Last updated: 10 March 2022

What is the People’s Vaccine Alliance?

The People’s Vaccine Alliance is a coalition of organisations and activists working together towards equitable access to medical technologies that help to prevent and respond to COVID-19 and future pandemics. This would be based on shared knowledge and freely available to everyone everywhere – a global common good. The call for a #PeoplesVaccine is backed by over 100 organisations, past and present world leaders, health experts, faith leaders and economists. See the full list of supporters here.

What is the WTO TRIPS waiver? Why does it matter?

TRIPS (Trade-Related Aspects of Intellectual Property) is an agreement signed automatically as countries join the WTO. setting particular standards for the protection of intellectual property rights. It is much wider than just vaccines and the medical sector. Last October, India and South Africa proposed a temporary waiver to the TRIPS agreement specifically for all COVID-19 health technologies, including vaccines. The waiver would mean more qualified manufacturers could make the vaccines without legal repercussions – this is urgently needed to ramp up vaccine supply. Over 100 countries now support the TRIPS waiver, including the US, but Germany, the UK and the EU continue to block it.

To beat this pandemic all WTO members should agree urgently on the temporary suspension of intellectual property rules [the TRIPS waiver], AND governments should use all policy and legal tools to influence pharmaceutical corporations to share the vaccine technology and know-how via the World health Organisation’s COVID Technology Access Pool – C-TAP and the South Africa mRNA hub.

What is C-TAP?
Following an initiative from Costa Rica, WHO has established the COVID-19 Technology Access Pool (C-TAP), which is a mechanism to facilitate sharing of technology, know-how and license intellectual property rights However, vaccine technology holders haven’t paid any attention to C-TAP, and not making use of it to advance the production of COVID-19 vaccines in developing countries.

Are intellectual property and patents the only barrier to mass production of any vaccine?

Pharmaceutical corporations use patents and other intellectual property rights to stop other companies from making the vaccines or medicines they have developed. We are saying that in these unprecedented times, companies should share their knowledge and not enforce intellectual property rights in the interests of public health.

But intellectual property is not the only barrier. Vaccines are not as straightforward as many other medicines to copy and many are made of biological material. Therefore, it is important that corporations and research institutions  also share the know-how, biological material and technology behind their vaccine with other companies that could manufacture them. We have seen some bilateral examples of this. For example,  Astra Zeneca has licensed production to companies in India, Brazil and in Argentina. However, this process should not be left to the goodwill of individual corporations or subject to secretive deals. The WHO COVID-19 Technology Access Pool (C-TAP) provides a global mechanism for such sharing. The C-TAP can promote technology transfer and the licensing of production to more companies and institutions that are able to manufacture safe and effective vaccines in order to maximise supply.

Aren’t there already knowledge-sharing initiatives such as Covax?

Covax is an initiative led by three global organisations: Gavi; Cepi; and the World Health Organisation (WHO). It is currently the only global mechanism for pooling demand for COVID-19 vaccines to try and secure access for poorer countries. While it is encouraging that many countries have agreed to work together, rich countries continue to cut bilateral supply deals with pharmaceutical companies which undermine this global effort and limit supply to poorer nations. So far Covax has not been transparent about the deals it is making with pharmaceutical companies and remains silent on how it will tackle monopolies. Covax lacks transparency on decision-making and developing countries have not been involved in strategic decisions. Civil society has also been excluded from decision-making processes.

Moreover, Covax does not use its purchasing power to push corporations to share the science, knowledge and technology behind their vaccines, which could lead to scaled up production. We are also deeply concerned that Covax is considering a tiered pricing model that would mean many middle-income countries, already facing economic turmoil and with under-resourced health systems, may not be able to afford the vaccine or would be forced deeper into debt.

For Covax to succeed it must:

  • Be transparent about decision-making
  • Publish the deals it makes with pharmaceutical companies
  • Meaningfully involve developing country governments and civil society in decision-making
  • Ensure maximum production of vaccine doses by pushing pharmaceutical companies and research institutions to share the science, technology and know-how behind their vaccines with the WHO COVID-19 Technology Access Pool (C-TAP)
  • Secure low and transparent vaccine prices
  • Ensure equitable distribution of doses according to the WHO’s equitable allocation framework.

How do you expect pharmaceutical companies to develop vaccines and treatments if there is no promise of a profit?

We are not suggesting that pharmaceutical companies shouldn’t cover their costs or make reasonable profit in normal circumstances. But instead they are exploiting their monopolies to charge excessive pricing – making billionaire CEOs and shareholders at the cost of ensuring everyone is protected. Pfizer, BioNTech, and Moderna are making $4 million an hour in vaccine pre-tax profit.

mRNA vaccine companies like Pfizer and Moderna are making eyewatering profits despite the vaccine research and development being bankrolled by billions in taxpayers’ money. Nine new billionaires have been created from these vaccine profits and Pfizer and Moderna are making billions in profit by keeping prices artificially high while locking out competition that could make the vaccines more affordable and save millions of lives.

