[CTC] COVID-19 isn't over. How to help everyone, everywhere endure the next stage.

[Arthur Stamoulis]

See also this new global civil society letter: https://peoplesvaccine.org/wp-content/uploads/2022/12/PVA-Letter-to-WTO-DG-Dr-Ngozi-Okonjo-Iweala-1.pdf <https://peoplesvaccine.org/wp-content/uploads/2022/12/PVA-Letter-to-WTO-DG-Dr-Ngozi-Okonjo-Iweala-1.pdf>



https://www.usatoday.com/story/opinion/contributors/2022/12/15/covid-tests-treatments-paxlovid-wto/10891676002/
COVID-19 isn't over. How to help everyone, everywhere endure the next stage.
Hundreds of treatments are being developed, but unless governments urgently intervene, they also will remain out of reach for many people on earth.
Ángel GurríaOpinion contributor

After more than two years of disruption, many of us are looking forward to a normal holiday season this year. The threat posed by COVID-19 has not gone away, but we are entering a new phase of the pandemic, with new tools that can prevent severe illness. At this time of reflection, however, we must ask why these avenues remain the preserve of the richest.

Nearly 6 million Americans have been treated with Pfizer’s Paxlovid <https://khn.org/news/article/paxlovid-covid-sticker-shock-insurance/>, a medicine recommended by the World Health Organization <https://www.who.int/news/item/22-04-2022-who-recommends-highly-successful-covid-19-therapy-and-calls-for-wide-geographical-distribution-and-transparency-from-originator> to reduce the likelihood of hospitalization and death during a COVID-19 infection.

A study by the U.S. Department of Veterans Affairs has even suggested that Paxlovid could protect patients from developing long COVID <https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5837>.

For much of the world, however, treatments like Paxlovid might as well be a myth.

Only a quarter of Paxlovid gets to developing countries

Doctors in rural Haiti, Madagascar and Nigeria told researchers they had never heard of the medicine <https://itpcglobal.org/wp-content/uploads/2022/08/Mapping-Access-Gaps-in-COVID-19.pdf>. Only a quarter of all orders of Paxlovid <https://www.oxfam.org/en/press-releases/just-quarter-pfizers-covid-19-treatment-orders-will-go-developing-countries> will go to developing countries.

Opinions in your inbox:Get exclusive access to our columnists and the best of our columns every day <https://t.co/b5Eu1GKNOY?amp=1>
This is acutely felt in Latin America. Being middle-income economies, most Latin American countries have been excluded from deals to license generic versions of COVID-19 medicines. As such, they face paying 10 times the price of a generic equivalent, $250 instead of $25, clearly unfair, particularly given Latin America’s astounding pharmaceutical capacity. 

Developing countries have faced severe delays and, even when doses were available, a patient anywhere must test positive for COVID-19 before a medicine like Paxlovid can be prescribed. 

In the West, COVID-19 tests are readily available in most pharmacies, but for every 50 tests administered in a rich country, just one is administered in a lower-income country <https://www.who.int/publications/m/item/act-accelerator-facilitation-council-working-group-report-on-diagnostics-and-therapeutics>. 

These countries have already paid the highest price for this pandemic. After waiting far longer to receive vaccines, low-income countries have suffered four times more deaths <https://www.oxfam.org.uk/media/press-releases/covid-death-toll-four-times-higher-in-poorer-countries-than-rich-countries/> than rich countries, worsening the economic shock of the acute phase of this pandemic.

Unless we ensure everyone has access to tests and treatments, the global consequences of the next phase will be no less dire.

Long COVID keeping millions out of work, hurting economic recovery

We are only now beginning to understand the threat of long COVID-19. In the United States alone, it is keeping up to 4 million people out of work <https://www.brookings.edu/research/new-data-shows-long-covid-is-keeping-as-many-as-4-million-people-out-of-work/>, costing the economy trillions of dollars <https://www.webmd.com/lung/news/20220928/long-covid-could-cost-economy-trillions-experts>.

While we don’t yet know what impact it is having on developing countries, without access to treatments and tests, it will be devastating.

