More people will die from Covid-19 in the coming year, and most will be unvaccinated. The vaccines that could save millions of lives are not reaching the poor majority of the world's population. In high, upper-middle income, lower-middle income and low income countries, the current share of people fully vaccined is only 2.5%.
The UK, Canada, Germany, and other EU states have supported a deliberate policy to deny vaccines to the poor in the world, and defended an immoral and unethical economic system which places big pharma patents ahead of millions of lives. Is the only option left to ask if the states facilitating this will be prosecuted in the international criminal court on the grounds of a crime against humanity?
The impact so far. The official statistics of global Covid deaths may underestimate the actual number of deaths. The death rates in India are 10 times higher than the official figure. More than 1.5 million children have been orphans by the Pandemic.
One year after the discovery of multiple effective vaccines, we still face vaccine apartheid. A few pharmaceutical companies make a lot of money by selling patented vaccines to wealthy countries. The global vaccine price is between $2 and $37 per dose, with Pfizer/BioNTech and Moderna being the most expensive. Moderna's market value rose from $6.9 billion to $134 billion, Pfizer's rose from $206 billion to $314 billion, and BioNTech's rose from $6 billion to $84 billion.
Efforts to distribute vaccines to poorer countries are not working. The Covax Advanced Market Commitment was set up in September 2020 by the Global Alliance Vaccine Initiative, in alliance with the World Health Organization, to accelerate the development and manufacture of Covid-19 vaccines, as well as diagnostics and treatments, and to guarantee rapid, fair and equitable access to them Donor countries would fund guaranteed volumes of vaccines from manufacturers to supply low- and middle-income countries.
The Covax scheme was supposed to deliver 2 billion doses by the end of the month. The Covax scheme had shipped only 669m doses to 144 countries by the end of December, with just 250m going to the poor. Millions of vaccine doses donated to African countries have either been sent back or destroyed because they have passed their expiry dates. The WHO established a Covid-19 vaccine technology transfer hub to speed up global manufacturing. The vaccine manufacturers refused to participate. The distribution of at least 20 billion doses is required to make the world vaccine with three doses. Pfizer/BioNTech predicts that it will be able to expand production to 4 billion doses by the end of the year.
What can the world do when huge financial interests are placed before the survival of millions of men, women and children? There are many options. A patent waiver is one of the things. India, South Africa, and others called for one a year ago to make sure emerging economy companies were not at risk of litigation. The USA and France supported them. Canada, Japan, South Korea, and the UK all blocked the move to protect big pharma. Bill Gates is a major donor to Covax. The WTO failed to broker an agreement after months of wrangling.
Dr Peter Singer, senior adviser to the WHO director general, has proposed appealing to the moral and ethical values of the pharma board members and investors. Many people have led institutions that are committed to global public goods and equity. They might have religious or moral principles that would make them think differently. There is no precedent for such a display of altruism when the stock market is booming.
Taking action against states such as Germany, Canada, the UK, and so on, over what is arguably aninfringement of human rights is a more effective line of action. Their policies break the UN convention on the rights of the child, which requires states to combat disease and malnutrition, with particular attention paid to the needs of developing countries. The UN guiding principles on business and human rights, endorsed by the UN human rights council, call for businesses to comply with all applicable laws and to respect internationally recognised human rights.
Both of these conventions are broken frequently and have little or no teeth. The option of prosecution in the international criminal court for crimes against humanity is the nuclear option. These are described in the Rome statute as a widespread or systematic attack directed against any civilian population, and an inhumane act that causes great suffering, or serious injury to the body or to mental or physical health. International lawyers should act quickly.
We can't let this happen. There could be 12 million deaths in the next year. People all over the world want justice. They should have a right to vaccine access, since many of the vaccines in question were researched and developed by government scientists. Anyone who stands in the way of saving lives should be held responsible.
The professor of global health at the University College London is a former director of the World Health Organization.
