During the COVID-19 pandemic, the world\u2019s 20 largest pharmaceutical companies spent nearly as much enriching shareholders as they did on research and development<\/a>.<\/p>\n\n\n\n Industry giants Amgen and Novo Nordisk paid shareholder dividends that were double their R&D spending, while Novartis and AbbVie directed over $10 billion more to shareholders than to research.<\/p>\n\n\n\n As the virus swept the globe, exposing deep inequities in access to pandemic countermeasures, Global South nations struggled to secure life-saving vaccines and treatments, as high-income countries hoarded supplies, imposed export controls, and bought up most available stock. With time, we would learn that vaccine hoarding alone is estimated to have claimed over 1.3 million lives<\/a>, with a disproportionate impact in low- and middle-income countries<\/a> (LMICs).<\/p>\n\n\n\n Despite substantial shareholder payouts that exceeded many of its R&D budgets, the pharmaceutical lobby was hard at work to undermine global proposals aimed at promoting greater access to vaccines, therapeutics, and diagnostics in the Global South. Armed with the contested premise that such efforts would \u201cstifle innovation,\u201d the industry lobbied<\/a> extensively<\/a> against a waiver on Trade-Related Aspects of Intellectual Property Rights (TRIPS) that would have temporarily suspended World Trade Organization (WTO) intellectual property restrictions on life-saving products.<\/p>\n\n\n\n The waiver, as originally proposed by India and South Africa in October 2020<\/a>, sought to temporarily suspend specific provisions of the WTO TRIPS agreement to ensure that WTO intellectual property rules did not create barriers for timely access to countermeasures to combat the pandemic. This proposal, if adopted, would have supported efforts to broaden production and address global supply gaps in vaccines, diagnostics, and treatments until widespread vaccination became available. While the waiver by itself would not have been a complete solution to the issue of access, it would have made a meaningful contribution by removing trade barriers to critical countermeasures during the worst health emergency in over a hundred years. It would have also signaled essential global cooperation in the fight against the hoarding of pandemic-related health products, and what has been called as the vaccine apartheid.<\/p>\n\n\n\n Despite support by nearly 100 developing nations, and more than 170 former heads of government and Nobel laureates<\/a>, the waiver faced significant opposition from some wealthy nations. Subject to intense lobbying efforts by the pharmaceutical industry, many high-income countries \u2013 including the UK, members of the EU, and initially the United States \u2013 sought to delay the proposal through stalling tactics stretching over an astounding 18 months, until the waiver was dead in the water. All of this occurring during a critical period of the worst global health crisis in recent memory, when swift action on all fronts was vital to addressing inequities and saving lives.<\/p>\n\n\n\n New Public Citizen research<\/a>\u00a0shows that, in the US alone, corporations, trade groups, and other organizations deployed more than 500 lobbyists during the COVID-19 emergency to shape the US government\u2019s global position on intellectual property, with nearly 90 percent of these lobbyists opposing the TRIPS waiver.<\/em><\/p>\n\n\n\n In Europe, where a substantial portion of many nations’ economies comes from the pharmaceutical industry, the Corporate Europe Observatory revealed<\/a> that, as of 2021, over 40 pharmaceutical companies reported spending an estimated \u20ac25.3 million annually on lobbying while deploying 290 lobbyists to influence EU policies. A spokesperson from Janssen, the pharmaceutical research and development subsidiary that developed Johnson & Johnson\u2019s single-shot vaccine, went even further by allegedly threatening the Belgian Prime Minister\u2019s office that the company would reconsider their investments in the country if Belgium backed the waiver<\/a>.<\/p>\n\n\n\n (Also see: A STOP AIDS report based on investigations in Europe: Access Denied \u2013 What happens when Big Pharma is in the driving seat<\/a>)<\/em><\/p>\n\n\n\n While the US would shift its stance<\/a> and eventually support a narrow waiver limited only to vaccines, adopted through the WTO\u2019s Ministerial Decision on June 17, 2022<\/a>, Big Pharma\u2019s efforts had already paid off as the implementation of any<\/em> waiver was significantly delayed and its scope substantially narrowed.<\/p>\n<\/blockquote>\n<\/blockquote>\n<\/blockquote>\n\n\n\n Despite being rebooted in Geneva this past September, negotiations have not broken through critical disagreements that exist along the North-South divide on how to address critical areas for equity, including the proposed Pathogen Access and Benefits Sharing System (PABS), \u00a0and provisions on the transfer of technology and know-how for the production of pandemic-related health products. High-income countries\u00a0continue to oppose meaningful advances on PABS<\/a>\u00a0and to push for binding provisions that would define\u00a0technology transfer<\/em>\u00a0in terms of \u201cvoluntary\u201d and \u201cmutually agreed terms\u201d \u2013\u00a0a preferred industry position<\/a>\u00a0that is being defended strongly by mostly developed countries, and other Geneva-based actors.<\/p>\n\n\n\n Even though many wealthy nations have at their disposal broad legal and regulatory tools to compel the industry to share technology and know-how through non-voluntary means, the hypocrisy of fighting for language that could deter LMICs from doing the same, cannot be overstated. Furthermore, some of these rich countries also oppose the inclusion of a \u00abpeace clause\u00bb that would reaffirm a collective commitment by signatories to refrain from \u00abany direct or indirect pressure\u00bb to discourage the use of TRIPS and other flexibilities under Article 9 \u2013 a provision related to research and development.<\/p>\n\n\n\n Considering the complexities of these global negotiations among countries with vastly different capabilities and circumstances, it is easy to lose sight of the damaging influence the pharmaceutical lobby has had on the process. However, the fundamental issue standing in the way of the grand bargain that can prevent deadly outbreaks and make available medical tools to fight them, is whether wealthy nations are prepared to break steps with the pharmaceutical industry and say \u201cno\u201d to insatiable greed and corporate interests.<\/p>\n\n\n\n Drugmakers and other actors, have a financial interest in keeping medical tools and knowledge proprietary, only sharing these strictly on their own terms\u2014even during global catastrophes\u2014and they are doing all they can to protect their ability to profit without being burdened by concerns over equity.<\/p>\n\n\n\n A blow-by-blow account of the highly political and contentious negotiations around the TRIPS Waiver proposal at the World Trade Organization (WTO) between October 2020 and March 2024. <\/em><\/p>\n\n\n\n The protracted, but unsuccessful negotiations show how the WTO failed in addressing the challenges of COVID-19 that resulted in more than 15 million associated deaths due to the pandemic. So while the \u201cTRIPS Waiver\u201d failed to become a trade policy option at the WTO in the context of health emergencies, it undoubtedly reset the debate on the role of IP in global health.<\/em><\/p>\n\n\n\n This newly updated book is a compilation of nearly 70 stories that chronicle these negotiations between 2020-2024 published in the Geneva Health Files during this period.<\/em><\/p>\n\n\n\n\n
\n
\n
II. GHF PUBLICATION: SEPTEMBER 2024<\/h1>\n\n\n\n
![\"\"\/](\"https:\/\/substackcdn.com\/image\/fetch\/f_auto,q_auto:good,fl_progressive:steep\/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F20ff3ea2-73a6-40f8-bb39-be474416210c_4000x2667.png\")
<\/figure>\n\n\n\n