In March, with Italy days into its first nationwide COVID-19 lockdown, a hospital in Lombardy was running out of valves for respirators when a start-up called Isinnova came to the rescue by 3D-printing them.
But this feel-good story of human ingenuity has a darker side. Isinnova had approached the valves' manufacturer for access to its blueprints, only to be told those were company property subject to a patent. It meant the start-up team had to reverse-engineer the valves to make them.
Throughout the battle to end the pandemic, equitable global access to technologies and treatments has been a major concern. To this end the World Health Organisation set up the COVID-19 Technology Access Pool and the Access to COVID-19 Tools Accelerator,as well as the more widely publicised funding pool for vaccine access, COVAX, to which Australia contributed $80 million from our aid budget, along with a series of other funding measures to help our neighbours in the Pacific and south-east Asia, including with vaccines. These commitments are admirable, and amount to a significant contribution to the wellbeing of our neighbours.
But with major pharmaceutical companies rolling out vaccines and millions of doses being bought by the United States, Britain, the European Union and Australia, developing countries argue such attempts to give them purchasing power in the market will only go so far. In October, India and South Africa asked the World Trade Organisation to temporarily waive intellectual property (IP) protections so that vaccines and other equipment for fighting COVID-19 could be made more cheaply at greater scale. Australia joined Britain, the US and the EU in opposing the move, arguing that existing rules on licensing would be sufficient to meet demand.
We have been here before. During the HIV/AIDS crisis of the 1980s and '90s, developing nations faced off with developed nations and their pharmaceutical industries over the price of treatments, until the WTO's Doha Declaration of 2001 allowed governments to set patent arrangements aside to protect public health, particularly during a national emergency.
Developing nations say that the existing WTO flexibility rules which allow them to compulsorily license treatments and equipment in an emergency must be decided case by case, and that in the past Western nations have used political pressure to block such licences.
Private drug manufacturers insist that IP rules guarantee them a return on their investment and willingness to assume risk, which are key drivers of the research that has created COVID-19 vaccines. In this case, however, governments and donors have also been a major force in funding the effort.
The WTO waiver as requested would be limited to COVID-19 treatments, and would only last until enough people had been vaccinated to achieve herd immunity.
Former WTO appeals judge James Bacchus opposes the developing countries' application but concedes "the credibility of the [drug] companies, the countries that supported them, and the WTO itself were all damaged" by the HIV/AIDS dispute.
The Morrison government has decided to line up with wealthy countries on this contentious question. It places us in direct opposition to Indonesia, where COVID-19 is rampaging through the population and which supports the waiver proposal.
At a time when we are competing with China for regional influence, this stance creates an opportunity for Beijing, where President Xi Jinping has already said any vaccine developed in China will be a “global public good”. That offer won't go unnoticed in Africa, which is struggling with a second wave of infection and a new variant of COVID-19. Indians may well adopt the approach of the Italian start-up and seek to make their own cheaper vaccine, as they did in the fight against hepatitis B in the '90s.
Without vaccinating enough of the global population that we all develop herd immunity, the return of international commerce and travel will be plagued by fear and delays, further crimping the national and global economies, and risking the deepening of global inequality.
The Age believes that the WTO flexibility arrangements should be given an opportunity to work as they are intended, for the benefit of countries that cannot afford to buy their way to the front of the queue for life-saving treatments.
However, if the rules stand in the way of wide dissemination of these vaccines, a more radical solution such as the temporary waiver of intellectual property rights might need further consideration.
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