Opinion: It's time to end the stranglehold on lifesaving medicine

Sunday marked the 20th anniversary of the World Trade Organization’s Declaration on the TRIPS Agreement and Public Health. Hailed as a victory, the so-called Doha Declaration was intended to open the vise grip that pharmaceutical companies have on essential medicines and vaccines, provide new pathways for countries to produce their own affordable drugs, and save lives. But two decades on, corporate abuse of medical patents is more ingrained than ever.

Perhaps we shouldn’t be surprised. Everyone who campaigns for access to medicine has seen businesses derail attempts to change the system for years, even as it fails on crisis after crisis — tuberculosis, hepatitis, HIV, and more.

The Agreement on Trade-Related Aspects of Intellectual Property Rights, or TRIPS Agreement, ensured that new medical technologies were bound by strict IP laws in all WTO member states. The claim was that this would increase innovation by rewarding investment in medical science. While pharmaceutical companies have certainly seen rewards, millions still die every year from preventable and curable diseases, the vast majority of whom are in low- and middle-income countries.

Now, history seems doomed to repeat itself once again with COVID-19 vaccines. This year, booster shots given in rich nations have outnumbered the total doses administered in low-income nations.

Under the current system, we’re at the mercy of Big Pharma, relying on handouts or hoping for deals that may not ever arrive. And our health is big business. Pfizer recently raised its 2021 projections for COVID-19 vaccine revenues to $36 billion, and it expects another $29 billion next year as more boosters and child vaccinations are greenlighted in rich countries.

The public is not unaware of this vast financial gain. Over the past 18 months, the media has closely charted the jostling of different private enterprises and vaccine producers as they carve out their market share.

Names such as Pfizer, Moderna, and AstraZeneca have become synonymous with bulk international sales of doses — but not to low-income countries. And while a public sense of gratitude is of course evident for the vaccines that are returning life to a semblance of normal for many around the world, a deep distrust remains around the faceless corporations that are quietly making money behind the scenes by squeezing every dollar out of the system.

A limp strategy of appeasement isn’t going to work forever. We can’t rely on the charity of mega corporations when millions of lives hang in the balance.

The impact of the TRIPS Agreement extends much further than the COVID-19 pandemic; medicines for countless diseases are wrapped up in it. According to data from the Joint United Nations Programme on HIV and AIDS, AIDS killed 680,000 people globally in 2020 — despite numerous medicines available on the market to treat HIV.

It is the same story for TB, which still kills 1.4 million annually, and hepatitis C, responsible for nearly 300,000 deaths in 2019 — in spite of a plethora of treatments. Over the decades, attempts to escape pharmaceutical companies’ stranglehold on lifesaving medicines have fallen flat, tied up in red tape.

What’s different this time, however, is the level of attention on the system itself. COVID-19 has dragged this unjust system into the spotlight. For the first time since the early 2000s, we’ve seen the TRIPS Agreement and patent abuse repeatedly make headlines around the world. South Africa and India first called for a TRIPS waiver over a year ago, and more than 100 nations have thrown their weight behind it. An appetite for change is here.

At no other point in the past three decades have we had this level of public awareness and momentum on our side. As is the case with international development, climate justice, and many other global issues, the wealthiest countries possess the capability to change international structures for the better, but they lack the will.

So what needs to be done? First and foremost, we need to mobilize to apply pressure. A COVID-19 TRIPS waiver is certainly part of that, but it can't be the stand-alone demand.

Upscaling capacities is equally important to reduce the reliance on U.S. and European companies that have shown time and time again that they'll do anything to protect their margins. Focusing on pharmaceutical greed is also effective, but we must connect the dots to understand this as a core feature of the system rather than an unfortunate consequence.

In low- and middle-income countries — where the COVID-19 pandemic is still very much a threat — we need to mobilize civil society groups, health organizations, politicians, and community leaders to increase dissent at WTO. If the trade organization won't temporarily waive IP rights for vaccines and other medical technologies during a pandemic, when will it?

We need to raise the stakes and call for permanent change to the TRIPS Agreement, removing all lifesaving medicines and treatments from the open-ended IP rules routinely abused by profit-maximizing pharmaceutical companies.

This week, GSIPA2M-2021Virtual — the initial, virtual component of the second Global Summit on Intellectual Property and Access to Medicines — is bringing together more than 250 campaigners from all continents and across sectors to commemorate the progress made and the lives lost in the battle to end the abuse of medical patents following the Doha Declaration. The event will be a moment to take stock and look forward to how we can create a fair and just system that elevates people over profit.