Trade and Global initiatives to make COVID-19 vaccine available to all – TRIPS, C-TAP, COVAX, Gavi, CEPI

Explainer

Vaccines and  WTO trade rules (TRIPS)

July 24, 2020: The World Trade Organisation Trade-Related Intellectual Property Rights agreement entrenches 20-year monopolies for new medicines before cheaper versions can be produced. However there are some provisions that allow governments to import or manufacture cheaper versions before patents have expired in a national emergency. This was a result of public protest at the cost of Anti-Retroviral drugs during the Aids pandemic in 2002-04.

Under TRIPS, compulsory licensing and government use of a patent without the authorization of its owner can only be done under a number of conditions aimed at protecting the interests of the patent holder.

However, for “national emergencies”, “other circumstances of extreme urgency” or “public non-commercial use” (or “government use”) or anti-competitive practices, a government can issue a compulsory licence without seeking a voluntary licence and compensating the patent holder first — Article 31b.

Compulsory licensing must usually be granted mainly to supply a domestic market, so imports are also discouraged.

Global pharmaceutical companies have consistently sought to limit WTO exceptions to the 20-year monopoly on new medicines, and have used bilateral and regional trade agreements like the Trans-Pacific Partnership agreement and the US-Mexico-Canada agreement to extend monopolies.

C-TAP, COVAX, CEPI and Gavi are different initiatives to stop patent rights in TRIPS from blocking treatments and vaccines for COVID-19 from being universally available at low cost. C-TAP seeks voluntary suspension of patent rights, or suspension as part of public funding for research and development of treatments and vaccines. COVAX, CEPI and Gavi are market mechanisms that leave patent rights intact by using donations to reach production agreements with drug manufacturers to provide treatments and vaccines to poorer countries at low cost.

COVID-19 Technology Access Pool - C-TAP

The COVID-19 Technology Access Pool (C-TAP) was launched in May 2020 through the World Health Organisation to compile, in one place, pledges of commitment made under the Solidarity Call to Action to voluntarily share COVID-19 health technology related knowledge, intellectual property and data. The Pool will draw on relevant data from existing mechanisms, such as the Medicines Patent Pool and the UN Technology Bank-hosted Technology Access Partnership. Thirty-eight governments have endorsed the call but Australia has not yet endorsed it.

In April 2020, the US Food and Drug Administration launched its own Coronavirus Treatment Acceleration Program. The program does not suspend patents but uses available methods to move new treatments to patients as quickly as possible, while at the same time finding out whether they are helpful or harmful. However, these arrangements will only make treatments and vaccines available in the US. The US disassociated itself from the patent-sharing concept in the C-TAP project set out in the World Health Assembly resolution in May 2020.

COVAX – COVID-19 Vaccine

The COVAX Facility forms a key part of the COVAX pillar of the Access to COVID-19 Tools (ACT) Accelerator, a global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines under existing patent rules. COVAX is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, working in partnership with developed and developing country vaccine manufacturers. COVAX aims to accelerate the development and manufacture of COVID-19 vaccines at a lower cost.

It will achieve this by sharing the financial risks associated with vaccine development, investing in manufacturing upfront so vaccines can be deployed at scale as soon as they are proven successful, and pooling procurement and purchasing power to achieve sufficient volumes to end the acute phase of the pandemic by 2021.

On July 15, 2020, 75 countries submitted expressions of interest to protect their populations and those of other nations through joining the COVAX Facility. These 75 countries, which would finance the vaccines from their own public finance budgets, partner with up to 90 lower-income countries that could be supported through voluntary donations to Gavi’s COVAX Advance Market Commitment (AMC). Together, this group of up to 165 countries represents more than 60% of the world’s population, including more than half of the world’s G20 economies. Australia has reportedly expressed interest, but was not listed amongst the 75 countries on the COVAX website.

The Gavi COVAX AMC has raised close to US$600 million against an initial target of US$2 billion from high income donors as well as the private sector.

Coalition for Epidemic Preparedness Innovations - CEPI

CEPI is a partnership between public and government bodies, private pharmecutical companies, philanthropic, and civil organisations, launched at the World Economic Forum in Davos in 2017, to develop vaccines to stop future epidemics. It was initiated by the Bill & Melinda Gates Foundation. Australian former public service head Jane Halton is Chair of the CEPI Board, which is based in Norway. CEPI co-ordinates with the WHO. CEPI has initiated nine partnerships with pharmaceutical companies and research organisations to develop vaccines against the novel coronavirus.

CEPI was launched in response to a market failure to deploy for over 12 months an available 100 per cent effective vaccine during the 2014-15 Ebola outbreak in West Africa—which killed more than 11,000 people and had an economic and social burden of over $53 billion.

Gavi – the Vaccine Alliance

Gavi is a an older, more general  partnership to make vaccines availalbe between the World Health Organization, UNICEF, the World Bank and the Bill & Melinda Gates Foundation, launched in 2000. It plays a critical role in strengthening primary health care (PHC) and is committed to the Sustainable Development Goal (SDG) of Universal Health Coverage.

At the end of the 1990s there were almost 30 million children in developing countries who were not fully immunised against deadly diseases, and many others who had no immunisation at all. This was an acute market failure because powerful new vaccines were becoming available, but developing countries simply could not afford most of them.

In response, the Bill & Melinda Gates Foundation and a group of founding partners worked to encourage manufacturers to lower vaccine prices for the poorest countries in return for long-term, high-volume and predictable demand from those countries. Gavi shares the cost that developing countries pay for vaccines, which has resulted in more than 460 vaccine campaigns and boosted immunisation against virulent diseases.