On 2 October – seven months and over 2,000,000 Covid-19 deaths ago – the governments of India and South Africa petitioned the World Trade Organization to issue a temporary waiver on the Trips Agreement and ensure the “unhindered global sharing of technology and know-how … for the handling of Covid-19”. Back then, no vaccine had been approved for the prevention of the spread of the virus. But the 100 countries that joined the October petition over the following months knew then what has become apparent to everyone now: the system of pharmaceutical patents is a killing machine.
There is now broad and growing support for the Trips waiver – among doctors, Nobel laureates, senators and a large majority of the US public. On Wednesday, the Biden administration finally announced its intention to support some version of the proposal, changing course amidst a global surge of Covid-19 cases. “The extraordinary circumstances of the Covid-19 pandemic call for extraordinary measures,” said US trade representative Katherine Tai, committing to “text-based negotiations at the World Trade Organization”.
But a temporary waiver is only a temporary solution to a permanent crisis in the global health system. When Aids exploded across the world in the 1990s, calls for affordable generic antiretroviral drugs to stem the pandemic in Africa were met by threats and lawsuits from pharmaceutical corporations. And the Covid-19 pandemic is certainly not the end of this crisis: from Sars and Ebola to mutant strains of Covid-19, epidemiologists warn that we have entered a new age of pandemics.
To learn the lessons of a year lost to Covid-19 – and to prepare for a long century of recurring health emergencies – the temporary Trips suspension must give way to a total transformation of the pharmaceutical patent system. Pausing the gears of the killing machine is not enough. Our obligation is to dismantle it.
That obligation belongs to the US more than any other country. The US government has played both architect and enforcer of the intellectual property regime, threatening sanctions against countries like Brazil, Thailand and South Africa for daring to promote the generic production of life-saving medicines.
Yet an overwhelming majority of US voters support a more radical transformation of the pharmaceutical patent system. A new poll from Data for Progress and the Progressive International finds that 59% of US voters support waiving all patent protections to produce generic versions of life-saving medicines for critical diseases, from Covid-19 and HIV/Aids to heart disease and diabetes.
These preferences are not expressions of charity. The citizens of the United States are some of the chief victims of the patent system: according to a recent poll, one in four Americans cannot fill their prescriptions due to astronomical drug prices. The Covid-19 vaccine may have been provided to US citizens free of charge this time, but there is no reason to expect that the government will continue to foot the bill when drug-resistant strains creep back into the country and send millions of uninsured families to the hospital for treatment.
Pharmaceutical corporations will lobby our representatives to say that they are best placed to manage these pandemics – that what is good for the Pharmaceutical Research and Manufacturers of America (PhRMA) is good for America. “More than any other time in history, society is seeing and benefiting from the innovation supported by intellectual property,” they wrote in a letter to Joe Biden urging him to reject the Trips waiver at the WTO.
But US voters – whose tax dollars funded the medical breakthrough behind Moderna’s Covid-19 vaccine, just as UK voters funded AstraZeneca’s – are calling BS. Asked whether the US government should compel Moderna to share its vaccine technology with manufacturers around the world, 59% of US voters approved to just 27% who opposed, according to the new poll by Data for Progress and the Progressive International.
The new findings reflect a growing frustration with the primacy of profit in the public health system – not only the profits of the pharmaceutical corporations in the course of this pandemic (Pfizer made $3.5bn on its vaccine in the first quarter of 2021 alone), but also the refusal to invest in life-saving medicines that do not yield these massive returns. “When prices are so low they preclude profits, companies leave the market,” the WHO reported in 2017. The pharmaceutical industry may claim that rolling back patent protections will hinder future drug production. But it is governments that have had to intervene to catalyze vaccine production – and the public that has shouldered the risks.
There can be no illusions about the prospects for such a radical reorientation of US foreign policy. While Biden’s domestic agenda has sought to break with past dogmas of fiscal discipline and public disinvestment, his foreign policy has largely preserved the frameworks that he inherited from Donald Trump and Barack Obama before him. This is not a coincidence: the architecture of global governance was designed to be insulated from democratic pressures. Jan Tumlir, architect of the UN General Agreement on Tariffs and Trade, described the project most clearly: “International rules protect the world market against governments.”
But power concedes nothing without a demand, and in moments like these – when the paradigm is shifting, and the US president appears willing to push against the old third rails of American politics – the identification of the right demand is as important as its articulation. Suspension of Covid-19 patents may be an essential first step. But as US voters appear to understand, the path out of this pandemic is long. We will need great leaps to get there.
David Adler is a political economist and General Coordinator of the Progressive International
Dr Mamka Anyona is a scholar of global health governance and an advisor to a range of international organizations on global health issues