‘vaccine apartheid’ could extend outbreak by 2 years

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In December last year, the head of global health at the World Economic Forum, economist Arnaud Bernaert, put it simply what the world is experiencing today: “It is mathematics: of the approximately 12 billion doses of vaccines against 19 that the pharmaceutical industry is expected to deliver in 2021, nine billion have been set aside by rich countries. ” To circumvent the coldness of the numbers that do not lie, a campaign to waive intellectual property rights over the vaccines produced gives voice to countries that do not even have doses for their medical staff.

For herd immunity to be achieved worldwide, 70% of the planetary population needs to be immunized, and this will require 11 billion doses. According to the calculations of the Health Innovation Center at Duke University, only the high and medium / high income countries (one fifth of the world population) had six billion immunizations (2 doses).

On the other hand, low and middle income countries (the remaining four fifths of the planet) have orders for 2.6 billion doses – of these, 1.1 billion doses will come from the World Health Organization (WHO). This means that while 20% of humanity will be free of covid-19, the other 80% will be immunized over the next two or more years. Today, 75% of the vaccines applied were in the arms of inhabitants of only ten countries.

The vaccines that are manufactured (about 413 million doses in early March, according to market analysis company Airfinity, which could reach 9.5 billion by December) are delivered to countries that, in mid-2020, cleaned the shelves and have contracted enough vaccines to immunize their citizens more than once – the United States, for example, has a surplus stock of 30 million AstraZeneca vaccines that cannot be used because the immunizer has not been approved in the country even for emergency use.

Vaccinated six times

The hope for countries like those on the African continent and Central America is the COVAX Facility, a WHO initiative to guarantee up to two billion doses by the end of this year for low to middle income countries. However, wealthy countries like Canada (whose vaccine orders are sufficient to immunize every citizen of the country six times), Singapore and New Zealand have already declared that they want to receive their share of COVAX vaccines now.

To stop what many scientists and doctors are calling “vaccine apartheid”, a group of 100 countries, led by India and South Africa, is trying to get, in the World Trade Organization (WTO), that some of the property rights intellectual property on medical tools and technologies related to covid-19 are temporarily suspended until global collective immunity is achieved.

The proposal is supported by the so-called People’s Vaccine Alliance, a coalition of entities, including the United Nations agency for HIV / AIDS, Amnesty International and Doctors Without Borders. There was no consensus at the organisation’s last meeting, on March 11, and the matter is expected to resume in April.

Public money

USA, European Union and other countries (including Brazil) are opposed to the proposal. According to them, suspending patents can discourage future private investments in research, “obstructing scientific innovation”.

The group that wants to share technology until the pandemic is controlled argues that the laboratories have received robust investments from governments for the development of vaccines – public money that, according to a report published in February by the medical journal The Lancet, reached $ 10 billion (about R $ 56 billion).

The discussion is still about which technology should be shared. Messenger RNA vaccines, for example, are the ones that take the least time to produce. However, it is the lack of trained technical staff and the global scarcity of essential inputs that are, until now, the obstacle to the manufacture of the most efficient weapons against SARS-CoV-2.

Sharing

According to chemical engineer Zoltán Kis, from the Imperial College in London, there are no nucleotides (the basis for replicating the mRNA), enzymes (responsible for the replication process) and lipids (the layer where the mRNA is inserted so as not to degrade): few manufacturers, besides not meeting the demand, are reluctant to license their production processes.

“Lipids are the most expensive component, and a small number of companies own the intellectual property rights to one of the four lipid nanoparticles that form the ‘cage’ around the mRNA,” said Kis.

Experts are divided over the effectiveness of suspending the laboratories’ property rights. While some argue that it was an attitude like the one Brazil took in 2007, when one of the drugs in the anti-HIV cocktail started to be manufactured under compulsory license (when there is a health emergency), which allowed to stop the escalation of the disease in the country others point out that the measure will be harmless due to the different technological levels between the countries involved.

Since the beginning of the pandemic, WHO has advocated the voluntary transfer of technology, knowledge, data and intellectual property by universities and manufacturers to other companies through a global mechanism, Joint Access to Technologies against Covid-19. Almost 40 countries signed the agreement, drawn up in June 2020. To date, no technology has been shared.

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