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China has exported 240 million doses of Covid-19 vaccines around the world. Photo: Xinhua

US moves won’t solve vaccine access problem for poor soon: experts

  • Washington is trying to position itself as a global leader in vaccine access with a policy shift on IP rules and plans to send more doses overseas
  • But a ‘patent waiver doesn’t necessarily increase production capacity’, academic says
The United States is trying to position itself as a global leader in Covid-19 vaccine access with a sweeping policy shift on intellectual property rules and plans to send a tranche of doses overseas. But experts say it is hard to know when US action will have a significant impact on what poorer countries need now – supplies.
Export delays from crisis-stricken India have hit a global distribution programme, and wealthy countries have bought up supplies or, like America, are vaccinating their own people before sending doses abroad. That has left many countries even more dependent on China to take up the role of major global supplier.

The latest US measures are unlikely to change that fast, experts say.

On Wednesday the US veered sharply from its decades-old position on IP rights, voicing support for a waiver of protections for Covid-19 vaccines “in service of ending the pandemic”.
The move is a significant boost for a seven-month old proposal put forward at the World Trade Organization by South Africa and India and backed by more than 100 countries. They want a temporary waiver of protections on all medical products to fight Covid-19 in a bid to ramp up production.
Whether even a more narrow waiver of protections just on Covid-19 vaccines could make it through the WTO remains uncertain, with Germany on Thursday rejecting the US proposal.

But if it were to win consensus, the success of such a waiver could depend on vaccine developers sharing their know-how with other manufacturers and other support, experts said.

“By itself the patent waiver doesn’t necessarily increase production capacity,” said Prashant Yadav, a senior fellow at the Centre for Global Development in Washington and an expert on health care supply chains.

“If it is combined with a concerted effort to expand manufacturing capacity through technical and financial resourcing, then yes, it would make the US take a lead role in enhancing global access to Covid-19 vaccines,” he said, noting this could dilute the influence and contributions of China and Russia in supplying lower and middle income countries. “The impact won’t occur in the next couple of months though.”

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That will leave countries continuing to scramble for access to vaccines as the pandemic accelerates, in some areas fuelled by new variants of the virus.

“Variants will not wait until these issues are ironed out,” said Karthik Nachiappan, a research fellow at the National University of Singapore’s Institute of South Asian Studies. “Russia and China can continue to fill the void here by sustaining or increasing vaccine exports.”

South and Southeast Asian countries that were experiencing a new wave of infections would want immediate access to vaccines, he said.

A number of countries have relied on China for access to vaccines. The country has exported 240 million doses, according to British analytics firm Airfinity as cited by Bloomberg, making it the world’s largest exporter. Europe has sent out 77 million doses, according to an update in late March, while India has exported about 66 million.

A surge of Covid-19 in India has caused delays in exports pegged for the WHO-backed vaccine distribution scheme known as Covax Facility. It has so far delivered just 54 million doses out of the 238 million that were promised to about 140 countries by the end of this month.

A vaccine made by state-owned Sinopharm on Friday became the first Chinese product to be eligible for inclusion in the programme after it was listed for emergency use by the World Health Organization.

Russia has also played a role in supplying doses to other countries, with observers saying both Moscow and Beijing had sought diplomatic gains from strategic vaccine allocations – a charge both governments deny. Russia’s Sputnik V vaccine and two other Chinese vaccines by Sinovac Biotech and CanSino Biologics have yet to be licensed by the WHO.

Explainer | Why China’s intellectual property protection matters to Beijing and Washington

Some experts see US support of the IP waiver, as well as a recent plan from its “Quad” security grouping with Japan, Australia and India to produce 1 billion doses in India, as a reaction, in part, to the vaccine policies of Russia and China.

“Rather than having any strategic vision for global vaccine supply, the [President Joe Biden] administration has been responding to the vaccine diplomacy of China and Russia, the horrific situation in India and mounting global anger about the vaccine nationalism pursued by the United States and other high-income countries,” said David Fidler, a senior fellow for global health at the Council on Foreign Relations in New York.

“The real turning point for the US contribution to global vaccine supplies will come when the US government believes it can release vaccine doses on a large scale to Covax and other countries,” he said.

Biden has been clear in saying he will vaccinate Americans before sending doses overseas, opting instead to support global vaccine supply with a US$4 billion contribution to Covax.

An initial step towards a shift came last week, when the White House announced its plan to send 60 million doses of a vaccine by AstraZeneca overseas in the next two months. The vaccine has not been approved in the US.

But the picture could change in the coming months. Fidler said the moment when the US released supplies for global use was “on the horizon”, due to progress in domestic vaccinations. Nearly one-third of Americans are fully vaccinated.

“[This] will give low- and middle-income countries options they do not presently have, a situation that currently forces such countries to be more receptive to Chinese and Russian vaccine diplomacy,” Fidler said, noting, however, that diplomatic leverage by China and Russia for doses delivered would have already been won.

Katherine Bliss, a senior fellow in global health policy at the Centre for Strategic and International Studies in Washington, agreed that as domestic supply begins to exceed demand more US doses, such as AstraZeneca, could be distributed globally.

This would likely be via a combination of doses targeted for regional security or trade partners, in addition to supplies for Covax. However, there were also technical considerations like “existing legal agreements with manufacturers around liabilities and packaging”, she said.

Many countries would likely view the US doses as a favourable alternative to those on offer from China, which could diminish Beijing’s vaccine diplomacy, according to Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.

He pointed to the limited data transparency from Chinese vaccine makers, who have yet to publish their final phase trial data in scientific journals, and their vaccine efficacy. US products like the vaccines by Pfizer and Moderna, though more difficult to ship and store, have registered significantly higher efficacy in trials than doses by any Chinese product.

“If you are a lower and middle income country in the developing world when your options are very limited you focus on getting as many vaccines as possible,” Huang said.

“But when you have more alternatives, you are going to decide on your favourite choice … and efficacy does matter here.”

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