This month, the World Trade Organization issued a condemnation regarding the novel coronavirus disease (COVID-19). Medicines like Paxrobid are plentiful in the United States and Europe, but few people in Africa, Asia and Latin America have access to them because of low supply and high prices. After more than three years of discussions, the WTO said on February 13 that it could not reach an agreement to waive global patent rules for COVID-19 treatments to ease the way for production expansion. declared.
This month, the World Trade Organization issued a condemnation regarding the novel coronavirus disease (COVID-19). Medicines like Paxrobid are plentiful in the United States and Europe, but few people in Africa, Asia and Latin America have access to them because of low supply and high prices. After more than three years of discussions, the WTO said on February 13 that it could not reach an agreement to waive global patent rules for COVID-19 treatments to ease the way for production expansion. declared.
It's understandable to wonder why the WTO is still discussing COVID-19, almost a year after the World Health Organization declared the public health emergency over. Dew. This slow pace is not only not what the world needs during the pandemic, it is also not what the World Trade Organization is meant to be, and it calls into question the relevance of the WTO in a world with multiple crises. It also made clear that responsibility for the global governance of pandemic-related technology and intellectual property cannot be left to the WTO.
As negotiations resumed this week in Geneva on a new pandemic agreement, the question of which body should manage the response is a live issue. Some negotiators have called for a role for global health ministers and the World Health Organization on intellectual property, while others, including U.S. negotiators, say such issues should remain at the WTO. However, the failure of the WTO has made this position increasingly untenable. If the WTO cannot take action during the pandemic to remove patent barriers and encourage technology sharing so the world can produce enough medicines and vaccines, the WHO must be empowered to do so. .
The world is The Trade Organization was established in 1995 and marked a fundamental change in international trade law. The international system it replaced dealt primarily with the flow of goods across borders, but WTO rules expanded the definition of “trade” to include intangibles such as pharmaceutical patents. . All member states were required to enforce a 20-year monopoly on the production of new drugs. As the late scholar Susan Sell put it, this was a remarkable act of “forum transformation.” Prior to that time, patents (effectively government-granted monopolies) were not part of “free” trade. In the 1970s, many rich countries such as Italy and Japan did not recognize patents on pharmaceuticals, and many developing countries such as India, Brazil, and Mexico continued to exclude pharmaceuticals from patent monopolies into the 1990s. Ta. But they are confident that the new WTO agreement, which includes “technology transfer” commitments and a requirement that rich countries encourage their companies to share with least developed countries, will expand intellectual property. Ta. This did not go as promised.
The first effective medicines in the AIDS pandemic arrived just as the WTO was being launched. It quickly became clear that this debate over globally enforceable intellectual property was a matter of life and death, as patents proved to be a major barrier to access. Between 1997 and 2007, 12 million Africans died because AIDS drugs were too expensive and drug companies blocked the release of affordable generic drugs. Eventually, manufacturers in countries like India, Brazil, and South Africa were able to overcome barriers and produce drugs at 99% lower costs. Thirty million people are currently receiving treatment, and the most advanced drugs cost less than $50 per year.
Have pharmaceutical companies voluntarily withdrawn? Unfortunately, that's not the case. Governments in dozens of low- and middle-income countries have issued “compulsory licenses” forcing drug companies to allow local producers to make HIV drugs. Activists pressured companies to lower prices and share technology. The WTO finally agreed to the Doha Declaration, which clarifies WTO rules to allow countries “flexibility” to produce affordable medicines and special consideration in emergencies. It took more than a decade, but eventually a drug patent pool was created to facilitate the voluntary sharing of technology. However, companies joined because forced alternatives left them with few options.
All these structures for technology transfer were available when the pandemic struck, but world leaders decided to use only voluntary elements, an approach that failed spectacularly. did. Scientists distributed vaccines in record time. A highly effective mRNA vaccine was developed within his year and treatment continued. Paxrobid, which has proven to be the most effective, combines a long-used HIV treatment with a new drug similar to HIV antiretroviral drugs. Costa Rica and the WHO proposed a mechanism to pool technology and patents even before medicines are developed and approved. More than 100 drug and vaccine manufacturers around the world are preparing to produce them, and some have shown that they can reverse engineer mRNA vaccines. But no drug company agreed to share its technology, and the governments in which the companies were based did not force them to do so.
