The vaccine is a global public good.

Boaventura de Sousa Santos¹

There is a general consensus that the current pandemic will be with us for a long time. We are entering a period of intermittent pandemics whose precise characteristics are still being defined. The interplay between our immune system and the virus's mutations is not entirely predictable. We will have to live with uncertainty, however dramatic the advances in contemporary biomedical science may be. We know very little for certain.

We know that the recurrence of pandemics is related to the dominant development and consumption model, to the climate changes associated with it, to the pollution of seas and rivers, and to the deforestation of forests. We know that the acute phase of this pandemic (the possibility of severe infection) will only end when between 60% and 70% of the world's population is immunized. We know that this task is hampered by the worsening of social inequalities within and between countries, combined with the fact that the large pharmaceutical industry (Big PharmaThey do not want to relinquish their patent rights on vaccines. Vaccines are already considered the new liquid gold, succeeding the liquid gold of the 20th century, oil.

We know that government policies, political cohesion in the face of the pandemic, and the behavior of citizens are crucial. Greater or lesser success depends on the combination of epidemiological surveillance, reduction of contagion through lockdowns, the effectiveness of the hospital system, improved public understanding of the pandemic, and attention to specific vulnerabilities. The errors, negligence, and even necrophilic intentions of some political leaders have given rise to forms of healthcare-driven death policies that we call social Darwinism: the elimination of disposable social groups because they are old, poor, or discriminated against for ethnic, racial, or religious reasons.

Finally, we know that the European (and North American) world displayed in this pandemic the same arrogance with which it has treated the non-European world for the last five centuries. Believing that the best technical and scientific knowledge comes from the Western world, it has refused to learn from how other countries in the Global South have dealt with epidemics, and specifically with this virus. Long before Europeans realized the importance of masks, the Chinese already considered them mandatory. On the other hand, due to a toxic mix of prejudice and pressure from the lobbies Serving the interests of large Western pharmaceutical companies, the European Union (EU), the United States, and Canada have relied exclusively on vaccines produced by these companies, with consequences that are currently unpredictable.

In addition to all this, we know that there is a geostrategic vaccine war, very poorly disguised by empty appeals to the well-being and health of the world's population. According to the magazine Nature As of March 30, the world needs 11 billion doses of vaccines (based on two doses per person) to achieve global herd immunity. By the end of February, orders for approximately 8.6 billion doses had been confirmed, of which 6 billion were destined for wealthy countries in the Global North. This means that impoverished countries, representing 80% of the world's population, will have access to less than a third of the available vaccines. This vaccine injustice is particularly insidious because, given the global communication that characterizes our time, no one will be truly protected until the entire world is protected. Moreover, the longer it takes to achieve global herd immunity, the greater the likelihood that mutations of the virus will become more dangerous to health and more resistant to available vaccines.

A recent study, which brought together 77 scientists from various countries around the world, concluded that within a year or less, mutations of the virus will render the first generation of vaccines ineffective. This will be all the more likely the longer it takes to vaccinate the world's population. Now, according to the calculations of the People's Vaccine Alliance, At the current rate, only 10% of the population in the poorest countries will be vaccinated by the end of next year. Further delays will lead to a greater proliferation of fake news—the infodemic, as the WHO calls it—which has been particularly destructive in Africa.

There is a consensus today that one of the most effective measures will be the temporary suspension of intellectual property rights on COVID-19 vaccine patents held by large pharmaceutical companies. This suspension would make vaccine production more global, faster, and cheaper. And thus, global herd immunity would be achieved more quickly. Besides the health justice that would allow for this suspension, there are other good reasons to support it. On the one hand, patent rights were created to stimulate competition in normal times. Pandemic times are exceptional times that, instead of competition and rivalry, require convergence and solidarity. On the other hand, pharmaceutical companies have already received billions of euros of public money in funding to encourage faster vaccine research and development. Furthermore, there are precedents for patent suspensions, not only in the case of antiretrovirals for HIV/AIDS control, but also in the case of penicillin during World War II. If we were in a conventional war, the production and distribution of weapons would certainly not be left under the control of the private companies that produce them. The state would certainly intervene. We are not in a conventional war, but the damage the pandemic inflicts on the lives and well-being of populations can be similar (almost three million deaths to date).

It is therefore not surprising that a vast global coalition of non-governmental organizations, states, and UN agencies now exists in favor of recognizing vaccines (and health in general) as a public good, not a business, and the consequent temporary suspension of patent rights. Far beyond vaccines, this global movement focuses on the fight for universal access to healthcare and for transparency and public oversight of public funds involved in the production of medicines and vaccines. Meanwhile, some one hundred countries, led by India and South Africa, have already requested the World Trade Organization to suspend vaccine-related patent rights. These countries are not among those of the Global North. Therefore, the World Health Organization's initiative to guarantee global access to vaccines (COVAX) is destined to fail.

Let's not forget that, according to data from Corporate Europe Observatory, la Big Pharma Portugal spends between 15 and 17 million euros annually to lobby the European Union, and the pharmaceutical industry as a whole has 175 lobbyists in Brussels working toward the same goal. The scandalous lack of transparency in vaccine contracts is a result of this pressure. If Portugal wanted to lend distinction and genuine cosmopolitan solidarity to its current presidency of the Council of the European Union, this would be a prime opportunity for it to take center stage. This is especially true given that another Portuguese citizen, the UN Secretary-General, has just called for health to be considered a global public good.

Everything suggests that, in this area as in others, the EU will continue to shirk any global responsibility. In its attempt to remain aligned with US global policies, it may, in this instance, be outmaneuvered by the US itself. The Biden administration is considering suspending the patent on a vaccine-relevant technology developed in 2016 by the National Institute of Allergy and Infectious Diseases.

1-Emeritus Director of the Center for Social Studies of the University of Coimbra. Translation by Antoni Aguiló and José Luis Exeni Rodríguez.