Grace Fors (Socialist Alternative, US)

The U.S. is approaching “back to normal.” Millions are vaccinated, the CDC nixed its mask guidelines, and states everywhere are eagerly lifting restrictions in time for summer.

But globally, COVID-19 is exploding. Entire regions are wracked with new outbreaks. The disaster in India has spread throughout South Asia, and Brazil’s COVID crisis is mirrored in Argentina, Paraguay, and Colombia all reporting their highest daily deaths in recent weeks. Subsaharan Africa, far from being less impacted by the pandemic as mainstream media has reported, is revealing itself to be a hotbed of undiagnosed transmission. These regions facing the worst outbreaks are expected to wait the longest to access COVID vaccines.

At the time of writing, one billion vaccine doses have been administered, with over half going to three countries, while low-income countries have received just 0.2 percent. Twelve countries have yet to give a single shot, and it could be 2023 or later before vaccines are available to the general population.

While rich countries congratulate themselves for taking real steps toward herd immunity, it will all be for nothing if the virus mutates and spreads. The highly contagious and potentially vaccine-resistant B.1.617 variant first found in India has already spread to 53 territories.

The unfolding chaos exposes not only a callous disregard for human lives in the Global South, but also deeper problems with capitalism. From neoliberal patent laws, to vaccine nationalism, to severe global inequality, every aspect of our current system is deeply inadequate to address the crises of the 21st century.

“Trickle-down” vaccination

As soon as vaccines hit the market, western capitalist powers like the U.S., Canada, and the EU had already snatched up 96 percent of Pfizer doses and all Moderna doses. Many bought enough to vaccinate their populations multiple times. Bilateral deals with governments doling out billions to pharmaceutical companies to speed up development in exchange for priority access meant that even those with the money to bet on a vaccine were told there weren’t any left to buy.

A Duke University study warned, unless wealthy countries dramatically change their approach, most people in poor countries won’t have access to a vaccine until 2024.

COVAX, the United Nations program backed by the Gates Foundation, was established to try to correct this. Aside from providing cheaper vaccines less effective against variants, COVAX is flailing from lack of buy-in, and so far has only delivered a fifth of the doses it aimed for. Meanwhile India, a major COVAX supplier, has had to limit vaccine exports due to the mass death within its own borders.

Neoliberalism and the Dominance of Intellectual Property

Debates globally about what to do next have revolved around something called the “TRIPS waiver.” This refers to India and South Africa’s appeal to the World Trade Organization (WTO) to lift patent restrictions for treatments related to COVID-19, and allow countries to produce generic versions of the vaccines. As it stands now, only the companies who own the patent can legally produce or distribute these crucial treatments until the patent expires, typically 20 years. The WTO operates on consensus, so any one country can block the waiver. Since its proposal in October it has been blocked over and over again by the same wealthy countries that have hoarded vaccines and are home to the biggest pharmaceutical companies.

In a rational world, advancements created by society would serve society. The World Trade Organization has historically worked to ensure that doesn’t happen.

The WTO worked side-by-side with megacorporations like Pfizer to solidify enforcement of patent laws worldwide. The TRIPS agreement codified the “right” of capitalists to reap exclusive profits off their patented goods. Passed in the heat of the AIDS crisis, TRIPS played a key role in African countries waiting ten years to receive treatments that could have prevented tens of thousands of deaths. Meanwhile, neoliberal globalization dramatically increased the inequality between rich and poor countries, starved public health systems, and handed the multinationals dictatorial control over world trade.

The WTO’s role has resulted in the situation now where life-saving treatments are caught in a labyrinth of copyrights and trade secret laws. Even the lipid shells of mRNA molecules are subject to a web of licensing deals held by several companies.

TRIPS is meant to ensure monopolized profit for companies as well as the ability to sell their goods to the highest bidder. AstraZeneca can charge South Africa $5.25 per dose to the EU’s $2.15. Israel, while denying responsibility to vaccinate Palestinians, can pay Pfizer $23.50 per dose for advance shipments, and sweeten the deal by handing over citizens’ health data.

Ultimately, the debate over TRIPS reflects a fundamental crisis of the neoliberal world order. With so much of modern capitalism and global trade relying on hoarded intellectual property, winning equal access to medicines will require a dramatic restructuring of the economic system. The social basis for neoliberalism is eroding as well, demonstrated by the struggle that gained steam globally demanding the WTO lift the vaccine patent restrictions.

Biden and the Global Ruling Class

Until his recent reversal on the TRIPS waiver, Biden had been largely carrying forward Trump’s “America First” approach to vaccination. This nationalism has been the overarching strategy of most rich countries who are eager to vaccinate their populations, prop up demand, and get business revving again.

However, several factors have forced Biden to adapt his tactics. One is China and Russia’s “vaccine diplomacy,” sending doses to other countries with strings attached. In spite of his loyalty to Big Pharma — who spent $13 million on his presidential run and $92 million in DC lobbying in the first three months of 2021 — Biden is nevertheless hard-pressed to combat China’s influence on the global stage. This will take the form of courting other countries to ‘side’ with the U.S. by using vaccine provision as a geopolitical chess piece.

Public pressure like Kshama Sawant’s resolution to the Seattle City Council that was replicated in cities across the country, played a critical role in forcing his hand. While Biden’s move puts pressure on remaining holdouts like Angela Merkel and Justin Trudeau, much more is needed: mass mobilizations throughout the EU and Canada will be necessary to demand that leaders move to suspend patents and put real resources into distributing doses to the Global South.