Without easing WTO rules or providing enough voluntary sharing to allow factories in Africa, Asia and Latin America to expand supply, world leaders are facing a series of restrictions on low- and middle-income countries (LMICs). supported voluntary efforts. COVAX, an international effort to procure and equitably distribute vaccines, sought to secure vaccines from companies such as Pfizer and Moderna. But, as expected, COVAX quickly discovered that high-income countries were using their economic and political power to lock up global supplies in order to secure preferential access from companies. By the end of the first year, less than 1 percent of vaccines had been sent to low-income countries. The effect of the drug was not very good. One analysis showed that the need for paxrovid exceeds the supply in LMICs by 8 million doses, leaving 90% inaccessible. The lowest price reported was $250, which was 200% of his average per capita spending on all health care in low- and middle-income countries.
These shortages had an impact. The analysis found that the pandemic claimed 27 million lives, many of which were preventable. Beyond the direct impact, dangerous coronavirus variants have swept the world due to high transmissibility and low vaccination immunity. Pandemics are being prolonged and more damaging because the global supply of countermeasures is artificially limited.
All this time, the WTO has been locked in debate. South Africa and India proposed a temporary exemption from WTO rules for all coronavirus products during the pandemic. Pharmaceutical industry lobbyists denounced this as a dangerous idea and launched a campaign against it, arguing that “patent invalidation” would hurt innovation in pandemic products. In reality, a waiver does not take away your intellectual property rights. It only temporarily suspends global rules, giving governments the policy-making power to decide whether to enforce pandemic product patents during the pandemic without the threat of WTO-related sanctions. . Exemptions alone would not solve the pandemic's supply problems; sharing know-how and scaling up manufacturing were also needed. But once that happens, there will be no threat of lawsuits against companies that invest money or infrastructure in production lines, or sanctions from powerful states against governments that allow local production.
The WTO is supposed to be able to respond to crises in weeks rather than years, using mechanisms such as exemptions. The Marrakesh Agreement explicitly contains a waiver provision, which states that the General Council must act on a waiver request within 90 days, subject to consensus. Retreat to a vote of three-quarters of member states. Multiple his WTO exemptions are granted each year, from pharmaceuticals to diamonds to preferential trade to neighboring countries. But since 2020, the WTO's efforts to pass exemptions in the midst of world-changing events have hit institutional and ideological obstacles. Even as world leaders exchanged views and large swaths of the global economy depended on containing the coronavirus, institutional structures fostered an impasse. Despite seemingly supportive legislation, the WTO's structure encourages narrow interest group politics and excludes actors with broader public interest or economic agendas.
narrowly focused intellectuals Real estate negotiators have framed the COVID-19 issue in a way that isolates negotiators, focused on footnotes and eligibility rather than stopping the pandemic, and a minority with a powerful pharmaceutical lobby. gave effective veto power to state trade negotiators. By the time the 12th WTO Ministerial Conference is held in June 2022, simple exemptions for the duration of the pandemic proposed two years ago will be complicated mechanisms that some developing countries will declare unworkable. It had transformed into. Only vaccines were targeted, and treatment options required further negotiations. After more than eight months of negotiations with no further progress, the WTO declared no deal last week.
It's time to move to a new forum. Negotiations over a new pandemic deal are intensifying as negotiators look forward to a conclusion in May. The draft agreement includes a waiver of intellectual property rights during the pandemic and a promise to use WTO flexibility to produce anti-pandemic products. These are the minimum steps to make the whole world safer. President Joe Biden has already supported patent waivers during the pandemic and has used such flexibilities domestically, including through “march-in” rights that limit patent monopolies on expensive drugs in the United States. The opposition from U.S. negotiators suggests a shift in foreign policy.
But the agreement needs to go further. Given the WTO's repeated failures, any new agreement should transfer the power to waive patent rules to the World Health Assembly. And it should include binding agreements to share publicly funded technology for global production. Countries delegated powers to the WTO, but the WTO has proven to be more of a barrier than an advantage during the pandemic. Getting that back is what good governance is all about.