How – and How not – to Vaccinate the Whole World

How – and How not – to Vaccinate the Whole World
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The development of Covid-19 vaccines happened with impressive speed. But to end the pandemic, it's not enough just to have invented them. The shots also have to be manufactured, shipped, stored, and injected into arms around the world.

With an assortment of vaccines now proven safe and effective, global leaders are turning to these challenges. In the race to get the world inoculated, though, some bad ideas are gaining traction.

Chief among them is an effort, spearheaded by the governments of India and South Africa, to strip patent protections from Covid-19 vaccines. The two countries petitioned the World Trade Organization to make this change back in October – and have now recruited dozens of other countries to their way of thinking. Even the United States is considering throwing its support behind this effort.

Some proponents no doubt have their hearts in the right place – they claim that gutting standard intellectual property protections would speed up global vaccine distribution.

But there's no evidence to support this claim, and plenty to suggest that nixing patents would simply kill off future medical innovation. There are better policies the United States can pursue to improve worldwide access to shots.

The problem with the patent waiver is that, while the challenges to vaccine distribution are many, they have nothing to do with intellectual property.

For instance, most of the world's vaccine manufacturers are already operating at maximum capacity. Ramping up further would require new construction, equipment, raw materials, and trained staff. It can't happen overnight.

There are also significant logistical hurdles. Some vaccines can only be shipped and stored at very low temperatures, which requires infrastructure that many developing countries don't have in sufficient amounts. Some require two doses, a barrier for patients who live far from clinics. And some health care systems lack appropriate software or enough trained personnel.

Forcing vaccine developers to share their technology, intellectual property, and know-how with no strings attached, as the waiver would require, wouldn't solve any of these problems.

It would, on the other hand, discourage new drug research. It costs billions of dollars in private investment to bring a single new medicine to market. The process typically takes years, and most would-be products fall out along the way. By giving companies a period of time to recoup expenditures, intellectual property rights ensure continued investment in drug development. We need that financing to find new treatments, both for the diseases we know well and the inevitable next novel virus.

The United States has committed $4 billion to COVAX, the alliance to distribute vaccines to low- and middle-income countries. And it is home to companies that created several of the leading Covid-19 inoculations. But it can still do more to ensure that vaccines get distributed quickly and fairly around the world.

In particular, health authorities and political leaders need to recognize that not all safe, effective Covid-19 vaccines are the same. What works best in big-city North America may not be appropriate everywhere.

For instance, the U.S.-approved Johnson & Johnson shot requires only a single dose, a boon for patients who can't get to a clinic more than once. Akston Biosciences is pioneering a vaccine that can be stored for a month at 95 degrees Fahrenheit – ideal for hot climates. Altimmune and the University of Alabama, meanwhile, are working on a vaccine that can be self-administered as a nasal spray.

In short, science itself is overcoming current problems with distribution. The government can help by supporting the different Covid-19 vaccines coming online, through funding and regulatory approvals.

Doing so would help ensure that the right vaccines get to the places where they're most needed. At the same time, it would have the opposite effect of the WTO proposal. Whereas a patent waiver would cause disinvestment in drug research, providing support for a variety of alternative vaccines would help achieve what everyone really wants: Global herd immunity to lead us out of the pandemic.

Peter J. Pitts, a former Food and Drug Administration associate commissioner, is president of the Center for Medicine in the Public Interest.

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