Biden Must Reject Trump's WTO Policy That Could Lead to "Vaccine Apartheid" in Global South

President-elect Joe Biden has repeatedly pledged that, in contrast to President Trump, his administration will act swiftly and effectively to curb the Covid-19 pandemic. But so far, the incoming president has said nothing about whether he will reverse a key Trump administration action at the World Trade Organization (WTO) that's cutting off vaccine access to poor, majority Black and Brown countries in the Global South. Biden's silence comes amid mounting warnings that rich countries -- including the United States -- are hoarding most of the global vaccine supply while poor countries are left behind, and many Global South nations may not start mass vaccinations until as late as 2024. The president-elect is mum on the WTO's role in enforcing this vast inequality, even though there is plenty his administration could do to rectify it.

In October 2020, India and South Africa proposed that the WTO suspend its enforcement of key intellectual property rules that relate to Covid-19 treatments, in order to allow the production of generic, cheaper versions of the vaccines and therefore expand access in poor countries. Backed by roughly 100 countries, the proposal states that pharmaceutical patents and copyrights must not "create barriers to the timely access to affordable medical products including vaccines and medicines."

Critics say the WTO's intellectual property rules will lead to thousands of deaths in poor countries, and deprive the global public of vaccines that were developed with considerable public funding.

Yet, under the Trump administration, the United States--a powerful player at the WTO--has blocked the proposed intellectual property waiver, along with the European Union, Britain, Norway, Switzerland, Japan and Canada. "We believe that facilitating incentives for innovation and competition to develop, test and produce safe and effective therapeutics and vaccines for the Covid-19 response, including by respecting intellectual property rights, will best achieve this objective," the Office of the U.S. Trade Representative said in November.

But critics say the WTO's intellectual property rules will lead to thousands of deaths in poor countries, and deprive the global public of vaccines that were developed with considerable public funding. (The WTO's intellectual property rules were initially shaped decades ago by U.S. pharmaceutical companies seeking to maximize their profits, and this same pharmaceutical industry has emerged as a virulent opponent of the intellectual property waiver.) As the humanitarian organization Doctors Without Borders noted in a November 2020statement, "Since the start of the pandemic, pharmaceutical corporations have maintained their standard practice of rigid control over intellectual property rights, while pursuing secretive and monopolistic commercial deals that exclude many middle- and low-income countries from benefitting."

Biden has so far said nothing publicly about the Trump administration's blockage of the proposal, and his transition team did not respond to a request for comment from In These Times. Biden's appointee for U.S. Trade Representative, Katherine Tai, also has not made public remarks about the WTO proposal.

Biden did make one relevant comment in a July 2020conversation with Ady Barkan, a healthcare activist. Barkan asked Biden, "If the U.S. discovers a vaccine first, will you commit to sharing that technology with other countries? And will you ensure there are no patents to stand in the way of other countries and companies mass-producing those life-saving vaccines?" Biden replied, "Absolutely, positively. This is the only humane thing in the world to do."

However, Peter Maybarduk, the director of Public Citizen's access to medicines and knowledge economy group, which counters the ill effects of high pharmaceutical prices, said it's too soon to know exactly what Biden meant by those remarks, which were issued before India and South Africa put forward their proposal at the WTO. "What he meant by that commitment we'll see," Maybarduk told In These Times. "It would be good to get more details about that."

The details are critical, advocates for global access to medicines say, because there is much Biden could do to reverse the Trump administration's actions at the WTO.

"It's entirely within Biden's power to reverse the blockage," Maybarduk underscored. "The U.S. government could have new positions. It could strongly support South Africa and India's proposal and help make it a reality. U.S. opposition is the single most significant barrier to making the intellectual property waiver a reality."

Achal Prabhala, coordinator of the accessibsa project, which aims to expand access to medicines, and a fellow of the Shuttleworth Foundation, agrees with this assessment. "The Biden administration can start with dropping their opposition to the India-South Africa proposal at the WTO to suspend pharmaceutical monopolies in the pandemic; that would be a great start," Prabhala told In These Times. "Obviously, this would help poor countries find a path out of the pandemic."

Biden's silence follows a wave of nationwide protests this summer, after the police killing of George Floyd ushered in heightened awareness of racism and white supremacy in the United States. Biden has pledged to combat "systemic racism," yet on an issue concerning racial inequality on a global scale, he's been entirely silent, proffering instead modest "reforms" entirely domestic in nature.

