Corona: give vaccine to poorer countries? Merkel’s dilemma

BAt the start of a UN meeting last week in Geneva, the Secretary General of the United Nations, António Guterres, was furious: Only ten countries worldwide had used 75 percent of the available vaccines against Covid-19 for themselves, he said. More than 130 countries have not yet received a single dose. This “completely unbalanced and unfair” distribution is a moral failure, according to the Portuguese.

Chancellor Angela Merkel (CDU) also spoke about the omissions a few days later. “This is a fundamental issue of justice,” she said. For Germany, this means that, in addition to the financial aid, it “if necessary” has to give some of the vaccines it has already ordered to poorer countries, said Merkel. To what extent and when this could happen has not yet been determined. However, she assured that “no vaccination appointment in Germany would be endangered”.

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The annoyance of Guterre’s and Merkel’s vague promise of help contrasts with an agreement that the international community of states had already reached ten months ago: 190 countries, including the Federal Republic, joined the Covax initiative in April 2020, supported by the World Health Organization (WHO) and supported by foundations and private companies. The goal: to top up a fund with five billion dollars, buy vaccines and distribute them in such a way that each participating state can vaccinate around 20 percent of its population by the end of 2021. The vulnerable groups and medical staff in particular should benefit from this. The motto is: “Nobody is safe until everyone is safe.”

Not much is left of the solidarity sworn at the time; so far not a single person has been vaccinated through the Covax program. However, this is not due to the money: just last week the G-7 countries agreed to replenish the fund. US President Joe Biden pledged four billion dollars, Chancellor Merkel a further 1.5 billion euros, and the EU doubled its contribution. The real problem is another one: the vaccine is missing.

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Richard Hatchett is CEO of the CEPI research alliance

Because the western states have already bought up the majority of the vaccine doses or contractually secured them. Many countries are under domestic political pressure to order a lot and quickly – even at the risk of not being able to use some of the cans later. The development organization ONE has calculated that the EU, the United Kingdom, the USA, Australia, Canada and Japan – if they give their entire population two doses – have ordered a total of over a billion vaccines more than necessary.

At Covax, the numbers are more manageable, at least as far as the already approved manufacturers are concerned. The British-Swedish company AstraZeneca has ordered 170 million vaccine doses so far. In addition, there are 100 million vaccine doses produced by the Indian manufacturer Serum Institute of India, with which AstraZeneca has signed a license agreement. At Biontech / Pfizer, the order is 40 million vaccine doses. The first Covax delivery of a vaccine came Wednesday to Ghana, which received 600,000 doses of the AstraZeneca compound; on the same day vaccines were also loaded in India as part of the initiative.

“The federal government has ordered significantly more vaccine doses than we need”

With reference to further agreements, the Covax initiators assert that they will be able to deliver 1.3 billion vaccine doses to 92 countries by the end of the year. Whether that will work and, above all, how quickly is open. ONE therefore calls on the federal government to promptly comply with its announcement that it will sell some of the vaccines. “The federal government has ordered significantly more vaccine doses than we need,” says Germany director Stephan Exo-Kreischer WELT. “As soon as risk groups and health workers have been vaccinated in this country, Germany should gradually give vaccination doses to poorer countries.” The federal government should not make the mistake of distributing them until a vaccination offer has been made to all Germans. “That would be far too late and would cost us more than most people suspect.”

In fact, experts point out that the western states also have a self-interest in distributing vaccines worldwide. On the one hand, there is a particularly high risk of virus mutations in countries with high numbers of infections. This was most recently seen in South Africa and Great Britain. So it is possible that some vaccines against future mutations will not work. “If we were virus-free, it would come back overnight by plane or with a pallet of goods,” warned Federal Development Minister Gerd Müller (CSU) weeks ago.

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Source: dpa; Infographic WORLD / Jörn Baumgarten

The second self-interest is likely to be of a geopolitical nature. China and Russia have already discovered so-called vaccination diplomacy for themselves and are trying to secure their influence in countries like Turkey and West African Guinea through free vaccinations. European countries such as Hungary and Serbia have also received the Sinopharm vaccine from Beijing. French President Emmanuel Macron recently warned: “If you just give the affected countries money, they will order the vaccines in China or Russia.”

But is it really realistic that Germany and other western countries will soon cede part of their secured vaccines? In view of the currently still prevailing delivery bottlenecks, this is initially unlikely for Germany. There are increasing calls for a different solution to production bottlenecks: through stronger technology transfer or the release of patents to other manufacturers.

As early as January, CSU leader Markus Söder and Greens leader Robert Habeck argued in this direction. They brought up an “emergency vaccine industry” that is supposed to increase production volumes. Federal Minister of Economics Peter Altmaier (CDU) makes it clear that compulsory licenses are “a last resort” for him if there is no voluntary cooperation. However, there are different views as to whether the currently existing collaborations are sufficient. Federal Health Minister Jens Spahn (CDU) emphasized on Wednesday in the Bundestag that productions were currently being set up worldwide through cooperation, for example in India. “Wherever there is cooperation, there is no need for compulsion,” said the CDU politician.

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The SPD’s expert on global health, Heike Baehrens, sees it quite differently. So far there has been no production expansion on a larger scale in the Global South, says Baehrens WELT. This shows that the current system is “not crisis-proof”. The WHO is working hard to bring different producers together in order to voluntarily promote cooperation, for example through the Covid-19 Technology Access Pool. “So far this has not worked well because there is obviously too little incentive for manufacturers to share their know-how widely. The same applies to voluntary licensing between companies, ”says Baehrens. Her conclusion: “Time is of the essence. If manufacturers do not use the voluntary licensing mechanism in a timely manner, the temporary transfer of patents and production knowledge must not be a taboo. ”

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In addition to the left-wing parliamentary group, she also receives support from the Greens MP Ottmar von Holtz, rapporteur for his group for global health. “If positive economic incentives – such as purchase guarantees staggered in the price – do not mean that the global vaccination plan of the WHO can be adhered to, the issuing of licenses remains mandatory,” said von Holtz WELT. The Infection Protection Act, which was amended at the end of 2020, provides the basis for this. According to this, the Federal Ministry of Health is authorized in the context of the epidemic situation of national scope to order “that an invention … should be used in the interests of public welfare”. Thus, the state could grant licenses to pharmaceutical companies for a limited period of time.

A large number of poorer countries should be happy about this. India and South Africa had already submitted an application to the World Trade Organization (WTO) to suspend patent rights in October. More than half of the WTO members as well as organizations such as Unesco, Doctors Without Borders and Amnesty International support the proposal. The USA, the EU, Great Britain and other countries still strictly reject this.

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