Oxfam, Amnesty International, Médecins Sans Frontières and low-income countries are calling on the World Trade Organization (WTO) to void intellectual property rights when it comes to COVID-19 vaccines, fearing few in the developing world will have access to them otherwise.
India and South Africa's joint proposal has the backing of the World Health Organization and countries like Bangladesh, Pakistan, Australia and Sri Lanka; but is opposed by rich nations like the UK, Japan, Sweden, the US, Norway and Canada, as well as the European Union, who fear such a move would remove the incentive for companies to develop new vaccines and treatments.
Oxfam says its analysis found only one in 10 people living in the world's poorest 70 countries will have a chance of being vaccinated in 2021. In contrast, high-income countries representing just 14 percent of the world's population have rushed into bilateral deals with vaccine manufacturers - snapping up more than they need.
"Wealthy countries have purchased or pre-purchased 53 percent of the vaccine that is available, and it's left a very small amount of vaccines for 3.6 billion people that form the poorest countries in the world," Oxfam NZ spokesperson Joanna Spratt told Newshub. "Obviously they have a lot of people but just a handful of vaccines."
Oxfam singled out Canada as the biggest vaccine hog. It's signed agreements with several manufacturers - ordering more than 70 million doses of its homegrown Medicago vaccine, as well as those being developed by AstraZeneca, Sanofi and GSK, Johnson & Johnson, Pfizer and Moderna. The Medicago deal alone is for enough doses to inoculate the entire Canadian population. Including the others, they've bought enough to vaccinate every single Canadian five times over.
The two frontrunner vaccines - Pfizer's BNT162b2 and Moderna's mRNA-1273 - so far have only been sold to rich countries.
AstraZeneca - which developed its vaccine in tandem with the University of Oxford - has pledged nearly two-thirds of its production to developing nations, but Oxfam estimates this will only be enough for 18 percent of the world's population "at most". Its efficacy is also below those offered by Pfizer and Moderna, according to data from its controversial phase III trial, which has been plagued by confusion over dosage levels.
Both Pfizer and Moderna received public funding to help develop their vaccines - Pfizer from Germany (via its German-based partner BioNTech), Moderna from the US - which Amnesty says obliges them to help poorer nations.
"By buying up the vast majority of the world's vaccine supply, rich countries are in breach of their human rights obligations," said Amnesty head of economic and social justice Steve Cockburn. "Instead, by working with others to share knowledge and scale up supply, they could help bring an end to the global COVID-19 crisis."
Spratt said New Zealand needs to weigh in, in favour of the 'people's vaccine'.
"Globally what we need to do - and New Zealand has a part to play here - is get pharmaceutical companies to openly share their technological know-how and intellectual property rights about how to make the vaccine. If they share it, we can massively ramp up production and get enough vaccinations for everybody."
Newshub has contacted Megan Woods, minister in charge of procurement of COVID-19 vaccines, for comment. New Zealand has signed deals with Janssen Pharmaceutica and Pfizer, and has contributed to the global COVAX initiative to manufacture and distribute successful vaccine candidates.
Moderna, a small company that's only been around for a decade, has said it only has the capacity to make up to 125 million doses in the first quarter of 2021. Pfizer, a giant, says it can manage about 1.3 billion by the end of next year - a fraction of what is needed.
Precedents
There is historical precedent for waiving intellectual property rights in the face of a health emergency.
"When the HIV pandemic was raging across the world, initially treatments were extremely expensive," said Spratt. "Governments got together and there was a mechanism managed by the WHO where patents are registered with that mechanism that allows that knowhow to be shared more freely."
In 2001, the WTO loosened patent rights when it came to essential medicines, allowing developing nations - particularly in Africa - to buy low-cost generic versions of otherwise expensive medications to fight HIV. And in the 1950s, Jonas Salk - the developer of the first effective polio vaccine - refused to patent it, a decision which quickly led to polio's eradication across much of the world.
Pfizer and BioNTech, whose vaccine has been approved for use already in the UK, Bahrain and Canada, has "shown no sign of licensing or technology transfer of their patented products", an article published in medical journal The Lancet this week said.
Former New Zealand Prime Minister Helen Clark earlier this year said it was "so important" because "world's leading virologists are telling us that without a vaccine we'll never live normally again so there is such a compelling public health reason for getting this out to everyone everywhere".
Defenders of the status quo have said simply waiving patents wouldn't solve the logistical problems of getting vaccines to where they're needed.
"Unfortunately, it is not as simple as putting a recipe on the internet and committing to not sue other companies during the pandemic," a spokesperson for Regeneron, whose treatment was used on US President Donald Trump, told The Lancet.
"[Intellectual property] is the least of the barriers," added John-Arne Røttingen, chair of the WHO Solidarity Trial of COVID-19 treatments.
Even if all of the existing vaccines are found to be safe and production ramped up, Oxfam says two-thirds of the world won't have access to a vaccine until sometime in 2022.
"It shouldn't matter which country you're in or how much money you've got in your back pocket about whether or not you get a vaccination," said Spratt. "We need it to be freely and fairly shared for anybody who wants it. It's got to be a people's vaccine."
The WTO general council will meet in about a week's time. A decision is due before the end of the year. Decisions are generally made by consensus, so even just a few countries digging their heels in could derail the 'people's vaccine'.