The world was unprepared for COVID-19 despite other recent coronavirus outbreaks and despite
multiple warnings from the World Health Organization (WHO) and others. Although there was an
initial sharing of research among scientists and an unleashing of significant public, charitable, and
private funding to develop, test, and expand manufacturing capacity of new COVID-19-related
medicines, vaccines, and diagnostics, the status quo of exclusive rights ownership and commercial
control by the multinational biopharmaceutical industry continues unabated. Existing intellectual
property rules that allow private entities to maintain monopoly rights over the development, clinical
testing, regulatory approval, pricing, supply, and distribution of essential medical products have not
been altered. And, the determination of rich countries to secure preferential and disproportionate
access to proven and promising vaccines, medicines, diagnostics, and personal protective equipment
remains unchanged. In place of open science and coordinated clinical trials, scientific rigor in regulatory
assessment and broad regulatory approval, low-cost pricing and rational expansion of manufacturing
capacity, and equitable global access to all needed COVID-19 health products, we have needlessly high
prices, inadequate supplies, and nationalistic hoarding, especially, but not exclusively, by the Global
North.
Fortunately, there are multiple initiatives and proposals to counteract exclusivities, commercial
prerogatives, and rich countries’ preferential access to existing and novel COVID-19 health
technologies. These initiatives include more radical proposals to waive recognition and enforcement
of COVID-19-related intellectual property rights (IPRs) at the global and national level during the
pandemic and to extend the general least developed country transition period for enforcement of IPRs.
Other proposals focus on both voluntary and compulsory mechanisms to override IPRs, openly license,
and facilitate technology transfer of coronavirus vaccines, medicines, and diagnostics. Several global
partners have established an accelerator to speed development and marketing of new COVID-19 tools
and secure at least some supplies for low- and middle-income countries. Finally, regional cooperation
initiatives have been established.
Although there have been multiple initiatives and proposals to overcome industry’s exclusive rights
and commercial prerogatives, these efforts have not resulted in the needed paradigm shift in global
health such that life-saving and enhancing health products are viewed as global public goods rather
than as ordinary consumer products. Similarly, rich countries’ hegemonic hoarding of COVID-19 health
products and inadequate global coordination mechanisms have left the imperative of equitable
distribution of COVID-19 health products disarrayed, with the risk that twice as many people will die
from COVID-19 than if vaccines were to be shared globally. We can hope that this dystopian stasis will
be overcome, but it will take far more activism from governments, institutions, and civil society to
dislodge the current lethargic response and intellectual-property/ market fundamentalisms that leave
our world fractured in responding to this modern day plague. This global pandemic needs a global
response now and as a proving ground for future threats.
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