By Sr Bernadette Mary Reis, fsp
Pope Francis has repeatedly appealed that the Covid-19 vaccine be available to everyone. In fact, during his Christmas Urbi et Orbi discourse, he said, “In this time of darkness and uncertainty regarding the pandemic, various lights of hope appear, such as the discovery of vaccines. But for these lights to illuminate and bring hope to all, they need to be available to all.”
What exactly are the prospects for the availability of this vaccine in Africa? In an interview with Vatican News, Father Charles Chilufya explains the complications regarding the arrival of the Covid-19 vaccine in Africa. Father Chilufya is the Coordinator of the Africa Task Force of the Vatican Covid-19 Commission, and the Director of the Justice and Ecology Office of the Jesuit Conference of Africa and Madagascar, also known as JCAM.
Several issues must be identified and dealt with both globally and locally in order to provide a successful Covid-19 vaccination program in Africa.
The first issue, Father Chilufya identifies is supply:
“Rich countries are already out-buying poorer countries."
A second issue he names regards patents:
“In this time of urgency, patent laws may conflict with the equal provision of these medicines worldwide.”
International cooperation is also at issue:
“International organizations, in particular, the World Health Organization, have a crucial role in fostering an environment of international cooperation and enforcing equitable access to medicines on a global scale.”
But bureaucratic issues “predict a bleak future” regarding the Coronavirus vaccine, Father Chilufya states. However, he reminds us that medical care is a right defined in Article 25 of the Universal Declaration of Human Rights. It is not a privilege for some, but it is a right for everyone, he emphasizes. Responsding to bureaucratic issues can be done through several international agreements so that patented, cost-prohibitive medicines can be made available to populations who cannot afford the high costs.
Providing generic alternatives
Father Chilufya explains that an agreement regulated by the World Trade Organization, called the Trade-Related Aspects of Intellectual Property Rights (TRIPS), also governs pharmaceutical and medical licenses. According to the World Health Organization, “the TRIPS Agreement allows the use of compulsory licences. Compulsory licensing enables a competent government authority to license the use of a patented invention to a third party or government agency without the consent of the patent-holder.” Therefore, states can issue licenses for the development of bioequivalent, cheaper versions of medicines, often referred to as “generic” medicine. Most African countries rely on medicine produced in this way. It is specifically the World Health Organization who can ensure that these “possibilities in the international legal framework are available” regarding the Covid vaccine, Father says.
Even though legal frameworks may be in place, many countries in Africa lack the “adequate resources and infrastructure for the production of pharmaceutical products.” Such countries theoretically can make use of provision under the 2001 Doha Declaration that allows them to “import generic forms of medicines from countries with developing capacity,” Father Chilufya explains. Implementation has proved lacking, however, with this provision. Father cites Rwanda, the only African country that has used this scheme. However, the supplier abandoned the venture soon after it was initiatived because not enough profit had been generated.
International power dynamics
“The threat to the supply of the Covid-19 vaccine and health care provisions for poor countries like those in Africa” is exacerbated by the “power dynamics played out at the global and state levels”, Father continues. It is obvious that countries who can will first make sure the vaccine is provided to their own citizens. He therefore predicts that it is unlikely that the vaccine will make its way to poorer countries any time soon. Moreover, Father also points out, “poor countries are easily swayed towards the interests of more powerful states.” He cites the example of India whose government eased export restrictions on hydroxychloroquine last April after the United States threatened the country with sanctions.
Another reality that will most likely affect the global distribution of the vaccine are “individual national interests and the power of some states over others. And this is where the Pope is calling for reform”, Father Chilufya states. Countries who have “low-bargaining power” need the help of the World Health Organization and other international organizations, such as the Catholic Church, to help them. Otherwise, “it is hard to imagine that the vaccine will be equitably distributed” when there are already examples of regions and nations blocking the export of supplies even though the World Health Organization has “made a global call for sharing of resources to combat the deadly virus.”
Collaboration to end the pandemic
To protect public health worldwide, countries in dire need to be assisted. This requires collaboration, Father Chilufya emphasizes once again.
“If the disease is not dealt with in Africa, it will affect other countries. This is not just a local problem, as we all know. It’s a public health problem of global proportions.”
“International institutions protecting health rights must, therefore, develop a more interventionalist approach to ensure equal access to medicines, encouraging universal guidelines and global cooperation mechanisms. Instead of using the interdependency of nations as a bargaining tool, states should recognize a larger cause and work toward the common good of ending the pandemic globally. This pandemic could provide the opportunity to create a more cooperative global health system in the future.”