Vaccine apartheid: How Europe failed the global south

The division of the world into those who do and don’t have vaccines is a shameful episode that will live long in the memory. Ben Wray finds that there was an opportunity for a different outcome through the waiving of vaccine IP rights, but Europe shut the door on it.

Gordon Brown is not a happy man.

Ever since the 2008 financial crisis, when Brown as UK Prime Minister became a central figure in a fire-fighting mission to save the international financial system from collapse, Brown has been one of the key advocates of what could be described as internationalism-from-above; the doctrine that greater co-operation amongst the world’s most powerful states will invariably lead to benign outcomes for the whole world. Whenever there is an international problem, the solution for Brown is always more G7, more G20.

So why is Brown unhappy? Until the pandemic crisis, internationalism-from-above had never been truly put to the test. As Branko Milanovic has argued, covid-19 is “probably the first global event in the history of the human race”. Never before had the whole world faced the same threat, at almost the same time. Faced with such a stress test of global leadership, the force which Brown has pinned all his hopes on for universal human progress has been found to be parochial and profit-driven.

“In a shocking symbol of the west’s failure to honour its promise of equitable vaccine distribution, millions of Covid vaccines manufactured in Africa that should have saved the lives of Africans have been shipped to Europe in recent weeks,” Brown lamented. “Indeed I have learned from African leaders that…about 10m single-shot Johnson & Johnson vaccines filled and finished at the Aspen factory in South Africa will be exported to Europe, at the very time that Africa is grappling with its deadliest wave of Covid-19 infections yet.”

In a furious piece in The Guardian, Brown went on to accuse the European Union of “neo-colonialism” in its approach to vaccine distribution, while previously describing the G7’s efforts to ‘help’ the world’s poor as “a colossal moral failure”. Yet for Brown, no amount of evidence shakes his belief that the solution is always more internationalism-from-above: his answer is a new G20 summit.

For those around the world at the sharp end of this ‘global leadership’, their patience with the powerful may not be as inexhaustible.

‘Vaccine apartheid’ is not hyperbole

World Health Organisation Director-General Tedros Ghebreyesus’ use of “vaccine apartheid” to describe the current situation is not hyperbolic: the world is undoubtedly segregated by vaccine access.

This is what it means to talk about capitalism being structurally racist: black Africa is dying in a queue behind white Europe and America’s vaccine hoarding (10 vaccines per person in the EU, eight per person in the US) and its ‘booster’ shots, ignoring the WHO’s pleas for a global moratorium on boosters until 10% of every nation is vaccinated. Pfizer has already calculated booster jabs in to its forecast for upcoming revenues, expected to rise to $33.5 billion. The ugly truth is it’s more profitable for Big Pharma and more politically desirable for rich countries to continue to supply vaccines to themselves rather than to the global south.

Africa wouldn’t have to rely on western vaccine hand-outs if it could manufacture it’s own, but of course it doesn’t have the patent rights as they are the private property of Big Pharma. That’s despite every Big Pharma vaccine having relied on huge sums of public money in their creation in the first place. States and their corporations work hand in glove to support their profitability at the expense of humanity as a whole.

“By the end of 2021, rich nations will be sitting on one billion unused doses, even though some poorer countries have not yet received the vaccines that they have paid for,” the British Medical Journal finds.

And the result is not just a rising covid-19 death rate among the world’s poorest. It’s the knock-on affects. As the hospitals fill up with Covid cases, routine care – under-resourced at the best of times – collapses.

“For example, 23 million children missed out on basic, routine childhood vaccines in 2020, the highest number since 2009,” Zain Chadlar and Madhukar Pai write in Nature. “The death toll and suffering from this disease will be felt for years among the world’s most vulnerable residents, both adults and children.”

And then there is the wider socio-economic affects. As covid-19 slows growth in the global south compared to the global north, the global inequality that has caused vaccine apartheid deepens. An additional 30 million Africans are thought to be in extreme poverty. Unesco finds that many of the gains made on gender equality in the global south in recent years from increasing girls’ education are being rolled back as the pandemic goes on and on.

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Promises were made at the peak of western concern about vaccine inequality which have since been broken. Covax was supposed to supply two billion doses by the end of 2021, and an additional 1.8 billion by early 2022. As of August, UNICEF reported Covax had shipped 209 million, around one-tenth of what was promised.

“To put that number into perspective, that is enough doses to fully vaccinate only half the population of Nigeria,” Charlotte Kilpatrick writes.