Additionally, the more far-sighted sections of the capitalist class are seeing the threat to global capitalism posed by the pandemic, especially the devastating outbreaks in BRIC countries India and Brazil. There is fear about the global implications of economic collapse in various regions, and concern about repayment of predatory debts held by U.S. banks and corporations. Indeed, the International Chamber of Commerce estimates that wealthy countries failing to invest in vaccinating poor countries would cost the global economy $9.2 trillion.

We need a real plan to take on the task of vaccinating the world: the Battle Royale between the wealthiest countries will only make things worse.

Big Pharma calling the shots

Between the AIDS epidemic, the opioid crisis, and COVID-19, the deaths caused by Big Pharma are likely in the hundreds of thousands.

While Biden and the ruling class look to pharma companies as the cure to the pandemic, they are the biggest thing standing in the way of ending it. Pfizer’s vaccine is the most promising against the worst effects of variants, and yet just .002 percent of its vaccines have gone to COVAX.

Pharma companies’ purpose is not to produce medicines or save lives, but to generate profit. Pfizer raked in an estimated $900 million in profits in the first quarter of 2021, and Moderna, $12 million. Recently, AstraZeneca’s CEO raised his pay to $25 million per year, causing outcry among wealthy investors itching for their share of the goods. Pharma companies are snagging contracts with wealthy countries as far ahead as 2024, and most have stated their intention to renegotiate prices upward. While the virus mutates, spreads, and kills thousands daily, Pharma CEOs are salivating at the prospect of continuing to cash in on treating new variants.

Pressure to waive the vaccine patents has brought to light Pharma’s murderous incentives. Unfortunately for the millions across the world gasping for air in hospital beds, according to wealthy Pharma investors, intellectual property is “oxygen to the industry.” They argue that profits are the only thing making the development of treatments possible, and that they’ll only research and produce future treatments if they can pay back their shareholders. Aside from their appalling lack of concern for human lives, we know this isn’t true. Government grants, and lab workers with modest pay are what really made the vaccines possible.

Big Pharma is out of control, and we can’t control what we do not own. Taking all of Big Pharma into democratic public ownership is the only way we can ensure that billions in revenue are used to send vaccines where they’re needed along with staff to facilitate technology transfers, not paid out to shareholders or eaten up by the stock market casino.

What’s next in solving the pandemic?

Even if the WTO lifts the patents, experts say the earliest the world could see additional vaccine capacity would be in 2022. Why?

To produce generic vaccines, governments would need to train staff, acquire raw materials in short supply, and retool factories for complex manufacturing — which could potentially go wrong. These obstacles to manufacturing capacity, cynically used by racketeers like Bill Gates to argue against lifting patents, in reality show why all information on vaccine production must be in the public domain. The vast financial resources that allowed wealthy countries to buy up vaccines must be used to invest in manufacturing infrastructure and skills needed to produce billions of doses worldwide.

Several other hurdles remain. Not all vaccines are made equal, and this is not lost on ordinary people across Africa held back by vaccine hesitancy. Public confusion and haphazard rollout have made administration of COVAX doses an uphill battle. Nigeria, the most populous nation in Africa, is struggling to get its 3.92 million doses into arms. The Democratic Republic of Congo had to return 1.3 million AstraZeneca doses from COVAX after news of rare blood clots, which caused several European countries to suspend its use, raised concerns.

There is justified anger and suspicion at being offered subpar vaccines compared to those available in wealthy countries. Sixty percent of people polled across five African countries said they were unlikely to try to get a vaccine. Additional investment in public education and outreach is needed, alongside public ownership of pharmaceuticals that would allow the creation of a People’s Vaccine untainted by the legitimate distrust of Big Pharma. This is especially important as it becomes increasingly likely that vaccines will be a long-term need for the global population.

The world needs more than just vaccines. In countries with raging outbreaks, vaccinating a small portion of the population is not enough. Rapid containment is needed along with contact tracing and lockdowns, which will require massive aid from rich countries and forgiveness of sovereign debt to stave off poverty and austerity resulting from lockdowns, as happened in Colombia.

This is all to say nothing of the impact of existing wars and atrocities in exacerbating the pandemic. Gaza, already deprived of vaccines by the Israeli regime, saw its only COVID-19 testing center blasted by Israeli airstrikes, and shipments of doses and critical supplies like ventilators are held up by blockades. Countries like Syria and Yemen, where hospitals have been bombed relentlessly over a period of years, have little resources to administer vaccines.

When it comes to increasing the global vaccine supply, the biggest concrete obstacle is a lack of critical raw materials. Vaccine makers are struggling to acquire filters and plastic bags used in manufacturing, and a grave oxygen shortage. Capitalism will distribute these on the basis of a market, selling to the highest bidder whether they need it or not. Decisions on how best to use these resources should not be left to profit-hungry corporations, but decided democratically in the interests of people worldwide against the pandemic.

Despite the obstacles in our path, there is a solution to the crisis. It just can’t be accomplished on the terms of Big Pharma and the WTO. Only on the basis of a dramatic overhaul of the current profit-driven system can we invest society’s resources in what working people need. The working class has the ability to streamline supply chains, upgrade public health infrastructure worldwide, and ramp up manufacturing to meet demand, and end the harmful environmental practices that lead to pandemics.

Now more than ever, global public health means a world without war, climate destruction, and profiteering. The alternative is a bleak future of permanent pandemic and spiraling inequality.

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