In a breakthrough for global health, the Biden administration on Wednesday announced it would support an international waiver of intellectual property law for Covid-19 vaccines, medications, and medical supplies during the pandemic. In other words: Countries in dire need of the vaccines or therapeutics currently being given to Americans would be able to copy them without fear of being sued. International officials and activists applauded the decision as a necessary move to end the global spread of Covid-19—one that could set a precedent for future health crises.
But freeing vaccine patents is just the first step. Next, companies need to share how to make the vaccines—known as technology transfer—and governments need to provide the resources, from raw materials to production capacity, to ramp up global vaccine production in a matter of weeks instead of years.
“Saying ‘I won’t sue you’ is not the same as saying, ‘Here’s the recipe for this technology,’” Dr. Matthew M. Kavanagh, assistant professor of global health at Georgetown University, told me. “We need a technology transfer so that we teach companies how to make their drugs, and then we need an infusion of money to build these new technology lines. And if we see all three of those things, it is entirely feasible to see production of vaccines within months instead of years.”
The companies that make Covid vaccines have already voluntarily entered into deals like these with certain companies. But Biden could compel them to strike more deals—and, crucially, enable these new companies to set prices and distributions on their own, rather than having Moderna or Pfizer call all of the shots. And the U.S. government could offer funding, like the billions already appropriated for manufacturing in the American Rescue Plan, to retrofit factories to start producing the vaccines. Such moves could massively expand the vaccine supply for years to come. They would also be a crucial step in getting the world ready for boosters and updated vaccines that might be needed as new variants evolve.
“With the new variants that we’re seeing, it’s even clearer that we need to have basically a major D-Day kind of effort to increase vaccine manufacturing globally, or we’re all going to be vulnerable to new variants, whether we’ve been vaccinated or not,” Brook Baker, a professor focusing on intellectual property and access to medicine at Northeastern University School of Law, recently said when I asked him about what measures Biden could take to fight the pandemic at a global level.
The United States has already dragged its feet quite a bit on this topic. Ambassador Katherine Tai, the U.S. trade representative, announced support for the waiver this week during a meeting of the World Trade Organization’s General Council, its highest decision-making body. But South Africa and India first introduced the Trade-Related Aspects of Intellectual Property Rights, or TRIPS, waiver, which would allow international companies and organizations to produce vaccines legally without patent infringement, in October. More than 100 countries have since voiced agreement or signed on as co-sponsors.
The announcement doesn’t mean this is a done deal: The U.S. will support a text-based negotiation on the waiver, which could involve significant changes to water down the initial proposal, and at any point, any country could halt the process. But the U.S. voicing support could go a long way toward persuading notable holdouts like the European Union and the United Kingdom.
The importance of wholesale technology transfer, rather than piecemeal relaxations of intellectual property law, is amply illustrated by one of the vaccine companies’ actions already. Moderna promised back in October not to enforce its patents during the pandemic. But that “got us nowhere at all,” Kavanagh said. Each mRNA vaccine uses more than 100 different patents, owned by a variety of companies, research institutions, and individuals. Moderna might not have enforced the patents it owns, but it can’t free the others upon which the vaccine relies. And it was unclear how long Moderna’s free-for-all would last and when it might start taking action against intellectual property infringement again.
“Nobody in their right mind is going to set up a whole factory with the threat of a patent fight hanging over their head,” Kavanagh said. If the U.S. makes good on Wednesday’s announcement, throwing support behind a complete waiver, “governments can say to companies, and even to themselves, ‘Go ahead, make the vaccines, we’re good to go, for the period of this pandemic, everything is covered,’” Kavanagh said.
But that’s only the first step. It could take months for companies to reverse-engineer the vaccines and understand how they’re made—and then months more to produce them. The major vaccine companies should, instead, share these processes with other manufacturers right now, in order to have vaccines produced as soon as three to six months from now, Kavanagh said.
Moderna and Pfizer stock fell in response to Wednesday’s news. But they could still make money on technology transfer agreements. In these agreements, they’d get paid with every contract. Even in compulsory licensing agreements—where, say, a government forces one company to help another manufacture its vaccines—the original company is paid royalties.
And much of the work on the vaccines was financed by billions in U.S. taxpayer dollars, anyway. “Publicly funded research in the middle of a pandemic should be immediately shared as widely as possible to reach as many people as possible so that production can happen around the world to end the pandemic,” Kavanagh said.
As an accompaniment to throwing support behind patent waivers, the U.S. could send supplies to other nations instead of hoarding them for additional doses we don’t need. The government could also help existing facilities transition to Covid vaccine production. One of the objections to patent waivers, Kavanagh said, has been that “there’s no unused production capacity in the world to make mRNA vaccines, and that is entirely true. But a year ago, no company in the world had made an mRNA vaccine at scale. We are going to have to see a real investment of money and effort into saying let’s build new productive capacity.”
After all, the U.S. and the world will need long-term production of these vaccines—whether for routine childhood Covid-19 immunizations or for boosters. The facilities that can be repurposed around the world should be repurposed, Baker said, including those in low- and middle-income countries. “There should be regional vaccine hubs in all regions of the world so that people aren’t dependent on just one place of a vaccine manufacturer or one supplier of key ingredients and components.”
In the meantime, while these negotiations are being hammered out, governments should donate existing or upcoming doses to the people who need it the most. “That is absolutely a key and critical thing that could be done,” Kavanagh said. Such actions would help halt the record-setting rise in infections that we are now seeing around the world, which experts worry are fueling the rise of new variants.
In the longer term, these actions could set a precedent for global action—both during this pandemic and in future health crises. “The fact that we are, even months into the pandemic, debating the TRIPS waiver still is, I think, a failure of global health coverage. This should have been a no-brainer,” Kavanagh said. “That would set a clear precedent for the future about what good responses to pandemics look like through the immediate and unquestioned sharing of technology, which can be transformative.” Over and over, scientists and experts are saying the same thing about the global fight against Covid-19: No one is safe until we all are.