Covid-19 laid bare staggering global disparities in healthcare access. By November 2022 – nearly two years into the pandemic – almost 13 billion doses of Covid-19 vaccines had been administered around the world, but less than 25% of people in low-income countries had received a dose.
While many blamed vaccine patents for these disparities, the real culprits – as recognized in an October 2023 U.S. International Trade Commission report – were more complex. Regulatory, clinical, and trade barriers, along with a lack of adequate healthcare infrastructure in many countries, were the primary factors that limited access to shots worldwide.
Despite those facts, the World Trade Organization (WTO) allowed countries to waive intellectual property rights on Covid-19 vaccines that they were originally obligated to respect under the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement. While no country exercised the waiver, some now insist that the WTO extend it to Covid-19 tests and treatments.
But it's been nearly one year since the World Health Organization (WHO) declared an end to the Covid-19 global health emergency. As a result, a waiver extension is wholly unnecessary. It would also impede efforts to provide low-income countries with treatments for a wide range of diseases beyond Covid-19 – ultimately hampering progress toward closing global healthcare disparities.
More specifically, it would hinder such efforts currently being undertaken by the world's leading life sciences companies. Through voluntary licensing and collaboration with foreign drug and device manufacturers, governments, NGOs, and international organizations, the biopharmaceutical sector is working to strengthen global healthcare systems and medication access. None of that would be possible without strong IP protections.
Take the case of Eli Lilly and Company, which developed the first monoclonal antibody treatments authorized for Covid-19 less than a year into the pandemic. As part of Lilly's 30x30 goal to expand access to quality healthcare for 30 million people living in resource-limited settings annually by 2030, Lilly contracted with third-party manufacturers overseas to ensure that the global supply of its monoclonal antibodies would meet projected demand. These voluntary partnerships were enabled by strong IP protections, which permitted Lilly to rapidly transfer the technology used in its Covid-19 treatments without putting the security of those underlying technologies at risk.
Indeed, thanks to voluntary agreements forged by different companies, hundreds of Covid-19 treatment production facilities exist in countries from Brazil and Kenya to India and Bangladesh. Additionally, more than 381 voluntary agreements have led to the production of over 15 billion Covid-19 vaccine doses.
Voluntary partnerships are enormously important for strengthening global health equity beyond Covid-19. EVA Pharma, an Egyptian company, is collaborating with foreign partners to manufacture high-quality insulin for more than one million people in low- and middle-income countries, primarily in Africa.
Extending the TRIPS waiver would send a strong signal to biopharmaceutical and medical device companies that the international community has little regard for vital intellectual property rights – disincentivizing the voluntary partnerships critical for advancing worldwide health equity.
It would also put patients at risk from unsafe medicines. If companies are forced to license their technology to other manufacturers, they won't be able to guarantee the security of their own supply chains. Unauthorized producers could enter the market without oversight or quality control, and patients could unknowingly be supplied ineffective, contaminated, or impure drugs. The results could be deadly.
The impact of Covid-19 was most devastating for the world's poorest nations. In response, the Biden administration signaled a strong commitment to enhancing health equity and access to life-saving medicines globally. It is fortunate, then, that the TRIPS waiver extension will not go forward without U.S. endorsement. The administration has an opportunity to make good on its commitment by rejecting this new waiver – ensuring that biotech companies can continue to provide patients worldwide with innovative treatments.
Cynthia Cardona leads social impact at Eli Lilly and Company and serves as president of the Lilly Foundation.
