The big barriers to global vaccination: patent rights, national self-interest and the wealth gap

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Ilan Noy, Te Herenga Waka — Victoria University of Wellington and Ami Neuberger, Technion – Israel Institute of Technology

We will not be able to put the COVID-19 pandemic behind us until the world’s population is mostly immune through vaccination or previous exposure to the disease.

A truly global vaccination campaign, however, would look very different from what we are seeing now. For example, as of January 20, many more people have been immunised in Israel (with a population less than 10 million) than in Africa and Latin America combined.

Notwithstanding recent questions about the effectiveness of the initial single dose of the vaccine, there is a clear disparity in vaccine rollouts internationally.

That is a problem. As long as there are still existing reservoirs of a propagating virus it will be able to spread again to populations that either cannot or would not vaccinate. It will also be able to mutate to variants that are either more transmissible or more deadly.

Counterintuitively, an increase in transmissibility, such as has been found with the new UK variant, is worse than the same percentage increase in mortality rate. This is because increased transmissibility increases the number of cases (and hence the number of deaths) exponentially, while an increase in mortality rates increases only deaths, and only linearly.

Evolutionary pressure on the virus will inevitably favour mutations that make the disease more transmissible, or the virus itself more vaccine-resistant. It is clear, therefore, that every nation’s interest is in universal vaccination. But this is not the trajectory we are on.

Fast roll out: a busy coronavirus vaccination station in Israel in mid-January.
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Politics and profits

Fortunately, in the countries already vaccinating, the vaccine is (mostly) not allocated by wealth or power, but by prioritising those facing the highest risk. At a country level, however, national wealth is determining vaccine roll out.

Yet in the past we have managed to eradicate diseases worldwide, including small pox, a viral infection with much higher death rates than COVID-19.

There are two barriers that prevent us from rapidly pursuing a similar goal for the current pandemic:

• big pharma is profit-driven and therefore keeps a tight lid on the intellectual property it is developing in the new vaccines

• countries find it difficult to see beyond their national interest; not surprisingly, politicians are committed only to their own voters.

At this point, we don’t have a global system to confront either of these problems. Each vaccine’s patent is owned by its developer, and the World Health Organisation (WHO) is too weak to be the world’s Ministry of Health.

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The polio vaccine model

Overcoming big pharma’s profit motive has been achieved before, however.

In 1955, Jonas Salk announced the development of a polio vaccine in the midst of a huge epidemic. The news initially met with scepticism. Even employees of his own laboratory resigned, protesting that he was moving too fast with clinical experimentation.

When a huge placebo–controlled clinical trial involving 1.6 million children proved him right, however, he declared that in order to maximise the global distribution of this lifesaving vaccine his lab would not patent it. Asked who owned the patent, he famously replied:

Well, the people I would say. There is no patent. Could you patent the sun?

In an echo of the current moment, Israel (then a new state) was also experiencing a rapidly spreading polio epidemic. Efforts to purchase vaccines from the US were unsuccessful, as not all American children were yet vaccinated. So a scientist named Natan Goldblum was sent to Salk’s laboratory to learn how to make the new vaccine.

No lawyers were involved and no contracts signed. The young Dr Goldblum spent 1956 setting up manufacturing facilities for Salk’s vaccine in Israel and by early 1957 mass vaccination was underway.

Could you patent the sun? Dr Jonas Salk and a nurse administer a polio vaccine in Pennsylvania in the 1950s.
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Suspend patent rights

Israel, a small and relatively poor country in the 1950s, became the third country in the world (after the US and Denmark) to produce the vaccine locally and eventually eradicate polio. It took a handful of scientists, a modest budget and, most importantly, no patenting.

Like Salk, Goldblum was aware viruses have complete disregard for political borders. He was also involved in a very successful Palestinian polio vaccination campaign in Gaza.

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More recently, a highly successful international campaign in the early 2000s saw AIDS treatments distributed in poorer countries. Pharmaceutical companies that owned the patented drugs were forced to supply them at cost or for free, not at market prices set in the rich countries. This was achieved through public pressure and the willingness of governments to support the required policies.