As most vaccines and treatments have been funded by taxpayer money, governments should impose conditions on their funding to demand the removal of patents and other intellectual property barriers, the open sharing of know-how, and the transfer of technology to as many manufacturers as possible. In these unprecedented times, we should be aiming to maximise supply instead of maximising profits for pharma companies.

It appears that Omicron is less severe than previous variants, so surely this means the virus is no longer as a big a threat?

While the Omicron variant is considered “milder” than others like the delta version there is no guarantee that it would be the case with future variants. The potential impact of Omicron spreading through a largely unvaccinated developing countries is unclear. The head of the WHO, Dr Tedros Adhanom Ghebreyesus, has warned against describing Omicron as mild, as it is killing people across the world and putting health systems under severe pressure. In March 2022, 3.2 million people are estimated to have died in the period since Omicron was detected – 16% of all total deaths since the start of the pandemic. 1.8 million of those in low and lower middle-income countries.

Don’t we have enough doses now?

It is good that more vaccines are now being made but if the last year has taught us anything it’s that there is no guarantee that these will get to developing countries, or that their delivery will be predictable, timely, sustainable and affordable. What has not changed is that the next phase of this pandemic is difficult to accurately predict – there could be new, more dangerous variants that may resist the current vaccines.

Countries like the UK talk about moving into an endemic phase as if all the dangers are removed. Even in those countries, there is more cases diagnosed as long COVID-19 where people suffer unpredictable symptoms for long time. If the virus is “endemic” in one country, there is still the opportunity of developing dangerous variant in countries with low vaccination level and coming back to threaten those countries.
Therefore, sustainable, predictable, and affordable supplies of COVID-19 vaccines, tests and medicines are critical to protect people everywhere. Clearly relying on a handful of pharmaceutical corporations who put profits before patients and public health at every turn, acts against controlling the virus.

What about the billion doses pledged by G7 nations?

Every dose matters but countries need sustainable and much higher number of doses than donations can provide. We should not call it donation. In reality it is dose sharing of what rich countries hoarded when they pushed poorer countries to the back of the queue. Dose sharing is also a sign that the global system of pharmaceutical production and distribution is broken. Governments must act to fix the system by agreeing to waive the intellectual property and insisting that technology for these vaccines is shared – it’s the only route to ensuring there are enough vaccines for everyone and that poorer countries are not constantly pushed to the back of the vaccine queue.

Is there spare capacity to make more vaccines in the world?
Yes. Capable manufacturers are ready and willing to make hundreds of millions of doses if intellectual property barriers are removed and the vaccine technology and know-how shared. Pharmaceutical corporations like Moderna, BioNTech and Pfizer have also shown that new mRNA vaccine plants can be producing millions of doses within six months, but only a handful have been built because of monopolies and a total lack of interest in producing vaccines for developing countries. Yes, the world needs to further increase that capacity but the real problem here is the monopolies of the pharmaceutical industry that allow producing corporations to decide how many vaccines are made, who they are sold to and at what price. This is leading to many needless deaths.

India already produces 60 percent of the world’s vaccines and just over a fifth of the world’s COVID-19 vaccines to date, yet only Astra Zeneca and Novavax licensed their vaccines to one company (Serum) to produce the oxford vaccine. The Director General of the World Trade Organization, Ngozi Okonjo-Iweala, has reported that the governments of Pakistan, Bangladesh, Indonesia, South Africa, and Senegal have all said that they have facilities that could possibly be retooled to produce coronavirus vaccines.

Should vaccines be mandatory for everyone?

Vaccination is one of the most successful health victories in human history, and has led to a massive reduction in infant and child mortality around the world. Vaccines have led to the eradication of small pox and the near eradication of polio. They have saved millions of lives from measles, pneumonia and tuberculosis. In more recent years, vaccinating girls and boys against the human papillomavirus virus (HPV) has protected girls from cervical cancer and boys from genital diseases.

The World Health Organisation advises against mandatory vaccination and instead promotes the use of vaccines by raising awareness of their benefits. There is a debate about whether vaccines should be mandatory for certain groups in society, but it is better to persuade people of the benefits of taking the vaccine than imposing vaccination against their will.

Governments and pharmaceutical companies both have a responsibility to increase people’s willingness to take a COVD vaccine. To achieve this governments must put science before politics to build trust. Pharmaceutical companies and research institutions should contribute to the building of trust by ensuring transparency at all times in terms of: clinical trials; data on safety and efficacy; and cost and pricing. The People’s Vaccine Alliance calls on governments and pharmaceutical companies to ensure transparency on all aspects of vaccine development and testing to help build public confidence in COVID vaccines.

[1] https://edition.cnn.com/2020/09/08/health/covid-19-vaccine-pharmaceutical-companies-pledge-bn/index.html