Governments should maximize Covid-19 vaccine access and affordability for people worldwide, and those funding vaccines with public money should be transparent about the terms and conditions attached, Human Rights Watch said in a report released on Thursday. The rights group said governments should support India and South Africa’s proposal to waive some aspects of global intellectual property (IP) rules to enable large-scale manufacturing and make vaccines affordable for all.
The 77-page report, “‘Whoever Finds the Vaccine Must Share It’: Strengthening Human Rights and Transparency around Covid-19 Vaccines,” examines three significant barriers to universal and equitable access to any vaccine that is found to be safe and effective – transparency, supply, and pricing. Human Rights Watch spells out governments’ human rights obligation to ensure that the scientific benefits of the research they fund with public money are shared as widely as possible to protect people’s lives, health, and livelihoods. Human Rights Watch also argues that using public money without reporting its terms and conditions undermines the human rights principles of transparency and accountability. Governments should take steps to maximize the availability and affordability of safe and effective vaccines and minimize debt for low- and middle-income countries.
“Governments should urgently band together, be transparent, and cooperate to share the benefits of the scientific research they fund to help humanity,” said Aruna Kashyap, senior business and human rights counsel at Human Rights Watch and a co-author of the report. “More than a million people have died and another million are projected to die by the end of the year. Governments should use their funding and regulatory powers to ensure that corporate profit doesn’t determine who can get vaccines.”
Universal and equitable access to a safe and effective Covid-19 vaccine is critical to preventing severe illness and death while protecting livelihoods, getting children back to school, and enabling economic recovery. Like other infectious diseases, Covid-19 can spread rapidly across borders. Future vaccines may not provide lasting immunity, potentially leaving countries vulnerable to seasonal cycles or waves of infection. The International Monetary Fund has said that strong international cooperation on Covid-19 vaccines could speed up global economic recovery and add US$9 trillion to global income by 2025. A growing movement of advocates, including Covid-19 survivors and loved ones of those who died, are calling for a “people’s vaccine.”
Human Rights Watch interviewed experts on access to medicines, IP, and human rights, and analyzed international human rights law, national laws and policies, and a vast array of publicly available documents and secondary sources. The report draws on over six months of global reporting on the pandemic’s impacts on different populations, including health workers.
“I don’t even want to think when the actual poor people in need will get vaccines,” a nurse in a ward for Covid-19 patients in a government hospital in Karachi, Pakistan, told Human Rights Watch. “It will be hospital admin, doctors, politicians first, and everyone else later, if there’s any left.”
Governments are using public money to fund Covid-19 vaccines on an unprecedented scale. By mid-September, the Australia-based think tank Policy Cures Research (PCR) estimated that governments had given over US$19 billion for Covid-19 vaccine research, development, manufacturing, and distribution. Top government agencies funding vaccines were from the US, Germany, the UK, and Norway, and the European Commission. On October 13, the World Bank approved $12 billion in financing for Covid-19 testing, treatments, and vaccines.
A near-total lack of transparency around government funding and the terms has made it arduously difficult to understand the implications for global vaccine access. Some governments are directly negotiating opaque bilateral deals with pharmaceutical companies or other entities to reserve future vaccine doses, mostly for their exclusive use. In September 2020, Oxfam International reported that high-income countries have already reserved 51 percent of the doses of several leading vaccine candidates, even though those countries represent only 13 percent of the world’s population.
These deals undermine universal and equitable global access to any vaccine found to be safe and effective, especially for low- and middle-income countries. Governments using public money for Covid-19 vaccines are accountable to the public, and should publish what they have funded, and their terms, Human Rights Watch said.
Concerns around vaccine shortages also remain unaddressed. The global demand for any safe and effective vaccine is projected to far exceed supply. As of October 19, ten vaccine candidates were in the final phase of clinical trials. Those that prove to be safe and effective should be manufactured on as large a scale as possible to make them widely available.
Governments should take all measures, including using their funding and regulatory powers to require vaccine developers to transfer technology and share the IP, data, and know-how behind their innovations through open, non-exclusive licensing. This is especially important because vaccine manufacturing expertise or know-how are limited to a handful of countries.
Most governments, especially those from high-income countries, have ignored, denied, or played down the IP barriers to scaling up manufacturing, even though a growing number of low- and middle-income governments, IP lawyers, and lawsuits have drawn attention to these barriers.
Governments should support India and South Africa’s proposal of a waiver for key IP rules under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Governments should use their regulatory powers to require companies to share IP rights through open and non-exclusive licensing.
The Costa Rican government in May spearheaded a call to action with the World Health Organization to create the Covid-19 Technology Access Pool (C-TAP) – a common shared pool of rights to technologies, data, and know-how that everyone around the world could use to manufacture any medical products needed to tackle Covid-19, including vaccines. All governments should join the initiative and take urgent steps to implement it. Governments should also urgently cooperate to map out vaccine manufacturing capacity.
Vaccine pricing could also be a significant barrier to universal and equitable vaccine access. In many places, vaccines will only be accessible and affordable for all if they are free. Governments should ensure public money is used for public benefit, and not for private profits, and work to minimize debt for low- and middle-income countries. They should require companies to adopt transparent pricing verified by third party audits, Human Rights Watch said.
Some governments are funding the COVAX Facility, a global vaccine procurement mechanism to assist low- and middle-income countries to secure vaccines. The facility has yet to publish the contracts it has signed with companies. Participating governments should ensure that the facility’s decisions are aligned with governments’ human rights obligations and the principles of the WHO’s C-TAP.
“You can’t fight a global pandemic by allowing publicly funded vaccines to go to the highest bidder, at whatever price pharmaceutical companies set,” said Margaret Wurth, senior children’s rights researcher at Human Rights Watch and a co-author of the report. “When a safe and effective vaccine is found, it should be available and affordable for everyone, everywhere.”