Intellectual Property and the Politics of Public Good during COVID-19: Framing Law, Institutions, and Ideas during TRIPS Waiver Negotiations at the WTO.

CONTEXT: To facilitate the manufacturing of COVID-19 medical products, in October 2020 India and South Africa proposed a waiver of certain intellectual property (IP) provisions of a World Trade Organization (WTO) agreement. After nearly two years, a narrow waiver agreement that did little for vaccine access passed the ministerial despite the pandemic's impact on global trade, which the WTO is mandated to safeguard. METHODS: The authors conducted a content analysis of WTO legal texts, key-actor statements, media reporting, and the WTO's procedural framework to explore legal, institutional, and ideational explanations for the delay. FINDINGS: IP waivers are neither legally complex nor unprecedented within WTO law, yet these waiver negotiations exceeded their mandated 90-day negotiation period by approximately 18 months. Waiver opponents and supporters engaged in escalating strategic framing that justified and eventually secured political attention at head-of-state level, sidelining other pandemic solutions. The frames deployed discouraged consensus on a meaningful waiver, which ultimately favored the status quo that opponents preferred. WTO institutional design encouraged drawn-out negotiation while limiting legitimate players in the debate to trade ministers, empowering narrow interest group politics. CONCLUSIONS: Despite global political attention, the WTO process contributed little to emergency vaccine production, suggesting a pressing need for reforms aimed at more efficient and equitable multilateral processes.

Vaccine inequity-induced COVID-19 dilemma: Time to sober up.

OBJECTIVE: The aim of the study was to discuss the catastrophic consequences of inequitable vaccine distribution and analyze the main challenges to address it, helping to guide efforts to address inequities in vaccine coverage. METHODS: All published papers written in English were searched through PubMed, Web of Science, and Google Scholar with the combination of relevant terms of COVID-19 vaccine inequity. RESULTS: In this paper, we first outlined the scope of inequitable vaccine distribution and identify its truly catastrophic consequences. Next, from the perspectives of political will, free markets, and profit-driven enterprises based on patent and intellectual property protection, we analyzed in depth the root causes of why this phenomenon is so difficult to combat. In addition, some specific and crucial solutions that should be undertaken in the long term were also put forward in order to provide a useful reference for the authorities, stakeholders, and researchers involved in addressing this worldwide crisis and the next one. CONCLUSIONS: Achieving COVID-19 vaccine equity faces funding gaps, vaccine nationalism, and barriers to access to intellectual property and technology. Thus, the scope of global vaccine inequity is immense, and its repercussions will continue to be felt worldwide, especially among the world's most vulnerable residents, both adults and children. Beyond fundamental issues, the growing vaccine hesitancy and unreliable distribution in low-income countries must be addressed.

Can we move beyond vaccine apartheid? Examining the determinants of the COVID-19 vaccine gap.

While global health leaders call disparities in access to COVID-19 vaccines an 'apartheid,' this gap is not the first such disparity. The recurrence of these gaps in low and middle-income countries and especially in Africa, raises questions about their determinants and about the persistent failures of global health institutions to remediate them. We interrogate these determinants and questions by examining: (1) the distribution of COVID-19 vaccines; (2) primary determinants of vaccine access including availability and affordability; (3) factors affecting availability (hoarding, COVAX, and manufacturing capacity); and (4) factors affecting affordability (pricing, intellectual property rights (IPR), the TRIPS waiver and a potential pandemic treaty). We conclude that IPR constrained the affordability and availability of COVID-19 vaccines in ways inadequately addressed by COVAX and a waiver compromise thwarted by political, corporate, and philanthropic interests. While stronger limits to IPR in a pandemic treaty and a reformed International Health Regulations will not resolve structural inequities, they could meaningfully expand LMIC autonomy to protect public health. We urge equity-seeking Global South and North actors to fight for such IPR reforms as small and meaningful steps towards a more equitable global health order. Otherwise, criminally racist 'apartheids' will continue to be the norm when it comes to the distribution of essential health goods during global health emergencies.

Global inequities in access to COVID-19 health products and technologies: A political economy analysis.