A temporary withdrawal of the patenting rights to the successful COVID-19 vaccines, with or without compensation for the developers, seems a small price to pay for an exit strategy from this global and incredibly costly crisis.

Act local, think global

Overcoming national interest is perhaps more complicated. Clearly, countries have an interest in vaccinating their most vulnerable populations first. But at some point, well before everyone is vaccinated, it becomes more efficient for countries to start vaccinating their neighbours (the countries they are most exposed to through movements of people and trade).

Disappointingly, rich countries today behave as though they will reach 100% vaccination rates before they give away a single dose, with many having bought well in excess of what is needed for 100% coverage.

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The COVAX plan to distribute vaccines in poorer countries has so far been an under-funded effort that has not yet delivered a single dose of vaccine. Even if COVAX were to be fully funded, it mostly aims to donate an insufficient number of vaccine doses to the poorest countries, rather than really bring about a universal vaccination programme.

Nevertheless, overcoming the profit-maximising interest of big pharma and the national focus of governments is not a pipe dream. The world has done it before.

Ilan Noy, Professor and Chair in the Economics of Disasters and Climate Change, Te Herenga Waka — Victoria University of Wellington and Ami Neuberger, Clinical Assistant Professor, Technion – Israel Institute of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Police raid offices of assisted suicide organization in Melbourne

Police raided the Melbourne offices of the assisted-suicide advocacy organization Exit International last Thursday, seizing documents related to the alleged assisted suicide of Exit International member Frank Ward. In response to this and to the raid of another Exit International member’s home, Exit International has told its 4,000 members to be wary not to attract police activity, reports James Tillman, LifeSiteNews.com.

"We haven’t had any incidents like this for a long time," said Dr. Philip Nitschke, head of Exit International.

The raid highlights the dubious legal status of Exit International’s activities. Because assisting or even encouraging suicide is illegal in Australia, Exit International bills its workshops, books, suicide equipment, and all its activities as merely providing people with knowledge and equipment to allow them to do what they want, not as actually assisting them in the act of suicide. According to Nitschke, such was the extent of Exit International’s contact with Ward.

"[Police] were suggesting we were involved in his death but we were not," Nitschke told Television New Zealand. "We would never be actively involved in something like that, helping him end his life, which would be committing a crime."

According to Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, such protestations of innocence are dubious.

"I think that this raid is long-overdue," he told LifeSiteNews.com (LSN). "Nitschke has been skirting the law for many years."

Frank Ward killed himself last June by inhaling helium, which causes asphyxia. This method of suicide is among those promoted by Dr. Nitschke. Schadenberg described to LSN how at a Right-to-Die Conference he saw Nitschke demonstrate "how a device that he claimed to have invented would regulate the flow of gas to ensure that … the act would result in their death."

"Nitschke was not concerned that he was aiding suicide by knowingly selling a device to ensure the success of a suicide."

A widespread dissemination of information on how to kill oneself, however, is precisely what Nitschke desires. In an interview

with National Review he said that someone needs to provide the knowledge of how to kill oneself "to anyone who wants it, including the depressed, the elderly bereaved, [and] the troubled teen."

"If we are to remain consistent and we believe that the individual has the right to dispose of their life, we should not erect artificial barriers in the way of sub-groups who don’t meet our criteria," he said.

The second raid on Thursday was directly related to this desire of Nitschke. Police came to the home of an elderly Exit International member in Sydney to search for the euthanasia drug Nembutal and information concerning its acquisition. They left with a small quantity of the drug and the "Peaceful Pill Handbook," a book by Nitschke and a co-author on how to kill oneself that was banned by the Australian government.

Nembutal is used by veterinarians to euthanize animals, and is tightly controlled in most places around the world. Nitschke’s organization, however, has striven to make it available to as many people as possible.

"Last year Nitschke was encouraging people to order Nembutal by mail order from a source that he had discovered," Schadenberg said. "Once again, he wasn’t concerned that people with chronic depression would access this information to kill themselves." Members of Exit International also travel to Mexico to buy the drug, where it is easily obtained.

Nitschke explained that because of the raids Exit Internatonal had sent an alert to its 4,000 members “warning them about the fact that … people should be very careful if they’ve gone to great lengths to get these drugs so that they don’t find themselves subject of any form of police activity”

Schadenberg, however, thinks it high time that such activity began in earnest.

