Devex CheckUp: At last, a TRIPS waiver compromise. But who’s happy?

After almost 18 months, there’s now a potential breakthrough in a hard-fought battle to waive intellectual property restrictions on COVID-19 vaccines. But the leaked proposal negotiated by South Africa, India, the United States, and the European Union has been met with mixed reactions, Andrew Green reports for Devex.

The proposed compromise would allow eligible WTO members to issue a single authorization to waive multiple patents, including on vaccine ingredients and processes, without fear of a challenge from the patent holders. All countries that exported less than 10% of the world’s vaccines in 2021 are eligible, which appears to exclude only China, the U.S., and the EU. It would also allow countries to export products manufactured under the agreement to other eligible nations, although a timeline for how long the waiver will apply remains to be decided.

WTO Director-General Ngozi Okonjo-Iweala described the compromise as a “major step forward” — but cautioned that the work is far from over, as the proposal still needs to receive unanimous support from WTO members.

But critics are concerned that the proposal bears little resemblance to the original proposed by India and South Africa, which included IP waivers for COVID-19 diagnostics and treatments. The leaked proposal says a decision on diagnostics and therapeutics would follow within six months. The pharmaceutical industry — which has long opposed the waiver — also criticized the proposal, calling it the “wrong solution” and “outdated.”

But some are taking it one step at a time. “I would have loved to have the TRIPS waiver agreed in full, especially covering all health technologies, but that’s what diplomacy is all about. It’s compromise,” says Jaume Vidal, a senior policy adviser at Health Action International. Though Vidal has been an advocate of the TRIPS waiver, he said the “waiver was not the goal,” and the true aim is to improve access to health technologies.

Read: TRIPS waiver compromise draws a mixed response

And yes, this will be on the quiz

For last week’s CheckUp anniversary, we created a global health quiz so you can test your own knowledge. Here’s a hint: One of the questions requires some background on the TRIPS waiver.

+ Review our coverage on how the TRIPS waiver got tripped. 

Moment to shine

This week, Africa CDC Director Dr. John Nkengasong finally appeared before the U.S. Senate Foreign Relations Committee for his nomination hearing to serve as the next head of PEPFAR, nearly six months after the White House announced its intent to nominate him for the role.

Get a rundown of what Nkengasong told U.S. lawmakers during his hearing.

Need some background on Nkengasong’s work? We have an in-depth profile. Plus, Devex Pro subscribers can take a deep dive into his tenure at Africa CDC — and how it shaped Africa’s response to the COVID-19 pandemic. Not gone Pro yet? Sign up and start your 15-day free trial.

Glass half full

Last week, we wrote about CEPI raising just over $1.5 billion against its target of $3.5 billion. Since then, Jenny has taken a closer look at the pledges: which nations and organizations were missing from the pledging event, what could have affected the outcomes of the replenishment, and what comes next.

Who pledged what: The Gates Foundation and Wellcome were the first to announce their pledges to CEPI in January, amounting to $300 million. The United Kingdom and Japan soon followed with £160 million ($211 million) and $300 million, respectively, in advance of the replenishment.

On the day of, pledges also came from Australia, with $74 million; Austria, with $5 million; Finland, with $7 million; Germany, with $87 million; Italy, with $22 million; Indonesia, with $5 million; Mexico, with $1 million; New Zealand, with $7 million; Norway, with $111 million; Singapore, with $15 million; and the United States, with $150 million over three years.

But several donors that previously contributed to CEPI were missing from the pledging table, including Canada and Saudi Arabia, which previously contributed $88.8 million and $150 million, respectively. France was also missing in action.

Why the limited funding? “A number of partners from whom we anticipate support were not in a position to make announcements at the Summit,” CEPI CEO Dr. Richard Hatchett tells Jenny. But there are also real challenges related to CEPI’s focus and the current global health architecture. Asking donors to invest in research and development is different from asking them to invest in the purchase and delivery of available vaccines or medicines. In addition, with the growing number of global health entities, there’s more competition for funding.

What happens now: CEPI says it’s still anticipating further commitments and looking at other avenues to raise funding. The U.S. omnibus appropriations law for 2022 also included $100 million for CEPI, bringing the country’s total commitments to the public-private partnership in this fiscal year to $150 million. A spokesperson for Global Affairs Canada also tells Jenny in an email that the government is “taking a careful look at the CEPI 2.0 investment opportunity and will communicate out any decision for further funding in due course.”

Read: CEPI hopeful despite underwhelming replenishment

Pitch-perfect

Malawi’s routine immunization coverage rates are some of the highest in Africa, writes Rebecca Alban, health systems manager at Seattle-based NGO VillageReach. A key ingredient to its success? Its reliance on a cadre of around 10,000 community health workers, known as health surveillance assistance, who make up more than a third of the country’s health workforce.

As low- and middle-income countries aim to vaccinate large swaths of their populations against COVID-19, Alban proposes tapping community health workers to fill the health workforce gap in countries, and assist in battling vaccine hesitancy and misinformation.

Opinion: Amid labor shortage, let community health workers give vaccines

What we’re reading

UNICEF data shows a surge in the number of children admitted to hospitals in Afghanistan with severe acute malnutrition. [BBC]

Pfizer requests U.S. FDA approval for a fourth COVID-19 vaccine shot for people 65 and older. [USA TODAY]

WHO puts prequalification process on hold for COVID-19 vaccine developed by Canadian firm Medicago, due to its ties with Philip Morris. [Bloomberg]