The Global North sent vaccines to Africa last. (Photo by RAJESH JANTILAL/AFP via Getty Images)
It’s not often that African health activists are pleasantly surprised by developments in global health. But this past weekend, the latest version of the draft Pandemic Accord delivered a rare moment of relief. And just in time.
The accord (now officially called the Pandemic Agreement) is a deal that’s supposed to prevent a repeat of the egregious inequities that unfolded during the Covid pandemic. Until now, it seemed unlikely that negotiators could agree on a draft that gets anywhere near this in time for the World Health Assembly on 27 May, when the World Health Organisation’s (WHO) 194 member states will vote to seal the deal — or not.
An editorial in The Lancet called a previous version of the draft pact “unjust” and “shameful” because it was so watered down and removed from its original goal to protect all people, rich or poor. A February iteration was rejected by the pan-African health body, Africa CDC, because it contained serious double standards that would mostly benefit wealthy nations. That’s according to Fifa Rahman, an adviser to Africa CDC’s negotiators, who was speaking during a webinar on 29 February.
The new text seems much closer to something that will put Africa on a strong footing for the next pandemic. There’s a hopeful detail, for example, in the section about the proposed Pathogen Access and Benefit-Sharing System (PABS). The PABS is supposed to be a monitoring tool because scientists worldwide will have a responsibility to share the genetic codes of new diseases they find that could lead to a pandemic. Nobody is allowed to patent genetic codes they get from the PABS, but the new text now also commits anyone who devises technology or medicine using the PABS to “benefit sharing” (albeit with some onerous caveats).
Still, the text is far from perfect and just one update remains before the May meeting in Geneva.
It’s crucial that Africa’s negotiators use what little time they have left to capitalise on the sudden, renewed political momentum.
For one thing, the draft text still has way too much wiggle room for pharmaceutical companies to repeat the hypocritical moves to which they’re so prone. Don’t forget that South Africa was charged double what the European Union paid for Johnson & Johnson’s (J&J) Covid vaccine.
The latest Pandemic Accord text might ensure access to tools designed using the PABS, but what about other innovations?
At the moment, the draft pact commits Big Pharma to publishing the patents for treatments, vaccines or diagnostics they come up with during a health emergency, but there’s still nothing obligating them to help others to understand how to turn a patent into a functioning, safe finished product.
In the parlance of the public health world, this is called “tech transfer”. The legal fraternity would call them trade secrets.
Without tech transfer, what manufacturers must do is akin to a novice baker having to make a complicated dessert with only a list of ingredients.
Early versions of the text fared better at ensuring access to this know-how, but it has disappeared completely.
Fortunately, legal experts have already come up with a plan.
Writing for Medicines Law & Policy, intellectual property expert Christopher Garrison argues that the solution is simple.
During a pandemic, or the threat of a pandemic, it should be possible for the WHO member states to force a pharmaceutical company to share ‘undisclosed information’ (trade secrets) if it’s deemed that it could be key in fighting a global health threat.
This would happen in two steps, Garrison argues. First, the government of the country in which the company is based must put pressure on it to share this know-how voluntarily. If this takes too long or doesn’t work, a backup process should kick in (if the pharma company is located in a WHO party state).
In this scenario, the company would be forced to share its secrets with qualified manufacturers around the world.
This is the kind of transparency we’ll need to ensure that future health crises have a different outcome to the one we just experienced.
In a welcome departure from the usual secrecy around such negotiations, the European Union published the deletions and additions it has proposed online.
We challenge other Global North nations to do the same. To the United Kingdom, the United States, Canada and others: if you’re going to support the companies who endanger global health security, at least be upfront about it.
All of these players — both Big Pharma and government — showed us that our African lives are worthless to them compared to the profiteering being offered by maintaining health injustice.
We must never let them forget it. We have to fight to ensure that any accord or agreement in our name is enforceable, does not rely on charity or pity, and is rooted in accountability not secrecy.
Tian Johnson (they/them) is the founder and strategist of the health advocacy nonprofit African Alliance. Click here to sign up for their newsletter.