Vidya Krishnan is a global health journalist working and living in India. She is the author of “Phantom Plague: How Tuberculosis Shaped our History”.
In his 1947 novel “La Peste”, Albert Camus wrote that all a man can gain, in the conflict between plague and life, is knowledge and memories.
From syphilis and tuberculosis to COVID-19, our collective knowledge and memories have taught us that laws become the vector of injustice. Regardless of the type of plague or time in history, we know that patients are reliably divided according to a predictable architecture of inequality, with race playing a huge role in who survives and who perishes.
In this latest scourge, the controversial law that has plagued North and South concerns the regulation of intellectual property (IP) on vaccines – a law in which former German Chancellor Angela Merkel played a major role. As we head towards another preventable wave of a preventable infectious disease, his stance on an intellectual property waiver for COVID-19 vaccines will be one of his defining legacies as a global leader.
In 2021, as she left office after sixteen years, Merkel was praised for leading Europe with steady hands through a complicated time, for invoking Christianity and welcoming a million refugees to Germany, and for having puts science before politics – unlike many leaders.
A theoretical quantum chemist by training, she has won praise for bringing “compassion and an insistence – unusual among politicians, even in the time of COVID-19 – that decision-making benefits from evidence” and has been called a ‘”difficult act to follow”. After the election of former US President Donald Trump, the New York Times even saw fit to give him the title “Leader of the Free World”.
But Merkel’s stance on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver for vaccines was a litmus test of her commitment to human rights and social justice. And at the dawn of the third year of a pandemic that has claimed more than 15 million lives, one wonders if it deserves this title.
The first COVID-19 vaccine was approved in December 2020. And experts in India and South Africa had proposed a TRIPS waiver even before then. Yet three years into the pandemic, with more than 12 vaccines approved and around 150 more in the pipeline, nearly 3 billion people are still waiting for their first doses.
Nearly 14.91 million people perished in the 24 months between January 2020 and December 2021 – most deaths occurring in 20 black and brown countries. The highest death toll has been in India, despite being the pharmacy of the world. And therein lies the problem.
This month marks a year since India’s traumatic second wave in which – according to conservative estimates – 2.7 million people died in four months. The numbers are staggering and the losses unconscionable, especially as Indian pharmaceutical companies are manufacturing COVID-19 vaccines at a fraction of the cost of the World Health Organization (WHO) COVAX facility.
The decision to tie vaccines to patent monopolies and centralize manufacturing has left the burden of vaccinating the rest of the world to Indian companies. But during the second wave, India had to halt vaccine exports to more than 90 developing countries, sending the pandemic response into a tailspin.
Today we are witnessing parallel pandemics on a global scale.
The proposed waiver is now backed by more than 100 countries, including the United States, more than 140 former heads of state, Nobel laureates and the Pope, all of whom have called on Germany to support waiving human rights. intellectual property on COVID-19 vaccines. and transfer vaccine technologies.
With Merkel’s Christian Democratic Union party at the forefront, Germany has always advocated for intellectual property as a driver of innovation and, therefore, for monopolies as an unassailable right of the thriving pharmaceutical industry. of the country, considering the right to health in the midst of a once-era pandemic that could be violated in a century.
Despite taxpayers’ “unconditional” investments in vaccine development — Germany has given $445 million to BioNTech and $298 million to CureVac — the government in Berlin has strongly supported their continuation in patent monopolies. BioNTech alone brought in more than €5.3 billion between April and June 2021 and estimates its annual revenue at €15.9 billion this year.
Even declaring that intellectual property is not an obstacle to increasing global production, Germany changed its patent laws at the start of the pandemic, giving more powers to its federal health ministry.
By May 2021, while the WE. and that New Zealand ended up supporting the TRIPS waiver, Germany responded by suggesting industry-led and industry-controlled solutions like donations, allowing a deadly status quo to persist. The European Union’s counter-proposal to the waiver was noted by the medical humanitarian organization Doctors Without Borders as a ploy “to delay and prevent moving forward with the TRIPS waiver”. And patent lawyers in India and South Africa also believe it was a deliberate attempt to delay trading, allowing pharmaceutical companies to slowly increase their large-scale manufacturing capacity, negating the need of a waiver of the patent.
In June 2021, months after the start of the COVID-19 pandemic and weeks before the G7 summit, all eyes were on Germany’s incumbent leader. Merkel was ‘in the way’, Human Rights Watch said, referring to a waiver of intellectual property over COVID-19 technologies, making it harder for the world’s poor — primarily black and brown nations — to access vaccines. .
Overall, the EU, UK and Switzerland – along with a coterie of other fence keepers, including the US – have blocked meaningful progress towards ending the pandemic in Africa , Asia, Latin America and the Caribbean. For 20 months, between bystanders and naysayers, world health leaders and institutions – all based in the Global North – quietly negotiated the terms of a TRIPS waiver over a two-year period, as the number of deaths increased.
This week, the standoff came to a head when finally a compromise deal on a waiver was reached at the World Trade Organization. The deal, on paper, gives governments the option to compel pharmaceutical companies to share vaccine revenue for the next five years, but realistically low- and middle-income countries have failed to compel Big Disputed Pharma, let alone within a year. five-year period. It also falls short of a request from India and South Africa to exempt all COVID treatments and diagnostics.
But activists were disappointed with the result. “It’s hard to imagine anything with less benefit than this, in response to a massive global health emergency,” said James Love, director of Knowledge Ecology International.
For those of us in the Global South, our knowledge and memories teach us that power does not negotiate, compromise or extend flexibilities. It also teaches us that it is not necessary to act with great wickedness to inflict damage. The refusal to act with urgency and empathy does the job.
By the time India’s second deadly wave hit, only 4% of the population had been vaccinated because the country was supplying the WHO instead, having delivered around 66 million doses of the vaccine to 95 countries. Over a period of four months, millions of Indians were swallowed by the plague, and after all the screaming and crying died down, here’s what we remember: vaccines were available, and India was producing them for the world, when millions of us perished.
From the perspective of India – and of postcolonial nations in Asia, Africa and Latin America – Merkel looks like a deeply flawed leader who has played a powerful role in leaving vulnerable people unprotected.
This is the moral crime of our generation – not too dissimilar to the denial of balm to African American sharecroppers enrolled in the Tuskegee Syphilis Study, repeated again in the 1990s during the HIV epidemic when African nations , at the epicenter of the crisis, were the last to receive antiretrovirals.
The decisions of Western powers – especially Germany, which had the influence to break the vaccine stalemate – have inflicted untold misery on black and brown nations.
This is Merkel’s lasting legacy.