This paper presents a political economy analysis of global inequities in access to COVID-19 vaccines, treatments, and diagnostic tests. We adapt a conceptual model used for analysing the political economy of global extraction and health to examine the politico-economic factors affecting access to COVID-19 health products and technologies in four interconnected layers: the social, political, and historical context; politics, institutions, and policies; pathways to ill-health; and health consequences. Our analysis finds that battles over access to COVID-19 products occur in a profoundly unequal playing field, and that efforts to improve access that do not shift the fundamental power imbalances are bound to fail. Inequitable access has both direct effects on health (preventable illness and death) and indirect effects through exacerbation of poverty and inequality. We highlight how the case of COVID-19 products reflects broader patterns of structural violence, in which the political economy is structured to improve and lengthen the lives of those in the Global North while neglecting and shortening the lives of those in the Global South. We conclude that achieving equitable access to pandemic response products requires shifting longstanding power imbalances and the institutions and processes that entrench and enable them.

Is Intellectual Property the COVID-19 Bad Guy? Lessons We Could Learn from the Pandemic.

At the time the COVID-19 pandemic was declared there was no vaccine and other medical products were insufficient to meet demands. At the time intellectual property was considered a limitation to an effective pandemic response and the World Trade Organization considered a waiver of intellectual property addressed by the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The lesson from the COVID-19 pandemic and TRIPS waiver is that given enough time sufficient medical products will be delivered, albeit there remain some complicated delivery challenges and vaccine hesitancy issues. This column addresses the moment before that medical product saturation and the inherent limitation imposed by industry policies. The column concludes that the private sectors' motivating factors need to be integrated into the design of global public health pandemic responses from the start.

Scaling Up the Global COVID-19 Vaccination Program: Production, Allocation, and Distribution with an Emphasis on Equity.

After just over 2 years, the COVID-19 pandemic continues to contribute to extensive morbidity and mortality worldwide. In addition to the burden and loss caused by the virus itself, collateral consequences of the pandemic wreak havoc on the global economy, disrupt essential health care services and childhood education, and weaken existing mechanisms of preventing other infectious diseases such as HIV and tuberculosis (TB). These impacts are unequally felt in low- and middle-income countries due to an insufficient supply of COVID-19 vaccines and an unfair allocation process of distributing vaccines worldwide. An emphasis on equity throughout the continued scaling up of the global COVID-19 vaccination program with production, allocation, and distribution of COVID-19 vaccines could begin to mitigate the disparities in vaccinations seen across the world. Current policy solutions including COVAX, intellectual property waivers, technology transfer in South Africa, and dose donations are examined to evaluate efficacy in increasing equitable access to COVID-19 vaccines.

Exploring risks of investor claims brought forth after the TRIPS waiver for COVID-19.

This research plans to explore the risks of the investment claims involved in the ongoing technology transfers to COVID-19 vaccine manufacturers based on the recently approved 'Agreement on Trade-Related Aspects of Intellectual Property Rights' (TRIPS) waiver. These investment claims are based on the various intellectual property rights protected under international investment laws. The recently approved TRIPS waiver only deals with the patent rights involved in producing the COVID-19 vaccine but does not deal with the other related intellectual property rights such as trade secrets. This work sounds the alarm of investment dispute for the mass-production of vaccines based on the TRIPS waiver. The research suggests a plan by which the Indian government can address the global issue of COVID-19 technology transfer in India.

Solidarity across borders: A pragmatic need for global COVID-19 vaccine equity.

The COVID-19 pandemic is one of the most disruptive social, political and economic crises of the modern era. In today's interconnected world, the pandemic shows how quickly infectious disease outbreaks can spread across continents. Since the initial outbreak, the introduction of several vaccines has brought hope to a virus-weary world. In spite of the remarkable results of approved vaccines, many lower-middle countries are yet to receive a single vaccine shot. This manuscript highlights the fact that global health inequities have intensified during the pandemic. While many wealthy nations have ramped up vaccination efforts and cautiously opened their borders, many in the developed world are still waiting to be inoculated. With the rise of several resistant variants, this work argues that public health policy experts demand a greater need for global solidarity in vaccine access. This is not only important ethically, but it is also a pragmatic response.