As we near Australia’s 80 per cent vaccination rate targets, the promise of Australia opening up again is becoming a reality.
To get there, the government has taken extraordinary measures to source more vaccines, including purchasing one million Pfizer doses from Poland at an undisclosed price, entering a vaccine swap with the UK, and withdrawing 500,000 vaccines from its COVAX stores.
COVAX is a scheme funded by more than 100 countries with the goal of ensuring equitable vaccine access, particularly for developing
Australia has contributed financially to COVAX, and therefore is entitled to these doses. But the choice of withdrawing vaccines that could otherwise be provided to developing nations highlights the short-term cost of Australia’s initial vaccine complacency, and the difficult trade-offs of vaccine supply in a pandemic.
Providing Australians with their first vaccinations is the government’s immediate priority, as is appropriate. But as initial immunity wanes, the government will be delivering booster shots.
Australia has secured 60 million doses for 2022 and 25 million doses for 2023 for boosters from Pfizer-BioNTech.
Australia’s regional neighbours are faring worse, with both COVID-19 and vaccine procurement. Only yesterday Indonesia reported 4128 new infections, but only 21.5 per cent of Indonesians have been vaccinated, and yesterday Vietnam reported 10,508 new infections, with only 15 per cent of Vietnam’s population vaccinated.
These countries are struggling with far worse outbreaks – high rates of COVID-19, inadequate resources for treatment and, crucially, very low vaccination rates. Only 2 per cent of global vaccines have gone to the world’s 50 least-wealthy nations, home to 20 per cent of the world’s population.
Already Australia has been generous with pledging to donate 20 million
AstraZeneca vaccine doses to countries in our region, but we must think bigger and more sustainably.
Do well by doing good
Donating vaccines is not just altruism. Australia must protect its neighbours to minimise SARS-COV-2 mutations causing variants of concern, which have previously come from severe outbreaks in other
countries, like the Delta variant which arose in India.
These mutated strains may reduce vaccine effectiveness, require larger proportions of the population to be vaccinated to reach herd immunity,
and may even require new vaccine development. Ultimately, the longer our region and the entire world remain unvaccinated, the longer Australia’s border restrictions could last.
Australia has several ways to support our neighbours. The first is to support vaccine patent waivers, allowing nations to produce more mRNA vaccines.
Thankfully, Australia has agreed to support patent waivers for COVID-19 vaccines. In the interest of the fight against COVID-19, India and South Africa have proposed suspending TRIPS – Trade-Related Aspects of Intellectual Property (TRIPS) – a key trade provision that restricts the use of patents.
However, the World Trade Organisation (WTO) has rejected this suggestion eight times. One motivation behind the WTO’s rejections may be a lack of support from other WTO members.
The TRIPS Council will meet on October 13 and again on November 30 2021 to further progress discussions about a possible waiver. Currently the European Union, Japan and the UK oppose the waiver.
Oxfam is accusing the 20 richest nations of putting relations with pharmaceutical companies ahead of ending the pandemic. Intellectual property waivers were vital to unlocking access to HIV treatment in many countries and so should be effective for COVID-19.
In fact, the Doha Declaration was exactly about this, allowing patents to be circumvented for essential pharmaceuticals in order to protect public health.
However, during this COVID-19 pandemic, the pharmaceutical industry and governments argue that the profit motive is a critical incentive to
encourage future innovation in medicine and health, and patent waivers may dash this incentive.
But how many billions in profit are needed to provide this ‘incentive’ in exchange for prolonging the pandemic? Patent waivers don’t have to be all-or-nothing. Waivers can be provided for a certain period of time, or until a proportion of poor nations are vaccinated.
Patents and profits
Recently China, France, Spain, the WHO, and the Biden administration have supported patent waivers as long as wealthy nations do not use the generic vaccines produced under these waivers. Countries are meeting in small groups at the present time to develop a draft proposal to take to the WTO Ministerial Council for a final decision around December 3.
Of course, patent waivers alone do not facilitate the production of vaccines. Countries hoping to build this capacity need the support of pharmaceutical companies; only these companies have the
expertise to teach locals how to source raw ingredients, build manufacturing capacity and train staff.
Moderna and Pfizer have not yet committed to help the WHO arrange this in South Africa, and discussions are only just underway between these companies and South Korea, Malaysia, and Indonesia.
At present, poorer nations wanting to produce their own vaccines must rely on older technologies, some of which (like Sinovac) have lower efficacy against COVID-19. Australia should support international efforts to urge pharmaceutical companies with mRNA know-how to expand production sites and twin any Australian development of mRNA capacity with potential companies in an Indo-Pacific country.
This would be a catalytic contribution to ending the pandemic and improving the security of the region – economically and in global health terms.
If patent waivers do not come to be, and expanding global mRNA production proves too difficult, at minimum the Australian government could collaborate to build out AstraZeneca production capacity in
the Indo-Pacific region – in Vietnam or Indonesia.
Expanding this capacity and ensuring CSL is producing as much AstraZeneca as possible locally are effective actions the Australian government could take today.
Beyond government action, Australian business, philanthropy and individuals can contribute funding to the COVAX Facility as well as support partnerships improving the transport, storage and delivery of vaccines across Australia and our geographic region. These actions will help improve access to COVID-19 vaccines for all.
Australia not only has an obligation to help its regional neighbours but has a strong interest in ensuring that the COVID-19 pandemic is stopped as soon as possible.
All efforts to support the availability and supply of vaccines to developing nations will help save countless lives, stop the emergence and spread of dangerous variants, support the recovery of the global economy, and improve our standing in the global community.
Further discussions to move other countries to supporting patent waivers, supporting widespread mRNA production, and ensuring more rapid production of AstraZeneca locally are all practical and vital steps the Australian government must take to ensure humans triumph over the COVID-19 virus.
Dr Verity Chadwick is a junior doctor at Royal North Shore Hospital, Sydney. Professor Joel Negin is Head of School at the Sydney School of Public Health. Professor Alexandra Martiniuk is a Professor of Epidemiology at the University of Sydney