As some of the world’s wealthiest countries move closer towards fully vaccinating their populations against COVID-19, there could not be a starker contrast when looking at countries in the Global South.
The legacies of imperialism and the entrenchment of neoliberalism in recent decades have driven inequality between the world’s rich and poor. This is further highlighted by the global distribution of COVID-19 vaccines.
Despite bearing the brunt of the pandemic, in terms of deaths per capita, less than 1.5% of people in low income countries have received a single dose of vaccine. The Institute for Health Metrics and Evaluation estimates the pandemic has killed 6.9 million people globally, as of May this year.
Profiteering from the pandemic
As Naomi Klein explains in The Shock Doctrine: The Rise of Disaster Capitalism, capitalists seek to make profits from crises. Pharmaceutical companies have exploited the global pandemic to make billions of dollars in profits and created huge vaccine inequity as a result.
Pharmaceutical companies are selling vaccines at prices far exceeding the production cost. For example, the pharmaceutical giant Moderna has charged different countries between 4 and 13 times the estimated production cost and averages a profit margin of 50% per dose. Moderna has already indicated its intention to raise the price of its vaccine after the pandemic.
This immoral profiteering has created many new billionaires, such as Moderna’s CEO Stéphane Bancel — worth US$4.3 billion — and BioNTech’s CEO Ugur Sahin — worth US$4 billion. The combined wealth of these new “COVID billionaires” is enough to vaccinate all the people living in low-income countries 1.3 times, based on the current average vaccine cost of $19 per dose.
As a result of letting the market determine the distribution of vaccines, more than 90% of all COVID-19 vaccines administered thus far have been in the world’s wealthiest countries. It is more profitable for pharmaceutical companies to sell vaccines to wealthy countries, rather than to poorer countries who cannot afford the exorbitant prices.
Wealthy countries have made agreements directly with pharmaceutical companies to purchase enough vaccines to inoculate their populations several times over. High income countries, which represent a fraction of the world’s population, have hoarded more than half the current global vaccine supply.
It is estimated that most high income countries will be fully vaccinated by the end of this year, and most middle income countries will achieve this by the end of 2022. However, low income countries will not have widespread coverage until at least after 2023, if at all.
Intellectual property
A huge contributor to global vaccine inequality is the current monopoly on patents, technologies and knowledge related to the development and production of COVID-19 vaccines. This is in spite of the fact that the development of mRNA vaccines, such as those manufactured by Pfizer and Moderna, occurred in public institutions using largely public funding.
The Trade-Related Aspects of Intellectual Property Rights (TRIPS) is an international treaty which ensures big pharmaceutical companies control the intellectual property for COVID-19 vaccines, which means they can establish themselves as the sole producers and suppliers of vaccines.
India, South Africa and Kenya proposed a temporary waiver to the World Trade Organisation in October last year, regarding parts of the TRIPS agreement relating to COVID-19. The proposal was to suspend the current monopolies on technologies for the detection, prevention, treatment and response to COVID-19.
Specifically, the proposed waiver would apply to patents, and knowledge relating to vaccine production, which is currently kept secret by pharmaceutical companies. The waiver is supported by more than 100 countries, however some wealthy countries, such as Australia, Germany and Britain, have blocked the waiver in order to protect the profits of pharmaceutical companies.
The waiver would allow more countries in the Global South to produce their own vaccines at a lower cost and scale up global vaccine supplies, rather than pay the exorbitant and often unaffordable prices set by pharmaceutical companies, or rely on the failed COVAX initiative.
Maaza Seyoum, from the People’s Vaccine Alliance Africa summarised the current situation: “As long as the pharmaceutical corporations retain their monopolies on the life-saving technology, they will always prioritise contracts where they can make the most excessive profits, leaving developing countries out in the cold.”
Although the current monopoly on technologies and knowledge should be broken up permanently, even a temporary waiver would allow more countries in the Global South to produce their own vaccines. The transfer of technology and funding to the Global South must also be a priority to ensure a more equitable vaccine distribution. Currently, there are only a small number of countries in the Global South, such as Taiwan and Cuba, who are producing their own vaccines.
Cuba: a socialist approach
Cuba has already produced two successful vaccines, Soberana 2 and Abdala, with efficacy rates of 91.2% and 92.8% in clinical trials, respectively. The Cuban government has plans to export low-cost vaccines once its own citizens are vaccinated. Cuba has already been in talks with Argentina, Mexico, Bolivia and Honduras for them to either start producing their own vaccines from Cuba’s or buy the vaccines directly at a low cost.
Cuba has offered a transfer of technology and supply of materials to countries, such as Ghana, so that they can begin producing the vaccine. In fact, Iran has already started mass-producing the Soberana 2 vaccine.
Cuba’s vaccines are relatively cheap to produce, and easy to store and transport as they do not require extremely low temperatures, such as with the Pfizer vaccine. This would make Cuban vaccines suitable for many regions in the Global South where refrigeration is inadequate.
Cuba demonstrates a socialist approach to the fight for a people’s vaccine, which sits in stark contrast to the unjust, profit-driven approach taken by pharmaceutical companies. Organisations and activists around the world are demanding a free, mass-produced and equitably distributed COVID-19 vaccine. They are calling on pharmaceutical companies to openly share their technologies and patents to allow for global vaccine production. This is a moral imperative which capitalists are willfully ignoring in the pursuit of profit.
Epidemiologists warn that the current vaccine inequity endangers the world’s poorest people and populations in rich vaccinated countries, as it heightens the risk of new mutations of the virus, which may render current vaccines ineffective. Social and economic justice has to be at the forefront of the COVID-19 vaccine response, which must put human need before corporate greed.