G-20 shoots for global COVID-19 solidarity; advocates say aim higher

A Global Health Summit of the G-20 group of nations garnered fresh funding and pledges from wealthy countries to share millions of vaccine doses with lower-income states Friday. However, the World Health Organization warned that a “significant funding gap” remains to properly resource the Access to COVID-19 Tools Accelerator, the multilateral effort to provide tests, treatments, and vaccines around the world.

The European Union vowed to donate 100 million doses by the end of the year, including 30 million each from France and Germany, as well as 15 million from Italy, though details will be hashed out at a meeting of national leaders next week.

The European Commission unveiled an initiative worth €1 billion ($1.2 billion) on manufacturing and access to vaccines, medicines, and health technologies in Africa. And BioNTech, Pfizer, Johnson & Johnson, and Moderna together pledged 1.3 billion doses to be delivered to low-income countries at no profit and to middle-income countries at lower prices by the end of this year, with the commission noting that many of these will go via the COVAX vaccine-sharing initiative.

Italy pledged €300 million for COVAX, which is aiming to secure and finance 1.8 billion doses for 92 lower-income countries this year. Gavi, the Vaccine Alliance, which helps oversee COVAX, said Friday that the new commitments mean it has raised over $7 billion of the $8.3 billion it wants from governments and companies for 2020-2021, ahead of the Gavi COVAX Advance Market Commitment Summit on June 2.

Friday’s event, which European Commission President Ursula von der Leyen and Italian Prime Minister Mario Draghi chaired in person in Rome, also generated the Rome Declaration, a set of principles and commitments designed to serve as “voluntary orientation for current and future action for global health.”

The most scrutinized section was on intellectual property, as Europe continues to temper enthusiasm from South Africa, India, and more recently the U.S. on suspending IP rights for COVID-19 treatments and vaccines.

Outlining the short-term options for making more vaccines available, the declaration listed “working consistently within the [existing World Trade Organization agreements] … and Promoting the use of tools such as voluntary licencing agreements of intellectual property, voluntary technology and know-how transfers, and patent pooling on mutually-agreed terms.”

However, von der Leyen said she had heard from leaders of low-income countries that flexibilities in existing instruments were difficult to use, adding that Europe would present a new “third-way” proposal on the topic to WTO in early June.

Still, Anna Marriott, Oxfam health policy manager and policy co-lead for the People’s Vaccine Alliance, slammed the summit outcome, saying in a statement that “Pharmaceutical corporations have had more than a year to voluntarily share their intellectual property and know-how but have instead put profits before people at every turn.”

With wealthy countries having secured the lion’s share of vaccine doses, Marriott noted that COVAX’s stores of actual vaccines “lie empty.” 

Earlier in the day, Draghi said, “The differences in the vaccination rates are staggering,” noting that “close to 1.5 billion doses of vaccines have been administered in over 180 countries worldwide; only 0.3% of them are in low-income countries.”

That’s because the same wealthy G-20 countries behind the Rome Declaration secured doses for their own citizens first. Asked at a press conference whether that pattern of self-interest would change in future, von der Leyen replied, “It has to change, and it is changing,” pointing to the need to boost production worldwide.

Draghi replied that Europe had behaved “just a little better” than the global average by continuing to export vaccines produced in Europe to countries that were blocking their own exports. However, he conceded: “We have understood, we all made mistakes. Now it’s time to repair.”

Eloise Todd from the Pandemic Action Network told Devex that while Friday’s announcements were positive, “a step change in ambition” was necessary ahead of the summit of the G-7 group of nations in the U.K. from June 11-13. She said that meant sharing 1 billion doses — a target also recommended Friday by Bill Gates — and fully funding the ACT-Accelerator, which also covers testing and treatments and is currently underfunded by $18.5 billion.