Once the United States has used all the vaccine doses it needs, the rest of the world still will be desperate for more. President Joe Biden should begin planning now to donate surplus doses to others — and think about ways over the long run to get lifesaving vaccines to poorer nations in a more equitable way.
Based on contracts, most of the doses coming off production lines from the major drug companies are going to the United States, European countries and a few other wealthy nations. As The Washington Post reported over the weekend, the time needed to ramp up production, along with shortages of raw materials, has left many nations in the lurch that could not afford to reserve early supplies. Most of Africa and parts of South America and Asia are not expected to achieve widespread vaccination coverage until 2023. Exacerbating the chasm between haves and have-nots, those nations with vaccines have engaged in a burst of vaccine diplomacy, seeking influence and leverage in the way the shots are distributed and sold.
India and South Africa are spearheading an effort, supported by a wide array of nongovernmental organizations and a large group of Democrats in Congress, which would waive World Trade Organization protections on intellectual property in hopes of disseminating vaccine technology more widely. At issue are protections covering copyrights, industrial designs, patents and trade secrets. So far, the Biden administration has rejected the waiver and with good reason. It would not produce what is most needed today — a sudden boost in manufacturing to meet global demand — and it would represent an abrupt change in the rules of the game under which the pharma companies succeeded in developing remarkably effective vaccines in record time. Yes, the companies stand to profit from their monopolies on individual vaccines, but it won’t be conducive to future innovation to strip away their intellectual property protections. Yes, the United States spent $10 billion in Operation Warp Speed to accelerate the vaccine development and manufacturing effort, among other contributions, but notably it did not require companies to turn over their intellectual property to the government or to share it.
That said, the United States must recognize that it is in its interest to fight the pandemic everywhere. Biden wisely reversed former president Donald Trump’s refusal to participate in the Covax Facility, aimed at providing vaccines to the neediest nations, and committed $4 billion to the effort. The next step should be sharing the future U.S. vaccine surplus, estimated to eventually reach more than 1 billion doses, once every American who needs and wants to be vaccinated has gotten a shot. The doses can go to Covax to distribute, and it would be a gesture of U.S. leadership. In the longer term, the United States and others should work with the companies to establish licensing deals and technology transfer to boost manufacturing. The recent cooperation between Johnson & Johnson and Merck is an example that could be broadened with a goal of improved production around the world. The drug companies could, without sacrificing their business model, share know-how in manufacturing with producers in less developed countries, and the United States could help strengthen regulatory authorities there to make sure those vaccines are every bit as good as those in the wealthier nations.