June 20, 2021

From Vaccine Apartheid to Vaccine Neocolonialism?

Prabir Purkayastha

THE prime minister in his speech on June 7, partially reversed his widely criticised Covid-19 vaccine policy. What concerns us here is that he also went on to give a false account of India’s vaccine history: that it had not been able to vaccinate its people earlier and could not manufacture vaccines indigenously. It is only now – according to Mr Modi – that India had manufactured two vaccines indigenously. This is an attempt to divert attention from the dismal failure of his government in scaling up vaccine production despite India having the largest vaccine production capacity in the world.

India is one of the earliest countries to produce vaccines indigenously, with public institutions such as Haffkine Institute, Mumbai, Central Research Institute, Kasauli, Pasteur Institute, Coonoor, BCG Vaccine Laboratory, Chennai playing a key role. This was the base on which India’s successful smallpox and polio eradication, and its universal immunisation programme took place. It was this base, coupled with India’s 1970 Patent Act, that helped India emerge as the global pharmacy for generic drugs and vaccines. India is one of the largest suppliers of vaccines globally and was so well before Modi and BJP won the 2016 elections.

The second issue is his claim of atmanirbhar Bharat, as distinct from self-reliant India, the earlier slogan post-independence. Atmanirbhar in Modi’s scheme is simply producing things in India without developing indigenous knowledge or capacity. Self-reliance included not only local production but also developing knowledge, without which we would continue to be dependent. According to Modi, India becomes atmanirbhar as long as things are locally produced, even if it means by borrowing technology, whether for Rafale aircraft or Covid-19 vaccines. That is why Modi claims Serum Institute’s Oxford-AstraZeneca vaccine as one of two India’s indigenous vaccines, even though the intellectual property is owned by Oxford-AstraZeneca and not India.

The battle over intellectual property for vaccine production is not simply over patents but about the access to the know-how required to produce vaccines. Without this access, the control over vaccine technology would remain with Big Pharma, who can then decide whether they extend the license to companies like Serum Institute or not; or for what period; or what should be the monopoly profits they can squeeze from such producers and consumers. This is by virtue of owning the “knowledge”.

According to WHO, with only $50 billion, we can vaccinate the entire world by middle 2022 and end the epidemic. Even the rich countries should have a stake in this. IMF calculations (A Proposal to End the Covid-19-Pandemic, May 2021) show that if the pandemic continues, the world would lose 9 trillion dollars by 2025; or 200 times the money required to eradicate the pandemic.

According to current figures, we have fully vaccinated less than 1 per cent of Africa and less than 2.5 per cent of Asia as against about 42 per cent in the US and UK. At this rate, the rich countries will vaccinate all their people in the next three-six months, while the rest of the world takes another three years. The recent announcement of the G7 of providing one billion doses till middle 2022 is grossly insufficient, as it is only one-eighth of the doses that WHO estimates the world needs.

It is clear that unless we can ramp up production in many countries, we will see much lower production of vaccines and the continuation of the pandemic for a much longer period. Why is it that the rich countries led by the US are not taking this trajectory that would end the epidemic much sooner?

To answer this question, we need to look at the options that exist for increasing the production of vaccines. Vaccinating the world against Covid-19 demands that the production of vaccines be distributed across the globe. For example, Africa, with a population of 1.3 billion, imports 99 per cent of its vaccine requirement. This cannot continue. Unless we have a large number of production facilities, the global vaccine supply will be held captive to large producers like the US and India, where domestic considerations can trump international obligations.

The 73rd World Health Assembly in May 2020 passed a resolution on sharing technology for producing vaccines, medicines and diagnostic kits to combat the threat of Covid-19. The only opposition was from the US. This means suspending all intellectual property on vaccines, medicines and diagnostics and sharing technology and knowledge across the globe to boost up local production.

For Big Pharma, vaccines, medicines and diagnostics are a new global market. It fought this trajectory tooth and nail. They were aided by rich countries and Bill Gates, who after accumulating a huge fortune from monopoly rents on his Windows operating system, has emerged as the private czar of global health. Bill Gates, other private foundations and Big Pharma backed a path for licensing transfer of technology for local production, while the intellectual property remains with Big Pharma.

The difference between the two is simple: in one, technology and knowledge would be accessible to any entity capable of making vaccines or other products and make them self-reliant. On the other, as the intellectual property remains with Big Pharma, they would decide the price and the duration of the license. And without know-how, any further development would depend on Big Pharma. This is the same difference we see between self-reliant India and atmanirbhar Bharat, Modi style.

This model of licensing a few large companies in other countries is at the heart of Big Capital’s strategy to defeat self-reliance and indigenous production. During the AIDS epidemic, Big Pharma tried to sue South Africa for buying cheap, generic AIDS drugs from India at one-thirtieth the price of their patented drugs. It was possible to manufacture AIDS drugs cheaply in India because of its patent laws and its indigenous capacity. This was a public relations disaster for Big Pharma.

Learning from this fiasco, they have been promoting a policy, where the gap between their monopoly profits and the prices which the poor can pay, are bridged temporarily by aid from rich countries and philanthropic institutions. The rich country governments and various charities are willing to provide money to Big Pharma for this “altruism” during the pandemic to prevent a self-reliant vaccine and pharmaceutical industry from emerging in the third world.

The US believed in using India as the supply hub of vaccines for the low and middle-income countries. That is why Bill Gates and his various vaccine initiatives focussed on Serum Institute of India, the world’s largest vaccine manufacturer by volume as the lynchpin of their vaccine supply. The rich countries would keep their supplies of mRNA and other vaccines for themselves, WHO’s charitable model COVAX platform, with tied technology and captive suppliers would take care of the rest, albeit at a much slower pace than what the world requires. This policy came a cropper on Modi government’s incompetence in expanding vaccine production rapidly within the country and the huge second wave that it failed to control. This meant India reneging on its commitments to the COVAX platform and its failure to supply vaccines to 92 low and middle-income countries.

There is another reason why Big Pharma may not want to end the pandemic but might like to see it become endemic. This is the road we are now travelling. As vast swathes of people remain unvaccinated, more and more people will continue to be infected, providing the SARS-CoV-2 virus with a fertile habitat for mutation. This will increase its ability to bypass our vaccine enhanced defences. For us, it is a huge risk as such variants force us to continue our periodic lockdowns, physical distancing and disrupt a whole range of economic activities. But for Big Pharma, it can generate huge profits for a long time as we would require booster doses every year.

The other question is if the economies of the poor countries are disrupted for the next two-three years, while the rich countries emerge in a relatively Covid-19 free environment, what happens to global inequalities between countries? We know that the pandemic has hit the global poor much harder than the rich, whose wealth has even increased under the pandemic by $ 4 trillion. Are we seeing the widening of the gap between the rich and poor countries even further? Is this, like disaster capitalism, a version of pandemic capitalism? Are vaccines then a way to prise open the economies of the poor countries to strengthen neocolonialism?