A New York Times piece from December 2020warns, "While many poor nations may be able to vaccinate at most 20% of their populations in 2021, some of the world's richest countries have reserved enough doses to immunize their own multiple times over." As poor countries await a vaccine, unable to do anything about the WTO's punitive restrictions, many thousands will no doubt die of the virus. Since 27 of the 28 poorest countries on earth are in sub-Saharan Africa, those who suffer will disproportionately be Black. (Within the United States, Black and Brown people account for a disproportionate share of Covid-19 deaths.)

While the Trump administration's blockage of the WTO proposal has not attracted widespread attention in Congress, some are speaking out. "If there is anything we must learn from this horrific pandemic, it is that we are all in this together," Sen. Bernie Sanders (I-Vt.) told In These Times via a spokesperson. "We have got to stand up to the pharmaceutical industry and say that during a global health emergency, people's lives are more important than patent monopolies and obscene profits. We cannot allow rich countries to buy up the vast majority of the world's vaccines, while most of the world, living in poorer countries, has to wait in line for years."

Sanders continued, "It is time to reclaim America's moral leadership by supporting the effort at the World Trade Organization to allow safe, effective, generic vaccines and treatments to be produced cheaply and immediately, and distributed as urgently as possible to all -- as a matter of justice."

In a December 2020blog post, Rep. Jan Schakowsky (D-Ill.) criticized U.S. Trade Representative Robert Lighthizer, nominated by Trump in 2017, for "carrying big pharma's water at meetings of the Trade-Related Aspects of Intellectual Property (TRIPS) Council at the World Trade Organization." TRIPS is the WTO agreement that determines intellectual property rules.

"This waiver would enable developing countries to help themselves deal with the pandemic. Without it, they might not have access to COVID-19 vaccines for years, until as late as 2024," Schakowsky continued. "For this reason, my colleagues -- Reps. Chuy Garcia, Angie Craig, Susan Davis, Lloyd Doggett, and Andy Levin -- and I will be filing an amendment to the next spending bill we see, to prevent Ambassador Lighthizer from continuing this wrongheaded approach."

A proposal from Schakowsky to prevent federal funds from being used to oppose the WTO waiver proposal ultimately did not make it into the final version of the Appropriations Act for 2021.

The blockage of the WTO proposal is notable because, in order to provide immediate relief, the United States would simply be required to stop its objections -- a relatively easy feat compared with other gargantuan public health challenges the United States is facing, including a domestic vaccine rollout that is progressing at a frustratingly slow pace.

But according to Public Citizen, the U.S. government could go beyond merely stopping the harm it's causing and take positive steps to expand vaccine access around the world. In a report released in December 2020, the corporate watchdog group argued, "President-Elect Biden should launch a new program focused on supplying the world with a coronavirus vaccine. The program should aim to make as much vaccine as possible, as quickly as possible." Under such a program, Public Citizen argues, Biden should commit to "sharing the know-how and intellectual property needed to produce a vaccine, so manufacturers around the world can quickly start ramping up production. He should also build additional manufacturing capacity."

Meanwhile, instead of blocking international efforts to free up intellectual property, the United States could actively support endeavors like the World Health Organization initiative "to create a pool for sharing Covid-19 technology," the report notes. So far, that initiative only has the endorsement of 40 countries.

Prabhala says "the Biden administration could exert pressure on pharmaceutical companies, especially vaccine manufacturers" to "open up licensing of their products in non-rich-country markets." He notes that "while the public funding of these pharmaceutical companies and their vaccines has come with almost no strings (as is legally permissible and even encouraged in the U.S.), it need not remain that way."

Similar calls have been issued by activists around the world, including within the United States. In an open letter to Biden published in November 2020, more than 100 public health, racial justice and labor leaders called on the president-elect to make the vaccine a "a global public good, freely and fairly available to all, prioritizing those most in need worldwide."

Activists say global vaccine equality isn't inevitable: It's a deliberate policy choice. But without drastic action, the Public Citizen report warns, "The sheer magnitude of disparity--with a few million people in rich countries protected, with billions left behind--could ultimately resemble a global vaccine apartheid."