Perhaps worst of all is that there was a genuine opening to break the rich countries’ iron-like grip on vaccine distribution. That opening came when the United States relented on intellectual property rights, agreeing to a partial ‘TRIPS’ waiver. That it was Europe which shut the door on that opportunity should be a source of deep shame. The story of how that happened must be told, and should not easily be forgotten.

How the EU saved Big Pharma – in secret

The EU had been taken by surprise when US President Joe Biden announced on 5 May that he supported waiving certain TRIPS provisions. A week earlier, a 29 April meeting of EU civil servants noted that “in the discussion on the TRIPS waiver, the US and Australia are moving closer to the sceptical EU position”. After Biden’s shock announcement, stocks in Big Pharma immediately nose-dived.

Biden’s support encouraged other governments in the EU to fall in line, including the Spanish Government two days later, who were then followed later by the Greek Government. The European Parliament passed a motion backing the waiver in June. Once China had got behind the TRIPS waiver, it seemed resistance was collapsing. The European Commission then shifted from open hostility to a more tactful line. Commission President Ursula Von Der Leyen had said in late April that “I am not at all a friend of releasing patents”, but following the US announcement she now stated that the EU was “ready to discuss any proposal that addresses the crisis in an effective and pragmatic way”.

Just as what had once looked impossible was beginning to look inevitable, German Chancellor Angela Merkel made a crucial intervention against Biden, claiming that the US plan would create “severe complications” for vaccine production. Merkel’s comments did the trick as far as Big Pharma was concerned. Bloomberg reported: “Pharmaceutical stocks that had sunk on the news of the US proposal rebounded on Merkel’s stance. Moderna Inc. was down 2.1% after falling as low as 12% earlier. CureVac NV fell 5.4%, an improvement from its earlier 13% decline, while BioNTech SE was down 3.5% after earlier dropping 15%.”

CureVac and BioNTech (which is partnered with Pfizer) are German Big Pharma companies, with patented Covid vaccines. The German government put $445 million into building Pfizer/BioNTech manufacturing and development capacity for its vaccine: Merkel was merely protecting the government’s investment in German capital.

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The European Council, which comprises the heads of EU states and the President of the European Commission, held its one and only meeting about the TRIPS waiver on 20 May, where they decided to oppose opening up the patents. The meeting was held in complete secret. The public has only found out about the meeting’s existence because of leaked documents. It was not contained in any published minutes of meetings or in any press statements.

The notes of the meeting suggest Valdis Dombrovskis, EU Commissioner for Trade, “sought support for the sceptical line followed so far”. The sceptical line was backed by most member-states including, crucially, Germany, with only France, Spain and Hungary stating a temporary patent suspension could work. The chair agreed a ‘line’ coming out of the meeting that the EU was “open to discuss the waiver, but a balance would have to be found between the different relevant aspects”. The press office issued its usual ‘conclusions’ from the EU Council meeting, with the crucial discussion of the TRIPS waiver left out completely.

“The Council’s TRIPS waiver secrecy is a stark reminder of the need for sweeping reform of how EU governments take their decisions,” Corporate Europe Observatory, which has analysed the leaked documents, finds. “Governments might find the secretive ‘black box’ approach convenient, but from a democratic viewpoint it’s scandalous.”

The EU found allies in the UK, Switzerland and Japan in opposing outright the TRIPS waiver, setting their face against the US, China and 100 of the world’s poorest countries who had initially called for the waiver, which collectively represent the majority of the world’s population. But the WTO operates on ‘consensus’, and thus it refuses to even begin a formal discussion of the proposal first tabled by India and South Africa in October 2020. At the time of writing, the TRIPS waiver remains stuck. It should go without saying that if the EU had united with the US and China behind the TRIPS waiver, it would have happened by now.

Meanwhile, Africa hit a record number of officially recorded weekly deaths in early August, at 6,400, though the real number is likely to well exceed this, since excess deaths in South Africa (one of the few African countries with excess deaths data) are three times higher than average. The shocking reality is that a small part of the rich world has successfully blocked the world’s poorest from accessing life-saving drugs, because of a zealot-like commitment to private property above all other concerns.

A short history of ‘TRIPS’

Central to western exploitation of the global south in the 21st century is intellectual property rights, which since around the 1970s have become ever stronger and last ever longer to protect the IP holder’s monopoly at the expense of just about everything and everyone else. A key moment in the modern history of IP is the WTO’s 1994 TRIPS agreement (Agreement on Trade-Related Aspects of Intellectual Property Rights).

