Any vaccine against Covid-19 should be patent-free, produced at scale and made available at no cost to people everywhere, South Africa’s president and more than 135 public figures, including 50 former world leaders, have urged in an open letter.
Calling a vaccine humanity’s best hope of “putting a stop to this painful global pandemic”, Cyril Ramaphosa, who also chairs the African Union, called for a “people’s vaccine” that would act as a global public good.
Signatories of the letter, including Imran Khan, Pakistan’s prime minister, expressed fears that developing countries might not have quick or affordable access to a vaccine that is expected to be discovered and manufactured in the global north.
“We cannot afford for monopolies, crude competition and nearsighted nationalism to stand in the way,” said the letter, which was signed by dozens of former leaders, including Fernando Henrique Cardoso of Brazil, Gordon Brown of the UK and Helen Clark of New Zealand, as well as economists such as Nobel laureate Joseph Stiglitz.
The letter comes after a number of vaccine producers pledged at-cost manufacture and called for billions of dollars in upfront funding from governments to help them swiftly invest in large-scale production even while they are clarifying safety and efficacy.
Activists have expressed concern that civil society groups have had little voice in discussions over funding and that richer countries will dominate in a scramble for access to limited supplies.
Ebba Kalondo, spokeswoman for the AU, said African efforts to pool resources to buy diagnostic kits, reagents and personal protective equipment had been stymied by richer countries. That has raised genuine fears that when a vaccine is developed, it might not be available to people in poorer parts of the world, she said.
“Even when we are paying market rates, we are not getting the goods because they are being taken by richer countries,” Ms Kalondo said. “We have to think about solidarity as a practical and pragmatic realisation of shared vulnerability and the common interest to fight a threat we cannot fight alone . . . We cannot have pockets of wellbeing in a world that is unwell.”
Ha-Joon Chang, a Cambridge economist who also signed the letter, said there was well-established precedent in the World Trade Organization’s Trade-Related Aspects of Intellectual Property Rights agreement that allowed for overriding intellectual property in times of public health emergency.
This had been invoked during the Aids epidemic in the early 2000s as well as in 2001 when, after a spate of anthrax attacks in the US, Washington threatened to override patents held by Bayer, the German pharmaceuticals company, if it could not match generic prices for its anti-anthrax drug.
“The vaccine does not work unless a huge majority of people have access to it,” Mr Chan said. “It’s not like other drugs where rich people can pay and save themselves while other people are left to take care of themselves.”
In the letter, Mr Ramaphosa praised international efforts, including a pledge this month by 40 countries for $8bn in funding to help develop a vaccine, diagnostics and treatment. But “this massive and moral task”, he warned “could not be left to market forces”.
Instead, Mr Ramaphosa said, the WHO should press for mandatory sharing of all Covid-19 related technology as well as the scale-up of manufacturing so that any vaccine could be made available worldwide, regardless of ability to pay.
“Access needs to be prioritised first for frontline workers, the most vulnerable people and for poor countries with the least capacity to save lives,” he said.
Philippe Duneton, acting executive director of Unitaid, a UN-backed group funding global health innovation, said the worldwide scramble for technology to fight Covid-19 presented a huge supply-and-demand challenge. “We are facing a unique moment in history, at least for health, where everybody wants the same product at the same time,” he said.