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How to Fight Big Pharma — and Win 

A look inside the U.S. campaign for a WTO waiver of pharmaceutical monopolies for COVID-19.

A syringe prop seen displayed at the protest on March 11, 2021, outside Pfizer Worldwide Headquarters in Manhattan.

The Biden administration’s decision to support waiving World Trade Organization (WTO) intellectual property rules to help fight COVID-19 has the potential to help shift the global power balance toward governments and their people and away from mega-corporations.

At Public Citizen’s Global Trade Watch, an organization founded to dismantle corporate overreach of our “trade” and globalization policies, we celebrate the Biden-Harris administration’s departure from decades of U.S. trade officials relentlessly attacking other countries’ access-to-affordable-medicines initiatives on behalf of Big Pharma.

While this announcement was historic, there is more work to do to ensure that Big Pharma doesn’t weaken or delay the waiver.

The road leading to the Biden administration’s decision was paved by dozens of health, faith, labor and consumer advocacy organizations, over 100 members of the U.S. Congress and millions of people around the world who took action. Here’s the story of how that happened.

The U.S Campaign for an Emergency COVID-19 WTO TRIPS Waiver

The WTO requires its 159 member nations to provide pharmaceutical firms certain monopoly rights in a text called the WTO’s Agreement on Trade-Related Aspects of Intellectual Property or “TRIPS.” These monopoly protections mean that pharmaceutical corporations control how much and where vaccines, tests and treatments are made.

Last Autumn, it became clear that most people in low- and middle-income countries would not get vaccinated until at least 2022, and those in the world’s poorest countries might have to wait until 2024 for mass immunization, if it happens at all. Current production capacity would not supply nearly enough vaccines, treatments or diagnostic tests to meet global needs. Those concerns proved true: By early May, global vaccine production had not reached 1.5 billion doses, while 10-15 billion doses are needed. Creating greater supply capacity is critical.

Recognizing the unprecedented urgency of the fight against COVID-19, in October 2020 India and South Africa proposed a temporary waiver of TRIPS rules to increase global production of COVID-related health technologies. The Trump administration, doing Big Pharma’s bidding, promptly organized a handful of mostly wealthy countries to block even negotiations of the waiver.

Organizations representing the interests of the Global South, such as Third World Network and South Centre, global advocacy groups like Doctors Without Borders and Oxfam, and Public Citizen launched an international campaign supporting the waiver. But here in the U.S. and around the world, many thought reversing the U.S. blockage of negotiations was a long shot.

When Joe Biden took office in January 2021, a small group of organizations started strategizing about how to encourage the new administration to reverse the Trump position, which also was increasingly the focus of some Democratic members of Congress.

Public Citizen began by coordinating thousands of letters from our members to Congress and hosting a series of meetings with other U.S. groups that also hoped to make the waiver a reality. Public Citizen, Oxfam, Partners in Health, the Association of Flight Attendants-CWA, Doctors Without Borders, Health GAP, Human Rights Watch, Amnesty International, and the nurses and teachers unions, Avaaz, Right2Health, Be a Hero, and a host of other groups started to coordinate with the goal of reversing the U.S. position. (This truly was a feat achieved by hundreds of organizations. Any omissions are due to word limits and not the limited value of the work of our incredible allies!)

Regardless of the odds stacked against us, this ad hoc coalition sought to build the political pressure needed to take on the Big Pharma lobby and help create a path for the Biden-Harris administration to take action.

To educate and activate organizations who might be interested, we wrote and circulated a U.S. sign-on letter, which after hundreds of emails and calls, was signed by 400 U.S. organizations from Democratic Party base groups like Indivisible and MoveOn to dozens of national unions, consumer, faith, health, human rights, development and other civil society groups. The broad support for the letter inspired new constituencies to join the coalition to fight toward our increasingly realistic goal.

The next step was to prove strong political support for the waiver within Congress. Working with public health champions, Reps. Jan Schakowsky (D-Illinois), Earl Blumenauer (D-Oregon) and Rosa DeLauro (D-Connecticut), as well as allies in the Senate, the coalition helped to educate members of Congress in Washington and in their districts to build support for a letter to President Biden.

Our campaign continued to pick up steam, as Sen. Bernie Sanders (I-Vermont) sent a letter to Biden signed by 10 senators, and campaigners staged protests outside of Big Pharma shareholder meetings and at the homes and offices of brazenly anti-waiver, pro-Pharma members of Congress. After the story had been featured in the print press and on Democracy Now! and The Daily Show with Trevor Noah, the mainstream media finally began covering the waiver.

In the same week, Data for Progress released a poll showing that 60% of U.S. voters support the waiver. Be a Hero, working with More Perfect Union, produced a powerful video featuring health activist Ady Barkan reminding the president of his campaign promise to remove intellectual property barriers that block access to COVID-19 vaccines.

And finally, after months of hundreds of individuals hosting thousands of meetings, phone calls and direct email exchanges with members of Congress, the majority of House Democrats had signed onto the Schakowsky-Blumenauer-DeLauro letter calling on Biden to support the waiver and enter text-based negotiations at the WTO.

All of this campaigning was gaining momentum leading up to the critical decision point, a May 5 meeting of the WTO. That afternoon, U.S Trade Representative (USTR) Katherine Tai shocked the world with her announcement that the U.S. would not only reverse its blockage, but would engage in negotiations in support of a waiver. Some countries that had joined the U.S. in blocking negotiations reversed quickly. Others are reconsidering their positions. Some doubled down on the pro-pharma position. For instance, Germany Chancellor Angela Merkel came out harshly opposed to the waiver, which has made the European Union an obstacle to progress.

The Fight Is Not Over

Public Citizen, in coalition with national and international partners, will continue to organize until a waiver is enacted and we secure the funding to ensure more vaccines, treatments and tests are manufactured and people worldwide have equitable access. This will be a hard fight.

At least 100 Big Pharma lobbyists have been swarming Washington to fight the U.S. position change. Their goal now is to ensure the waiver either never is agreed upon or is gutted of all substance.

That’s why it is critical that U.S. activists keep pushing back against the Pharma lobby. And our partners in other countries must help the administration deliver on its promise to persuade the remaining countries still on the wrong side of the issue to stop blocking negotiations. Once talks begin, we need the fastest possible agreement on a waiver text that eliminates all intellectual property barriers on all of the health technologies needed to stop the spread of COVID-19, including diagnostic tests, treatments, vaccines and the equipment to make them.

The announcement from USTR notably only mentioned support for waiving intellectual property protections for COVID-19 vaccines. A comprehensive waiver that removes intellectual property obstacles to the needed production of much greater volumes of COVID-19 vaccines, treatments and diagnostic tests is essential to U.S. residents being safe from COVID-19 and our economy reviving, as well as the health and economic recovery of the world.

Global vaccine apartheid could cost millions of lives, push tens of millions more into poverty and spawn mutated virus variants that evade vaccines. There can be no end to the public health disaster or economic crises anywhere if people in developing nations are not vaccinated. There is more the U.S. can and should do, in addition to the waiver, to help the world produce billions more vaccine doses.

The announcement from the United States is something to celebrate, but our work does not stop here.

Note: Mariana Lopez contributed to this op-ed. Please visit Rethink Trade’s website to get involved in the campaign and follow updates from Global Trade Watch on Twitter.

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