“TRIPS imposed on the entire world the dominant intellectual property regime in the United States and Europe, as it is today,” Joe Stiglitz has argued. “I believe that the way that intellectual property regime has evolved is not good for the United States and the EU; but even more, I believe it is not in the interest of the developing countries.”

The TRIPS agreement for the first time forced medicine patents onto to low-income countries, regardless of their domestic situation. Thus, TRIPS is particularly notorious for its impact on public health programmes to tackle the AIDS epidemic in Africa, as the strong patent rights drove up the cost of such programmes significantly. It wasn’t until 2003, nearly a decade after the agreement, that AIDS patent restrictions began to be loosened. TRIPS has also been accused of creating artificial food scarcity and impoverishing farmers in the global south, as it effectively outlawed the saving and re-use of seeds from one season to the next.

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The cliche in defence of TRIPS and strong IP laws in general is that it promotes innovation, but one just has to look at the pharmaceutical industry to see the holes in that argument: innovation is only valued to the extent that it is profitable. Big Pharma blocked its scientists from researching vaccines before covid-19 appeared because there was more money to be made in identifying patentable products for the mass market. There was no profit in vaccines for a pandemic which did not yet exist. As Mike Davis argues in his 2005 book ‘Monster at the door’, warning of the looming threat of a global pandemic, Pfizer had made more money from a single anti-cholesterol medication than from all the vaccines in the world combined.

“The giants prefer to invest in marketing rather than research, in rebranded old products rather than new ones, and in treatment rather than prevention,” Davis adds.

As Dean Baker, Senior economist at the Center for Economic and Policy Research, finds in Rigged, “relying on patent incentives to support medical research encourages drug companies to direct research toward finding a patentable product. If, for example, evidence suggests that a condition can be most effectively treated through diet, exercise, environmental factors, or even old off-patent drugs, a pharmaceutical manufacturer would have no incentive to pursue this research…in fact, if they are concerned that such research could lead to an alternative to a patentable product that they might develop or be in the process of developing, their incentive is to conceal the research.”

“Research advances most quickly when it is open,” Baker adds. “However, companies seeking profits through patent monopolies have incentive to disclose as little information as possible in order to avoid helping competitors.”

IP monopolies blunt innovation through secrecy and artificial scarcity, limiting the bounty of technological progress to those who legally own it (generally, corporations), at the expense of those who actually need access to it (the rest of us). This problem is becoming increasingly acute in the ‘information age’, as Guy Standing has observed.

“Knowledge-intensive industries, which now account for 30 per cent of global output, are gaining as much from intellectual property as from the production of goods or services,” Standing writes. “This represents a political choice to grant monopolies over knowledge to private interests, allowing them to restrict access to knowledge and to raise the price of obtaining it or of products and services embodying it.”

Internationalism-from-below

If internationalism-from-above can fail so badly when it comes to solidarity in a global pandemic, what chances of it succeeding in the ecological crises which will surely define this century? One would have to be incredibly naive or seriously duplicitous to believe that some deep, as yet undiscovered, reservoirs of international solidarity will be found by governments in the context of global climate breakdown if they could not be found in the context of covid-19.

Vaccine apartheid, which coincides with the culmination of the US and NATO’s disaster in Afghanistan, should herald a renewal of internationalism-from-below; a politics which has no faith in the powerful states’ so-called “rules-based liberal order” and instead actively supports the struggles of the oppressed and exploited for sovereignty and self-determination.

Internationalism-from-below would defend illegal breaches of the WTO’s intellectual property system to get life-saving drugs to those who need it. It would actively support global south debt cancellation to get the bankers off their backs, and resist attempts to impose sanctions on countries which refuse to pay their creditors. Filipino writer and activist Walden Bello, perhaps the world’s leading advocate of internationalism-from-below, has made the case for “deglobalisation”.

“Deglobalisation is not a synonym for withdrawing from the world economy,” Bello explains. “It means a process of restructuring the world economic and political system so that the latter builds the capacity of local and national economies instead of degrading it. Deglobalisation means the transformation of a global economy from one integrated around the needs of transnational corporations to one integrated around the needs of peoples, nations, and communities.”

Deglobalisation is not a concept that Gordon Brown will ever embrace, but vaccine apartheid has led millions in the global south to begin to question whether globalisation works for them. As one African leader has said: “We never want to have to rely on the West again.”

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