Hundreds of COVID-19 treatments are being developed <https://www.bio.org/policy/human-health/vaccines-biodefense/coronavirus/pipeline-tracker>, including more than 70 in late-stage clinical trials. These could be more effective for preventing conditions like long COVID.

Unless governments urgently intervene, they also will remain out of reach for most persons.

COVID questions at World Trade Organization

Earlier in the pandemic, President Joe Biden won international acclaim by supporting a waiver of the intellectual property rules <https://www.usatoday.com/story/opinion/2021/05/06/covid-vaccine-patents-biden-boosts-american-leadership-column/4932766001/> that prevent low- and middle-income countries from producing COVID-19 vaccines. He stood strong in the face of a determined lobbying effort from the U.S. pharmaceutical industry, declaring that the United States was back on the world stage.

International leaders:How we're building better, more equitable vaccine systems <https://www.usatoday.com/story/opinion/2022/08/16/vaccine-pandemic-who-global-production/10299280002/>
World Bank Group:We need to reverse the global learning crisis before it derails a generation of children <https://www.usatoday.com/story/opinion/2022/11/08/covid-learning-loss-children-global-crisis/10654250002/>
The deal ultimately reached at the World Trade Organization (WTO), however, was far more limited. Rather than waive intellectual property rules, it provided a new route for countries to produce COVID-19 vaccines <https://www.nytimes.com/2022/06/17/business/wto-covid-vaccine-patent.html> without a patent holder’s consent and with fewer export restrictions. This constituted a tweak to rules for producing generic medicines, rather than a radical departure from the status quo.

On June 17, WTO members pledged <https://docs.wto.org/dol2fe/Pages/SS/directdoc.aspx?filename=q:/WT/MIN22/W15R1.pdf&Open=True> they would reach a decision on all COVID-19 medicines, including tests and treatments, within six months. Thursday is supposed to be the final WTO meeting before the deadline. But, last week, the United States asked for more time <https://ustr.gov/about-us/policy-offices/press-office/press-releases/2022/december/us-support-extension-deadline-wto-trips-ministerial-decision-requests-usitc-investigation-provide-0>. 

Washington has had more than two years to consider the issue. A further delay will not benefit those facing the consequences of COVID-19.

Support the production of lifesaving generics

Bringing tests and treatments into this deal would give every country the tools to help their populations through the next phase of the pandemic. Treatments and tests are easier to store and administer than vaccines, particularly in countries with weaker health systems and storage facilities.

Moreover, unlike vaccines, patents are the only real barrier stopping many lower-income countries from producing cheaper generics.

My own country, Mexico, has not taken a clear position. The government initially advocated for a full intellectual property waiver <https://www.aljazeera.com/opinions/2022/6/14/global-health-is-on-its-deathbed-we-need-vaccine-waivers-now> for vaccines, tests and treatments, but then joined those who question <https://ipwatchdog.com/2022/11/04/mexico-switzerland-question-need-extension-covid-ip-waiver/id=152544/> the need for action on the latter and reportedly called for a “compromise <https://healthpolicy-watch.news/how-do-you-spell-deadlock-t-r-i-p-s/>” that would limit a deal to certain products.

Washington can seriously influence political dynamics at the WTO. The support of the United States and Mexico, two key players of the Americas, will embolden other neighboring countries to support the production of lifesaving generics across the region.

Bringing treatments and tests into the WTO’s deal would not be a radical departure from the status quo. It is, however, a small tweak that could save countless lives and a major step in ensuring that everyone, everywhere can endure the next stage of the COVID-19 pandemic.

This could positively impact and fuel the global economic recovery – a remarkable Christmas gift to the world.


Ángel Gurría <https://www.oecd.org/about/secretary-general/former-oecd-secretary-general-angel-gurria-cv.htm>, secretary-general of the Organization for Economic Cooperation and Development from 2006 until 2021, served in the government of Mexico as minister of Foreign Affairs and minister of Finance and Public Credit. He is an honorary member of Club de Madrid <https://clubmadrid.org/>. Follow him on Twitter: @A_Gurria <https://twitter.com/A_Gurria>



Arthur Stamoulis
Citizens Trade Campaign
(202) 494-8826




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