The controversy surrounding the outbreak of COVID 19, the devastation it has wreaked on world economies and populations, and the speed with which a vaccine has been discovered have raised more questions than answers. Some commentators have indicated that after a hundred years of research into cancer, no vaccine has been found; 40 years after the outbreak of HIV/AIDS, no vaccine has been found – yet one year after the outbreak of COVID-19 a vaccine has been found. These commentators argue that the issues around COVID-19 and the development of a vaccine in record time is more of a conspiracy than a mere pandemic.
Prior to outbreak of the pandemic, news was awash that very soon people across the world would need to take a certain vaccine before travelling to western countries. The question is: which individuals or global corporations are the brains behind the virus’ outbreak, and who stands to benefit from a global vaccination programme?
Debate about the production of a vaccine for global vaccination brings to mind the top multinational pharmaceutical companies – Pfizer, Roche, Novartis, Merck & Co., Bayer, Allergan, GlaxoSmithKline, Sanofi, AbbVie and AstraZeneca, CSL, Takeda, Biogen, Johnson and Johnson among others. Statistics indicate that the pharmaceutical industry altogether has experienced significant growth during the past two decades, and pharma revenues worldwide totalled US$1.25trillion in 2019 – and still growing.
Indubitably, the arrival of safe and effective COVID-19 vaccines is a major development to combat the coronavirus pandemic. An effective COVID-19 vaccine will help protect people, especially populations of poor countries, who contract the various. As more people are vaccinated, families and communities will be able to gradually return to a normal routine. In Ghana, the arrival of 500,000 vaccines and the targetted vaccination of categories of people at risk – especially frontline health workers – has helped in reducing the daily infection rate.
Cost of production
One of the key issues surrounding the COVID-19 vaccine is the cost of production and distribution. The daunting challenge of cost and distribution is accompanied by questions such as who will pay for these. One of the vaccines that has shown success so far was developed by researchers at the University of Oxford and the pharmaceutical giant AstraZeneca in Cambridge, UK. News reports suggest that this vaccine can be stored in a normal refrigerator, which makes rapid distribution more feasible than would be the case for vaccines developed by AstraZaneca’s competitors. Ghana is one of the first beneficiaries of the AstraZaneca vaccine.
Importantly, AstraZeneca and Oxford have also pledged to provide their vaccine at cost-price to all poor during the pandemic phase. A cost analysis of various vaccines indicates that the Oxford-AstraZeneca vaccine at US$3 per dose is the lowest and comparatively cheaper than other vaccines.
The firm has also promised to maintain this price for low- and middle-income countries after the pandemic, when a vaccine will still be needed in case of future outbreaks. Also, the Johnson & Johnson vaccine is the second-cheapest – costing US$8.50 for each dose – compared other brands.
It is refreshing to note that both AstraZeneca and Johnson & Johnson have committed to not focusing on profiting from the pandemic. AstraZeneca’s, and perhaps Johnson and Johnson’s, commitment to lower the cost of production has not gone down well with competitors who have their eyes on the profit margin from a global pandemic.
Health as a human right
The right of everyone to have the highest level of attainable standard of human health is a foundation of the United Nations Declaration on Human Rights (UNDHR) and the African Charter of People and Human Rights. Article 25 UNDHR promotes the human right to health. It states: “Everyone has the right to a standard of living adequate for the health and wellbeing of him or her and of his/her family…including medical care (UNDHR 1948). Honestly, though this declaration was made with a moral imperative, other problems can and do divert national and international effort away from achieving this health objective. This is described as the law of unintended consequences.
That said, there is a correlation between health as a human right and the corporate social responsibility (CSR) of companies, especially multi-national pharmaceutical corporations. CSR in this context means a corporation, in the case of the pharmaceutical companies, using their assets, patents etc. for the benefit for mankind. Companies are expected to make this commitment, knowing that they will not make a profit and may even make a loss. As stated above, AstraZeneca and Johnson and Johnson’s commitment to reduce the cost of production for COVID 19 vaccines is in tandem with the letter and spirit of the UNDHR.
Access to medicines
A potential conflict between multinational pharmaceutical companies and developing countries could emanate from the laws on Intellectual Property Rights (IPRs). IPRs are driven by power-relations between corporations and poor countries. These power-relations are particularly serious in the field of healthcare. Evidence suggests that approximately 90 percent of medical research is directed toward disease affecting only 10 percent of the world’s population. According to a report by the Global Forum for Health Research (GFHR) malaria, pneumonia, diarrhea, and tuberculosis constitute close to 21 percent of the global disease burden, yet they receive 0.3 percent of all public and private spending on health research.
