Fri. Jan 27th, 2023

Is a patent waiver an effective solution to the problem of supplying vaccines to medium to low-income countries as soon as possible?

The biggest vaccine production capacity for medium to low-income countries (MLICs) is the Serum Institute in India which is already licensing the Astra Zeneca vaccine. Although it is the major supplier of COVAX, unfortunately, its full capacity is currently being used to supply India: more MLIC vaccine capacity will need to be mobilised.

A patent waiver would open the market for vaccines to producers who do not hold the right to use the patents of the available vaccines (ie which are neither developers nor licensors). But it is unlikely that freeing this untapped “generic” production capacity will solve the MLIC supply problem soon.

First, the number of vaccines approved for use in MLICs is small: Of the 14 vaccines which are in full/early/limited use somewhere in the world, only 5 are WHO approved for emergency use (Pfizer/BioNTech, Moderna, AZ, J&J, Sinopharm) and even these 5 are only approved in a handful MLICs.

Second, of the WHO-approved vaccines, 4 use the latest new virus technologies which idle vaccine production capacity in MLICs does not have expertise with (adenovirus & especially mRNA). Adapting these technologies will require tech transfer (which a patent waiver does not necessarily force) and time. The currently available corona vaccines with the old inactivated virus technology which MLIC production capacity is familiar with are all Chinese and one Indian. Whether China or India waive their patents is an important piece of the MLIC short-term supply problem.

Third, production at MLIC scale will require no bottlenecks in the supply chain for vaccine production. Finally, generic MLIC vaccine producers will have to find MLICs willing & able to pay the cost to produce which will require funding in the form of development assistance from high income countries (HICs).

Are there costs to invoking the patent waiver?

We will need private innovation in future to further develop current vaccines (for new variants) and new vaccines. Restrictions to patent rights for vaccines will be factored into the risk/reward analysis of for-profit firms deciding on research, development and production of future vaccines. To avoid this disincentive, patent waivers, if used, should at least be restricted to MLICs, minimising the effects on rewards, and should be clear ex ante to minimise the effects on the (political) riskiness of vaccine projects.  

Are there better solutions?

The most obvious is for excess supply in high income countries (HICs) to be donated to MLICs through COVAX. The US can already do this now, the EU will be able to do this soon. This would be more effective and avoids the need for tech transfer and adapting of MLIC production capacity as well as the long-term harm from disrupting the patent system. HICs should honour and beef up their financial pledges to COVAX, which would diversify its sources of vaccine production and unblock the Serum constraint. Finally, MLICs should beef up their approval of these vaccines for use.   


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