While in well-off countries, a third dose of vaccine is given in the hope of better coping with new variants of SARS-CoV-2, low-income countries are struggling to give their populations a first dose, which is a major risk. fertile ground for the emergence of new variants. What can be done to reduce this inequity? Skip the third dose? Or act more globally by forcing vaccine manufacturers to grant patent licenses that would allow all countries with facilities to produce COVID-19 vaccines?
“You have to do both: give a third dose to people at risk and health workers, and immunize African countries,” says Dr.r Don Vinh, microbiologist-infectious disease specialist at the MUHC. “The roughly 30 million doses needed for the third dose in Canada will not solve the dose shortage in Africa, where there are over a billion people to be vaccinated. Instead, we need to force the vaccine manufacturers, who have taken advantage of the situation and public resources to develop their vaccine, to suspend their intellectual property rights to their vaccine in order to allow the manufacture of vaccines in bulk for the rest of the world. . “
“Refusing the third dose at the individual level to help poor countries is not going to change much. From the moment vaccine manufacturers began to insist that a third dose was needed, Canada would have been ill advised not to administer this third dose. It would have been politically suicidal for any government not to do so. Public health priorities should have been defined at the level of international platforms, knowing that a third dose can be useful for certain immunocompromised people in particular, but that in terms of overall health, the therapeutic benefit of the third dose has nothing to do with the therapeutic benefit of a first dose to someone who has never been vaccinated, ”believes Marc-André Gagnon, professor at the University’s School of Administration and Public Policy. Carleton, in Ottawa.
“We would not ask ourselves this question if, at the outset, vaccine manufacturers had agreed to issue licenses while ensuring appropriate technology transfer so that production could be carried out correctly. These firms would thus have taken advantage of the fact that there would have been more laboratories which would have produced their vaccine and which would have paid them royalties, and we would thus have used the maximum of vaccine manufacturing capacities to participate in the war effort. . We assumed that in the midst of a pandemic, that would happen, but it was not the case, ”he explains.
From the moment vaccine manufacturers began to hammer home that a third dose was needed, Canada would have been ill advised not to administer this third dose.
As is known, the manufacturers of COVID-19 vaccines, with the exception of AstraZeneca, categorically refused to grant licenses and share their patents with the COVID-19 Technology Access Pool (C-TAP) which was set up in May 2020 by the World Health Organization (WHO) with the aim of pooling the patents associated with COVID-19 technologies and thus allow anyone who wants to produce vaccines to use these patents by paying royalties to the owner of said patents.
Pfizer and Moderna jealously protect their mRNA vaccine technology, because it is “very promising for various other treatments, in particular against cancer”, underlines Mr. Gagnon. “These companies do not want to share their technology at this time for fear that it will eat into their future markets, because, let us remember, the priority of pharmaceutical companies is not global health, but that of maximizing return for shareholders” , he said.
“As long as Pfizer and Moderna have the big end of the stick, that all countries are on the lookout for their vaccines and demonstrate vaccine nationalism as at the end of 2020, when each country was fighting against its neighbor at the door of the companies to buy vaccines, there is little hope that they will agree to issue licenses. We therefore need a regulatory solution, because market incentives are not working in the right direction, ”points out Mr. Gagnon.
Yet Moderna was able to develop its mRNA vaccine only with public funds and others from nonprofit foundations. “The patent, which is a mechanism to encourage financing by private shareholders and encourage them to take the risk of investing, is therefore not relevant for Moderna,” adds Mr. Gagnon.
Pfizer also received public funds, although to a lesser extent, but it was able to benefit from market guarantees, that is to say that its vaccine was not yet developed and guaranteed that it was would offset the costs by purchasing the vaccine even though it was not approved. “It was a way of eliminating the risk on the investments, and in such a case, the patent was not justified either,” explains Mr. Gagnon.
“Tens of billions of public funds have been given to accelerate the development and production of vaccines. Market guarantees were put in place to ensure that private firms would do everything they could, and as quickly as possible, to develop vaccines. Which worked very well. There would have been no patent, we would have developed vaccines at the same speed. But at this time, patents are becoming an obstacle to the distribution and organization of production that can serve the priorities of global public health, ”he insists.
The basic problem is that vaccine manufacturing capacities exist in different countries, including South Africa, which has large factories, and cannot be tapped given the current intellectual property system. A first regulatory solution would be to suspend the TRIPS Agreement (Aspects of Intellectual Property Rights Affecting Trade) for COVID-19 technologies.
Such a suspension would give access to patents to countries that request them against payment of royalties, and also allow the exchange of technological expertise between countries, which is currently prohibited under a compulsory license granted to a third party. country. However, for high-tech products such as mRNA vaccines, this exchange is absolutely necessary for countries that do not have the vaccine production capacities or the adequate expertise, says Mr. Gagnon.
A suspension of the TRIPS agreement was proposed in October 2020 by South Africa and India, but it still has not been approved by European countries and Canada, while, to the great everyone’s surprise, the United States supported it in May 2021.
According to Marc-André Gagnon, Canada does not support this proposal probably because it “fears reprisals from vaccine manufacturers who could express their dissatisfaction by adding new conditions on the cost of doses and supply, in particular “.
Last week, the World Trade Organization planned to discuss the suspension proposal again, but the meeting was called off due to the spread of the new Omicron variant.