Enough vaccine for the whole world – but distribution problem
In the run-up to the WTO ministerial conference in Geneva, calls for a limited release of patents for COVID-19 vaccines are getting louder again. Several former health ministers, patient representatives and public health experts signed an open letter from the NGO Attac Austria to the federal government. The Pharmig informed once again that enough vaccine was available – there was a problem with the distribution. Indeed, this proves one global vaccination dashboard. Also has the EU made their promise to buy much more than necessary, overfilled. Austria has already donated 2,143,000 doses, including mRNA vaccines. In addition: The editors also learned that Austria had ordered children’s vaccines.
In the end it turns out that Attac, according to its own statements, is “an international movement that is committed to a democratic and socially just organization of the global economy”, and Die Pharmig, according to its own statements, is “a voluntary, politically independent interest group for the Austrian pharmaceutical industry” , are not that far apart: Both want the entire world population to be vaccinated against COVID-19 as quickly as possible. And both say – “out of self-interest”.
But one after the other: On Monday, October 8th, 2021, five prominent faces appeared in front of the YouTube camera, some of which were heavy guns. The EU is “the last blocker” worldwide against the release of patents for Covid vaccines, drugs and medical equipment – the so-called TRIPS waiver, Iris Frey, Attac Austria, spokeswoman for the campaign “Release patents – stop pandemic”. TRIPS stands for the 1995 agreement on trade-related aspects of intellectual property. Among other things, this was the result of “lobbying” by Pfizer, Merck and General Motors.
India and South Africa insist on TRIPS waivers
India and South Africa are now insisting on a temporary, three-year TRIPS waiver, which is supported in the World Trade Organization (WTO) by more than 105 countries, including the USA. For a necessary three-quarters majority, however, the approval of the EU states would be required. Individual countries such as the Vatican, Spain, Poland and Italy have already indicated their support. Since Austria is not there, Attac wrote one Open letter to the federal government, signed by 29 people, including doctors, patient advocates and three former health ministers: Rudolf Anschober (Greens), Maria Rauch-Kallat (ÖVP) and Alois Stöger (SPÖ).
The letter calls on the Austrian government to “explicitly” support the TRIPS waiver at the WTO ministerial conference in Geneva (November 30 to December 3, 2021) and to contribute to stopping the “counterproductive blockade of the EU” and everyone to take the necessary measures “to quickly stop the deadly effects of this pandemic”. The countries of the global south have been demanding the TRIPS waiver since October 2020. Patents, secrecy and competition would prolong the pandemic and “lead to innumerable pressures and immeasurable suffering”.
MSF: “Triage” is already a reality for vaccines
“Triage is already a global reality,” says Marcus Bachmann, responsible for advocacy and humanitarian affairs at the nonprofit organization Doctors Without Borders / Médecins Sans Frontières (MSF). In Nigeria, for example, where he worked himself, only three in 100 are vaccinated at least once, in Yemen only one in 100 and in Burundi only one in 1,000. Vaccines are a “global shortage”, “artificially brought about” by patent rights. MSF has found at least seven manufacturers in Africa who, if patents were released, would be able to convert their production to mRNA vaccines at short notice. That works particularly well with mRNA vaccines, but in general the manufacture of vaccines is not a “rocket science” – contrary to what the pharmaceutical industry claims.
“Maximizing profit” at the expense of public money
One more thing Dr. Josef Probst, long-time director general of the former main association of Austrian social insurance institutions (now the umbrella association). He spoke of “profit maximization” versus equal opportunities, of human rights and morals as well as of a “wise perception of self-interest” – which is why the EU should not oppose vaccinating “everyone”. Then he calculated how much sales and profits individual pharmaceutical companies make, for example Pfizer in the third quarter sales of 24 billion dollars with a profit of 8 billion dollars, a third of sales, at Moderna it was as much as 66 percent (3.3 of 5 billion .). The vaccine development will be funded with public funds.
To date, Austria has donated 2,143,000 cans. These are divided as follows:
- 500,000 cans of AstraZeneca to Bosnia & Herzegovina
- 50,000 cans of AstraZeneca to Costa Rica
- 1,000,000 cans of AstraZeneca to Iran
- 42,000 cans of Pfizer to Montenegro
- 651,000 cans of Pfizer in the Western Balkans
This is exactly what bothers Priv.-Doz. Dr. Claudia Wild. The managing director of the Austrian Institute for Health Technology Assessment (AIHTA) emphasizes that even without a pandemic there would be twice public funding: once for basic research, the second time for patented drugs. In the case of Covid vaccines, there would also be the fact that they were never given “exclusively” from public funds in the form of “purchase guarantees” and liability requirements, that still existed. “Patents only protect the markets, the public sector has its back to the wall,” says Wild. It would be for an “open access pool” from which everyone can draw.