"It is simply about time that his offices were investigated, especially now that he has set up an office in Bellingham, Washington state, where he intends to launch his group into the United States,” he said.

“He intends to grow his group Exit International and he is doing this through his recent series of speaking engagements throughout the United States, Britain and Canada."

Report from the Christian Telegraph 

IRAN: THREE CONVERTS ORDERED TO STOP ‘CHRISTIAN ACTIVITIES’

Judge puts them on probation, threatening them with ‘apostasy’ trial.

LOS ANGELES, March 31 (Compass Direct News) – Declaring three Iranian Christians guilty of cooperating with “anti-government movements,” a court in Shiraz on March 10 ordered the converts to discontinue Christian activities and stop propagating their faith.

An Islamic Revolutionary Court judge handed an eight-month suspended prison sentence with a five-year probation to Seyed Allaedin Hussein, Homayoon Shokouhi, and Seyed Amir Hussein Bob-Annari. The judge said he would enforce their prison sentence and try them as “apostates,” or those who leave Islam, if they violate terms of their probation – including a ban on contacting one another.

A new penal code under consideration by the Iranian Parliament includes a bill that would require the death penalty for apostasy.

“The warning that they will be ‘arrested and tried as apostates’ if they continue their Christian activities is quite chilling,” said a regional analyst who requested anonymity.

The Islamic Revolutionary Court was created after Iran’s 1979 revolution to prosecute those suspected of seeking to depose the Islamic regime. The “anti-government movements” referred to by the judge are satellite television stations Love Television and Salvation TV. Unlike the Internet, which is heavily censored in Iran, the two 24-hour satellite TV stations can bypass government information barriers.

Sources said links between the accused and these organizations, however, remain tenuous.

“The TV link came up almost six months after [the original arrests], so it is very new,” said an informed source. “We believe they just made it up, or it is something they want to make appear more important than is the reality.”

The three men were arrested by security forces on May 11, 2008 at the Shiraz airport while en route to a Christian marriage seminar in Dubai. According to a report by Farsi Christian News Network (FCNN), at that time the families of the three men avoided formal charges by agreeing to terms of release, including payment of a bond amount. Details of the terms were undisclosed.

 

Churches Pressured

The sentencing of three converts from Islam follows more than 50 documented arrests of Christians in 2008 alone, and the recent government crackdown includes Christian institutions that minister beyond Iran’s tiny indigenous Christian community.

On March 19, Assyrian Member of Parliament Yonathan Betkolia announced that by order of the Islamic Revolutionary Court, an Assyrian Pentecostal church in Tehran would be closed. According to FCNN, the church in the Shahrara area of Tehran was facing closure because it offered a Farsi-language service attended by converts from Islam.

During a speech following his election to Parliament in October, Betkolia had lauded freedoms accorded to minority groups in Iran, and he has publicly protested the Shahrara church allowing “non-Assyrians” – that is, Muslims – to attend services. The regional analyst said that Betkolia made these pronouncements as the increase in government pressure on the Christian community has put him in a difficult position.

“As a representative of the Assyrian community, a priority for Betkolia is to ensure the preservation of the limited freedoms and relative peace his traditional Christian community enjoys,” said the analyst. “Disassociation from a church which has welcomed believers from a Muslim background should therefore be seen as a form of self-defense.”

The number of Assyrian Christians in the country is estimated at between 10,000 and 20,000, with estimates of Armenian Christians in Iran ranging from 110,000 to 300,000.

Advocacy organization Human Rights Activists in Iran strongly criticized the decision to close the Assyrian church.

“The closing of the church is clearly a violation of human rights,” the organization stated, “because the right to change one’s religion and the right of self-expression are hereby targeted by the Islamic Revolutionary Court.”

The pastor of the Shahrara church has indicated that cancelling Farsi-language services may allow it to continue, though it was unclear at press time whether the congregation’s leadership was willing to make that compromise. FCNN reported in February that church leaders had on some occasions cancelled Farsi-language services at church.  

Report from Compass Direct News