Thus, the pharmaceutical industry’s business trend has been investing in medicines with a large market and high prices, and less investment into diseases with a low return on investment. One cause of tension in the interface between human rights to health and intellectual property is applying IPRs, which are private rights to the provision of medicines that may be private goods but have public-good consequences.
Regarding the production of vaccines for COVID-19, human rights concepts must shape the use of intellectual property rights. The notion is that while human rights laws derive from the tradition of natural law, intellectual property rights were developed by western governments solely for the purpose of profitability. Of course, it makes sense for multinational pharmaceutical corporations to make profits from research and development, yet attention should be paid to the right to health against the right to own and protect patents.
While some human rights – such as the right to health – are absolute and unqualified, the right to health is qualified by other articles that consider the rights of others. Article 27 of the UDHR states: “Everyone has the right to protection of their moral and material interests resulting from any scientific, literary or artistic production of which he/she is the author”.
However, when humanity is under threat by a pandemic such as COVID-19, individual and corporate rights must be surrendered for the common good. A way out is what’s known as an ‘intellectual property bargain’. The intellectual property bargain indicates that though pharmaceutical companies have the right to protect their patents, they are equally under international obligation to share information and the benefits of their scientific discoveries with society. Expression of the need to balance the right to health against intellectual property rights has been captured in instruments like the International Covenant on Economic, Social and Cultural Rights (ICESCR).
TRIPS and CSR
In 1994 the Trade Related Aspects of Intellectual Property Rights (TRIPS) made it mandatory for all WHO members, including poor countries, to take steps to protect patents for pharmaceutical products. The interest groups at the forefront for TRIPs were multinational pharmaceutical corporations, insisting on protection from competition by producers of generic drugs. However, in the human rights context, the global pharmaceutical corporations do have obligations to both shareholders and stakeholders. Much as the corporations have the responsibility to make profit for their shareholders, they have an equal obligation to respond to societal needs like COVID-19. This response is in tandem with the principles of corporate social responsibility (CSR).
The original argument by Milton Friedman (1984) that businesses should have no responsibility, other than making profit has been subjected to several critiques. In his article ‘The CSR of business is to increase profit’, Friedman described CSR as prose – and wondered why businesses should have responsibilities in a free-market setting. However, his arguments have been debunked by development of the ‘stakeholder theory’ and the concept of social responsibility.
CSR has become an increasingly important element in business and corporate communications strategy, which has redefined the organisational focus on stakeholder-corporate relationship. In many contexts, CSR has become a response to external pressure from citizens, customers and potential customers, investors and NGOs. Corporations are now viewing CSR as a powerful tool in terms of enhancing an organisation’s legitimacy, promoting good public relations, as well as widening access to market.
Therefore, AstraZeneca and Johnson and Johnson’s decision to ensure affordable rates for the COVID-19 vaccine has long-term rewards in terms of market access and corporate branding. To be judged globally for adhering to the UNDHR principles is a good business strategy adopted by AstraZeneca and Johnson and Johnson. This is not the time for any pharmaceutical company to be driven by the profit motive alone; rather, humanitarianism should underlie the search for an affordable universal vaccine for all.
Over time, many stakeholders have used commitment to human rights in assessing the performance and responsiveness of pharmaceutical companies in relation to society. Consequently, there are increasing examples of the way human rights concepts are influencing policies of pharmaceutical companies regarding the use of patents. Studies have shown an increasing collaboration between the public and private sector in the production of infant medicines and vaccines.
In short, Public Private Partnerships (PPPs) have emerged as the best mediation between intellectual property rights and the right to health. Also, PPPs have been known to provide an alternative model for research and development, and proven to have the potential to close the gap between demand and supply of drugs and vaccines like COVID-19.
Perhaps without PPPs it would be difficult for pharmaceutical companies like AstraZeneca and Johnson and Johnson to promote their moral responsibility to poor countries like Ghana. Also, this is the time for multibillion-dollar global philanthropic foundations to support pharmaceutical companies to supply COVID-19 vaccines at lower cost for poor countries. All said, AstraZeneca needs to be recognised for its commitment to support poor countries like Ghana in combatting COVID-19.
(***The writer is a Development and Communications Management Specialist and Social Justice Advocate. All views expressed in this article are my personal views and do not represent those of any organisation(s). (Email: [email protected]. Mobile: 0202642504/0243327586