The United States, the United Kingdom and the European Union (EU) have effectively blocked poor countries from accessing affordable COVID-19 vaccines at the World Trade Organization (WTO). The proposal on the table from India and South Africa — to waive the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) — would have forgone patents to significantly expand global vaccine production. Over 100 countries supported the proposal before it was blocked in March, and on April 14, more than 170 Nobel laureates and former heads of state and government sent an open letter urging President Joe Biden to back the waiver. Despite growing pressure, the U.S. has made no promises ahead of the next WTO meeting on April 22.
This move is the latest nail in the coffin for vaccine equity. Just 10 countries have so far acquired 75 percent of the vaccines, while much of the geopolitical Global South has yet to receive a single dose. A now-viral map of global vaccine roll-out starkly demonstrates that vaccine access is running parallel to economic inequality. While COVAX — an initiative co-led by Gavi, the Coalition for Epidemic Preparedness Innovations and the World Health Organization — aims to supply vaccination for at least 20 percent of a participant country’s population, footing the difference is just too costly for many countries. Limited stock and supply bottlenecks mean less than 2 percent of global COVID-19 vaccines supply have gone to African countries. The World Bank projects it will take $12 billion for the continent to sufficiently vaccinate and interrupt virus transmission.
It has been described as a “vaccine apartheid,” spurring broad-based calls to fight the trend, most formally by a coalition called The People’s Vaccine, a group of civil society organizations endorsed by health experts, heads of state and economists, advocating for fair allocation of the vaccines, sold affordably and made available for people free-of-charge.
Research shows that until a critical global population is vaccinated, all countries remain susceptible to outbreaks and variants. The COVID-19 crisis, beyond its health toll, has already caused a massive economic crisis, education system break-down and political unrest around the world. A study commissioned by the International Chamber of Commerce Research Foundation projects than “vaccine nationalism” could cost rich countries up to $4.5 trillion. The study accounts for trade and international production network relations, showing that relatively open economies stand to lose up to 3.9 percent of their GDPs if their trading partners lag on vaccine access. Why then, if global vaccine access is in their self-interest, did the U.S., U.K. and EU go to such lengths to prevent it?
The answer is found in the legacies of colonialism, imperialism and neoliberal policies. Edward Said wrote in the Los Angeles Times, “Every empire, however, tells itself and the world that it is unlike all other empires, that its mission is not to plunder and control but to educate and liberate.” The United States leans heavily on political rhetoric of international cooperation, moral clarity and human rights. On March 11 — the same day the U.S. blocked the TRIPS waiver at the WTO — President Biden gave his first prime-time address, declaring that, “We know what we need to do to beat this virus; tell the truth, follow the science, work together.” Education and liberation to a T. Yet it can hardly be said that the U.S. followed its own advice at the WTO. Instead, the U.S. did what we can expect imperial powers to do: plunder.
Scholar Asli Calkivik writes that it is at the periphery that “the international system reveals its logic.” When we move to periphery — to the stake of countries in the Global South — as this case requires us to, we see with new clarity the hierarchies of the current world order.
From the start, the precursor to the WTO, the General Agreement on Tariffs and Trade, was one of many post-World War II multilateral institutions created by Allied states, and its current form as the WTO was instituted in a next wave of globalization efforts in the 1990s. Long-time criticism of the WTO’s governance structure shows that the U.S. and Europe have disproportionate decision-making power among WTO membership, which has led to neoliberal policies creating a widening gap between rich and poor countries. Corporate Europe Observatory notes that bargaining among member countries in the TRIPS case was left to working parties that lack transparency, with no minutes recorded, freedom of information requests denied, and no boundaries on the participation of pharmaceutical executives like the Pharmaceutical Research and Manufacturers of America (PhRMA), who have spent millions lobbying to kill the proposal. In this sense, we should not expect the WTO to rule in the favor of equity; it was never designed to.
If we rely on institutions that insist on this world order, we can project only a narrow range of futures, variations of nationalistic hoarding, scales of death and destruction — none of them leading to actual health or flourishing for communities on the political margins. Arundhati Roy wrote that COVID-19 “offers us a chance to rethink the doomsday machine we have built for ourselves.” If, as she proposes, this pandemic is to be “a portal, a gateway between one world and the next,” this TRIPS decision must spur us to walk through it.