Epidemiological interest: avoid mutations
Univ.-Prof. Dr. Gerald Gartlehner, Clinical Epidemiologist, Department for Evidence-Based Medicine and Evaluation, Danube University Krems, ties in with Probst and brings “self-interest” as an important argument: “We are only protected when everyone is protected.” According to the epidemiologist, mutations arise , who has already completed his basic immunization (three partial vaccinations) against COVID-19, in the densely populated countries with a lack of vaccination – and not if you do not test children.
Even before the public Attac event, which Pharmig then followed, this announced its own press conference, which began rather forgiving after a break of about an hour. “We are already in a position today to have vaccines for everyone”, assures Mag. Alexander Herzog, Secretary General of Pharmig, in Europe there are even too few people who are vaccinated. At least 11 billion doses of vaccine would have been produced by the end of 2021. It was not the production, but the distribution. As far as patent protection is concerned, this is the “enabler and driver” of innovation.
The vaccinations and drugs against COVID-19 were developed with the trust of patent protection. “The protection of intellectual property was a factor that companies could build on existing knowledge and bring the first COVID-19 vaccines to market in a very short time,” adds Renée Gallo-Daniel, President of the Association of Austrian Vaccine Manufacturers ÖVIH.
Problem raw materials and ultra-low freezers
Gallo-Daniel also reminds of the raw materials that are not available in infinite quantities. One also has to keep this in mind when discussing an expansion of production and citing the Pfizer vaccine as an example, for which 280 components from 86 suppliers in 19 different countries are required. The ÖVIH president agrees with the Attac spokesperson that “equal access” is needed for everyone. The following points are important for this:
- Optimizing production worldwide, which has been started by the manufacturers “in the last few months”, Gallo-Daniel names the Serotherapeutic Institute in India and a production facility in South Africa, but also in South America.
- Break down barriers so that it becomes easier to distribute produced vaccines worldwide, both for trade and for donations. This is currently being discussed intensively at EU level.
- Also optimize distribution, storage and use or materials such as syringes on site, e.g. with ultra-low freezers, especially in the southern hemisphere.
- Continue to work on innovations in order to have adapted vaccines and medicines available.
All of these points are “regardless of whether we revoke patents,” affirmed Gallo-Daniel. Herzog also emphasizes that there is a need for “comprehensive political will”. Pharmig also supports initiatives such as COVAX, which make vaccine doses available in large quantities in poorer countries around the world. Herzog also points out what has been done so far to support global distribution of the vaccines (see box). And on the allegations of profit maximization using public funds, the Pharmig Secretary General recalls that.
Herzog: “The question arises as to which problem one would like to solve with a patent release – pointedly, with the expropriation of an entire industry?” The association is always constructive when it comes to identifying and solving problems, “we set us at the same table ”. But: “Here, the impression that we have a solution and then a problem is being constructed a little stronger.” Pharmig is also involved through the European umbrella organization at EU level. Solutions such as opening factories in the Global South would show that industry “is very willing to take on its responsibilities.
According to the AGES dashboard, 18,600,000 vaccine doses had been delivered to Austria by the beginning of the week, 11,800,000 of which were vaccinated and 13,150,000 had been pre-ordered. When asked by the editors what will happen to the remaining 5.6 million vaccine doses, Herzog and Gallo-Daniel assure that nothing is guaranteed to expire. The ÖVIH President also informs that Austria has already issued more than 2 million cans, which is why there are not 5.6 million in stock, production continues. The expiration date has been extended from six to nine months.
Global dashboard shows EU engagement
On the COVID-19 Vaccine Market Dashboard Unicef can at least EVERYONE with Internet access track how much vaccine is produced by which manufacturer, at what prices in which countries: e the EU buys 3.9 billion doses (originally there were 1, 6 billion agreed) – this is the second highest value worldwide (after the COVAX initiative with 4.3 billion and even ahead of the USA with 3.2 billion cans). In contrast to some other EU countries, Austria has already donated mRNA vaccines (see box). On request, Gallo-Daniel informed about the mRNA vaccines for children: “Austria also ordered the dosage form for children as part of the European contract.”
Mückstein would announce patent release
Health Minister Dr. Wolfgang Mückstein (Greens) reacted on the same day of the two press events. For the rapid increase in the global vaccination coverage, you also have to go unconventional ways: “The temporary suspension of patents in this exceptional situation is one way that I would greet.”
Infographic
Infographic by Vaccines Europe (provided by PHARMIG), which shows what has been done so far (as of October 2021) to support the global distribution of vaccines, what is necessary for this, and the importance of patent protection. (Click to view as PDF)