Humanists International’s Lillie Ashworth wrote on the vaccine programmes in progress in several countries within a setup of “accelerated development and approval” for several of them, where this amounts to “an unprecedented scientific achievement.”
Ashworth’s concern in “Vaccines sans frontières: the ethics of equitable vaccine distribution” is the separation between the comparatively wealthier countries and the comparatively poorer countries in the world.
For example, if a country does not have sufficient infrastructure, due in part to its financial status, especially as regards healthcare, then the distribution will be inequitable.
International property law and nationalism are the core issues for the ability of the international community to provide equitable access and distribution of the coronavirus vaccines available at present.
Ashworth stated, “Much of the potential vaccine manufacturing capacity for 2021 has already been spoken for. The European Union, together with Canada, the United States, the United Kingdom, Australia and Japan have pre-ordered more than half of the global supply. While the People’s Vaccine Alliance has warned that almost 70 developing countries will only be able to vaccinate 1 in 10 people next year.”
Ashworth quoted UN Secretary-General Antonio Guterres as saying the nationalization, in the sense of turning inwards, vis-à-vis the virus and the vaccines, is futile in the international fight against the global pandemic.
“The more the virus is free to circulate, the more mutations there will be, and the longer it will take for the global economy to recover,” Ashworth wrote.
There are a number of unprecedented facts about the current vaccine unveiling. The first, of course, is the rapidity of its development. Another fact is the distinct demarcations of equitable access based on the income of a country.
Typically, Western and North American nations have higher finances and great medical infrastructure; thus, the access, development, and distribution of the vaccines is far more rapid than in many of the poorer countries in the world.
Additionally, as Ashworth described, “It took years for the antiviral drugs which revolutionized HIV/AIDS treatment in high-income countries to become widely available to African countries. A feat that was only achieved after intensive lobbying by civil society groups and the decision by an Indian company in 2001 to manufacture treatment at a low-cost (today, India continues to supply over 80% of the world’s HIV drugs).”
This rapid development still works through three phases of development for the vaccines to be considered reasonably safe.
Phase 1 deals with some volunteers. This phase assesses the safety of the immunological response to the vaccine and sets some baselines as to the correct dosages. The volunteers, typically, are healthier.
Phase 2 is given to hundreds of volunteers. It examines the immune response looking at volunteers by age, sex, and the like. Those people who the vaccine is intended to help the most. This happens in multiple trials while still within Phase 2.
A comparison group is not given the vaccine to compare and contrast the immune response to the vaccine, as such. It differentiates between possible confounding factors and can show the differences between no vaccine and vaccine cases by different ages and sexes.
Phase 3 is given to thousands of volunteers and then compared to another similar group of volunteers who have not received the vaccine. This creates a robust comparison group of people.
While, Phase 2 and Phase 3 are ongoing; the test volunteers and scientists are blind to who receives the vaccine and who receives the placebos. With the finalization of the trial, the results can show the efficacy of the proposed vaccine. If implemented, so successful, the vaccines are continually monitored for safety in the public domain.
The greatest need is a distribution network or some mechanism by which to implement vaccine rollouts for the international population, such a mechanism exists.
“COVAX, a global procurement mechanism dedicated to ensuring the access to COVID-19 vaccines for all countries, provides a promising example of multilateralism in action,” Ashworth said, “But will this be enough to overcome the impulse towards vaccine nationalism? Notably, the United States has not signed up to the COVAX facility, and vaccine hoarding behaviour by rich nations undermines the initiative by cutting into global supply.”
Ashworth, rightfully, pointed to the human rights inherent in these vaccine issues globally. That is, the right to health. As noted by the World Health Organization, in its Constitution, “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”
Thusly, the ideal is access for all and distribution across the world. The intellectual property law’s being vague is the crux of the matter for Ashworth, who sees the opacity as preventive of the attainment of said rights to health.
A challenge is the market basis for the vaccine program and the development itself. In that, the intellectual property laws can prevent the full distribution of the scientific knowledge behind and about the vaccine to reach an international or global audience in an equitable manner. The prices become standardized by the rendering nations themselves.
“Behind the scenes, a war is currently being waged within the World Trade Organization, where a proposal by South Africa and India to temporarily waive patents on COVID-19 vaccines – supported by 100 mostly low and middle-income countries and endorsed by UN human rights experts – is being blocked by a small group of high-income countries, including Brazil, the European Union, Canada, the United States, Japan and the United Kingdom,” Ashworth wrote.
In turn, those countries with the most financial investment in the vaccine programs around the world have some of the greatest abilities to restrict access to and distribution of the vaccines to countries with far less income, infrastructure, and ability to cope with the blows of the coronavirus seen in even some of the richest countries in the world.
As Member States of the United Nations, the status of a Member State comes with a variety of obligations and responsibilities. 194 countries in the world are officially classified as Member States of the World Health Organization, 193 in the United Nations. Both stipulate international human rights and responsibilities.
Therefore, as stipulated within the Constitution of the World Health Organization, these Member States, or countries with formal membership in the World Health Organization, have duties to fulfill to the international community via the World Health Organization.
Ashworth quotes the UN Committee on Economic Social and Cultural Rights (CESCR) General Comment No. 12 on the right to health:
[G]iven that some diseases are easily transmissible beyond the frontiers of a State, the international community has a collective responsibility to address this problem. The economically developed States parties have a special responsibility and interest to assist the poorer developing States in this regard.
Aptly, General Comment No. 24 deals with intellectual property rights. Those which will not deny access to essential medicines as something necessary to the enjoyment of life and health. In turn, this means fulfillment of this so as to enjoy the right to health, and also the constitutional obligations to the World Health Organization, too. This kind of rights-based analysis could form an M.A. thesis because it’s so obvious and necessary to report on it, as Ashworth has done commendably as an intern at Humanists International.
Her main concern stands as valid and evidence-based, as above, and shows the importance of an international infrastructure for equitable distribution of the vaccines to high-income and low-income Member States alike without barriers due to intellectual property, including the expansion of the construction of multilateral efforts seen in COVAX.
With files from Humanists International.