As the World Trade Organization (WTO) debate intensified this week over a demand to waive patent protections for COVID-19 vaccines and therapies, the group’s new director-general, Ngozi Okonjo-Iweala, urged members to “walk and chew gum” at the same time by working with “companies to open up and license more viable manufacturing sites now in emerging markets and developing countries. We must get them to work with us on know-how and technology transfer now.”

Okonjo-Iweala pointed to the heart of the problem that has led to more countries joining India and South Africa in demanding the waiver under the WTO's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS): the normal global capacity of vaccine production is 3.5 billion doses, but 10 billion doses of COVID-19 vaccines are needed.

“There is serious supply scarcity, and some countries are outbidding COVAX and diverting supplies” from poorer countries, she said in her first comments as director-general to the WTO March 1. On top of that, the International Trade Center recently reported that as many as 100 countries still had export restrictions and prohibitions that are hindering supply chains for medical goods and equipment during the pandemic.

Okonjo-Iweala called on the world’s wealthier countries to focus “on the immediate needs of dozens of poor countries that have yet to vaccinate a single person. People are dying in poor countries.”

Pan American Health Organization (PAHO) Director Carissa Etienne echoed the need for a swift global response in her weekly media briefing March 3 on the state of the pandemic in the Americas. While the region continues to be the epicenter of the pandemic, accounting for 55% of the COVID-related deaths reported worldwide last week, Etienne said it is behind in the level of vaccinations because most of the PAHO countries can’t get the doses they need through bilateral agreements with vaccine manufacturers.

“Expanding equitable access to COVID vaccines in the Americas must be a global priority,” Etienne said. “Wealthy countries are rolling out vaccines, while many nations have yet to receive a single dose. This disparity harms our principles of solidarity. But more than that, it’s a self-defeating strategy. As long as COVID-19 endures in one part of the world, the rest of the world can never be safe.”

A ‘third way’

As an interim solution while the TRIPS waiver debate continues, Okonjo-Iweala said she hoped “we can initiate a dialogue and information exchange between us and representatives of manufacturers associations from developing and developed countries. . . . This should happen soon so we can save lives.” She added that a world manufacturing convention that’s in the works could be used to build a global partnership.

Before taking office, Okonjo-Iweala had proposed a “third way” in which WTO members could broaden access to COVID-19 vaccines and therapies by facilitating technology transfers “within the framework of multilateral rules, so as to encourage research and innovation while at the same time allowing licensing agreements that help scale up manufacturing of medical products.”

She gave kudos to biopharma companies that were already looking for global partners, singling out Astrazeneca plc, Johnson & Johnson (J&J) and the Serum Institute of India for their willingness to license their COVID-19 vaccines.

Responding March 2 to the debate over the proposed TRIPS waiver, Patrick Kilbride, senior vice president of the U.S. Chamber of Commerce’s Global Innovation Policy Center, welcomed Okonjo-Iweala’s third-way solution, saying it is “worthy of further discussion and consistent with the ongoing success of government-industry efforts to bring an end to COVID-19 as rapidly and as safely as possible.”

Transparent and predictable intellectual property (IP) rights provided the legal and economic basis for an “unprecedented level of highly successful collaborations” that resulted in the development of COVID-19 vaccines and therapies, as well as global vaccine programs such as COVAX, Kilbride said.

Diminishing those rights “would make it more difficult to quickly develop and distribute vaccines or treatments in the future pandemics the world will face,” he warned.

In the past, the Trump administration opposed the waiver proposal. Now, under pressure from some Democratic lawmakers and advocacy groups that are generally opposed to biopharma patents, President Joe Biden is reportedly rethinking the U.S. government’s stance.

One of the lawmakers pushing the Biden administration to support the waiver is Rep. Janice Schakowsky (D-Ill.). Speaking at a House subcommittee hearing last week on COVID-19 vaccines, she lectured executives of five companies developing the vaccines for the U.S. market about the need for a waiver.

Without it, Schakowsky said, the billions of dollars being spent to reopen industries impacted by the pandemic will be wasted, as leaving poorer countries defenseless against the coronavirus will continue the global threat.

“This is something we should do so we have plenty for us and we have plenty for the rest of the world,” she added.

When it was their turn to speak, the executives from Astrazeneca, J&J, Moderna Inc., Novavax Inc. and Pfizer Inc. informed Schakowsky of all the millions of doses they’re donating to the global effort and the technology transfers they’re already engaged in. They also stressed the complexity of manufacturing the vaccines and the need for oversight to ensure the quality of the end product.