving them 5% of the vaccines already in the hands of the European Union and the United States. The US is more willing to donate US$4 billion to COVAX than to share vaccines. And the UK pledged to donate all the doses leftover once its population has completed vaccination, without specifying amounts or dates. In this environment, many countries are desperately waiting for “something to fall from the table.”

Halting the pandemic or
defending intellectual property

The “threat” hanging over the West is that China and Russia have sent 800 million doses to 41 countries, according to data from the UK science information and analytics company Airfinity, filling the gaps COVAX is leaving. Russia and China are more willing to grant licenses for vaccines to be produced in other countries: South Africa, South Korea, India, Argentina, Mexico, Brazil and Cuba.

Dissonant voices are also beginning to emerge, such as a coalition of countries led by India and South Africa, which have asked the World Trade Organization to waive intellectual property rights so generic drug manufacturers can begin to produce vaccines. The WHO has endorsed this initiative but, for obvious reasons, the US and the EU have rejected it.

Vaccine patents and monopolies by a few countries cause shortages in the market, with which prices are indiscriminately increased and the quantities to be produced can be manipulated. Furthermore, since intellectual property is controlled, the full potential of worldwide vaccine manufacturing, which would reduce shortages and lower prices, is not being exploited.

Recently, in anticipation of signals coming from the appearance of new coronavirus variants, such as in Chile, more than 20 world leaders have called for a global agreement to help the world. The call, however, is not to end the current pandemic but prepare for new ones that might come.

Are vaccines a commodity…

The greatest dilemmas of our time will be scenarios concerning health and the environment: either we manage vaccines and global health as a commodity governed by the market or we assume them as a universal human right.

In fact, we’re already experiencing vaccines managed by the market, where global health and economic recovery are held hostage to the excessive profit motive and the enrichment of a few pharmaceutical companies. These companies’ profits are a function of the risks in developing the vaccines, the existence of vaccines on the market and the patents guaranteeing them captive markets.

In practice, the high-income countries have borne the risks in developing new vaccines, subsidizing them to ensure their own supply. According to a report recently published by the British medical journal The Lancet, the vaccine producers received over US$10 billion in public funds. To reduce risks, according to disclosures from the Bureau of Investigative Journalism, they have gone to such extremes that Pfizer has been accused of “intimidating” some Latin American governments during negotiations for the purchase of its vaccines, asking them to put up sovereign assets such as embassy buildings and military bases to guarantee the contracts.

The argument that justifies this in economic terms is that these are the costs to scientific innovation in health. In other words, without these excessive corporate profit levels, not even the increasingly high indicators of deaths from COVID-19 would be sufficient incentive to innovate to save lives. This brings us to the height of the contradictions of our time, when it is claimed that in order to save the lives of some, the lives of many more must be sacrificed. This duplicitous narrative openly shows that if anything characterizes today’s world it is the incongruence and cynicism of the main international actors.

…or a human right?

The Office of the United Nations High Commissioner for Human Rights declared that vaccination is part of the human right to health and to universal primary health care. For those this concept frightens, it doesn’t imply disregarding the universality of market rules, but their subordination to guaranteeing the global human right to health.

From the perspective of managing vaccines as a human right, innovation would continue to be financed and financial risks mitigated, as they now are, with public resources. The exemption of intellectual property would enable the use of all generic mass manufacturing capacities. Expanding the offer of vaccines would lower their price and make them more accessible to the poorest. And, most importantly although least noticed, fewer people would die and humanity would be spared much misery and despair.

The survival of humanity should be made the driving force of scientific innovation and vaccines should become an international public good equally accessible to all the countries of the world. In such a scenario, vaccine diplomacy would lose its effect.

Faced with the “chronicle of a failure foretold,” the most diplomatic thing the WHO has managed to warn is that “the world is on the brink of a catastrophic moral failure,” assuming that anyone cares. Those of us who do care must go to the rescue of humanity’s Utopia, putting anti-COVID-19 vaccination management on the agenda of the debate between vaccines being a tradable commodity in the market or a basic human right.

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Fernando Soto Baquero is an economist who worked in public rural development policies and the eradication of hunger in Latin America and the Caribbean for the United Nations Food and Agriculture Organization (FAO). Edited by envío.

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