From the series The struggle against coronavirus
According to the British analyst firm Airfinity, some 9.5 billion doses of Covid-19 vaccines will be produced worldwide in 2021. This number is double the annual production of all types of vaccines in the pre-pandemic era (5 billion, excluding oral polio, travellers’ and military vaccines), and can be compared with the requirement of 11.5 billion to immunise two-thirds of the world’s population [Airfinity, March 8th]. The development of vaccines has been exceptionally rapid, but manufacturing them on a large scale has encountered difficulties and delays. In 2020, only 4% of the expected doses were in fact produced [ibidem].
Production is concentrated in a limited number of countries, largely interdependent due to supply chains that cross state borders and continents. The World Bank identifies, among the producing countries, a Covid-19 vaccine producers club
of 13 countries that manufacture both the active ingredient and its components. This exclusive Vaccine Club
is also awarded 60% of the total Advance Purchase Agreements (APAs) — the advance purchase of vaccines — with pharmaceutical companies [World Bank, The Covid-19 vaccine production club
, March 2021].
The World Bank’s concern is that aggressive forms of vaccine nationalism
, by limiting exports, are disrupting global supply chains. For its part, the World Health Organization (WHO) fears that in much of the world, such as in Africa, vaccines will not arrive until 2023 or 2024.
Crippled internationalism
In June last year, the Global Vaccine Alliance (GAVI), together with the Coalition for Epidemic Preparedness Innovations (CEPI) and the WHO, launched the COVAX programme. It covers 192 countries, with the aim of ensuring equitable global distribution of vaccines, initially providing two billion doses, two-thirds free of charge, to 92 lower-income countries. Donations were in short supply and, two months into the vaccination campaign, COVAX had still not been able to deliver a single dose to the poorest countries [Financial Times, February 13th]. Initially conceived as a single clearing house for vaccine orders around the world, from which all countries, rich and poor, would procure their doses
, notes the City newspaper, the program almost immediately
foundered in the race for bilateral deals between the richest nations and the vaccine companies, and the priority allocation to domestic needs practised by countries like the United States, the UK and, more recently, even India.
Limited production, coupled with the supply dispute that has arisen between the European Commission and pharmaceutical companies — in particular with the Anglo-Swedish company AstraZeneca — has prompted several European leaders (and various scientific and political figures) to raise the issue of patents. The President of the European Council Charles Michel at the beginning of the year raised the possibility of the EU adopting ‘urgent measures’ — provided for in Article 122 of the Treaty — to impose ‘compulsory licensing’ on companies [Politico, February 3rd]. In fact, last December, the request made by some countries, including India and South Africa, for companies to waive patent exclusivity was rejected by the United States, the UK and the EU [The New York Times, December 25th].
The protection of intellectual property is regulated by the TRIPS (Trade Related Aspects of Intellectual Property Rights) agreement of the World Trade Organization (WTO). The amendment, adopted at the Doha Conference in 2001 and subsequently clarified, provides for the right of a state, in the event of a national health emergency, to produce (or have a third-party produce) a drug without the permission of the company holding the patent on the product or its manufacturing process. In 2017, two-thirds of the WTO membership had ratified the amendment, making it operational.
The compulsory licence could facilitate the entry of new companies into the market, but it still leaves the problem of production capacity for high-technology medicines (such as new vaccines) unsolved.
A kind of ‘vaccine internationalism’ is called for by many. Its realization presupposes, however, the overcoming of barriers and conflicts, commercial and otherwise, between states, and of competition between economic groups; it involves the pooling of resources and productive capacity, the coordination and direction of the global production of vaccines and their distribution according to public needs worldwide. At the very least, it means stripping vaccines of their characteristics of a commodity, which is the form in which the products of human labour are presented in the capitalist social system.
The critics of neoliberalism
and globalization stop at the threshold of criticizing the very foundations of the capitalist socio-economic formation. They instead lash out at the excessive power of the banks or the greed of the multinationals, etc., and cultivate the illusion that it is possible to eliminate some of these most odious, but inevitable, forms of capitalism in its imperialistic maturity. Lenin called this wishful thinking
.
Industrial powers in confrontation
Airfinity calculates that at the end of March the production of Covid-19 vaccines stood at 229 million doses in China, 164 in the US, 125 in India, 110 in the EU (three quarters of which are in Germany, Belgium and the Netherlands), and 16 in the UK. China exported 48%, India 44% and the EU 42%. The USA and the UK have kept all of their doses for their domestic markets [Airfinity, March 24th].
Internal Market Commissioner Thierry Breton believes the EU is winning the industrial battle
: producing — he writes — over 200 million doses of vaccines, reaching current levels of production in the US, and the Union’s annual production capacity is expected to reach 3 billion doses by the end of the year. Breton also lays claim to the Union’s role as a top exporter worldwide. At least two-thirds of the 30 million doses administered in Britain were produced in Europe, and the UK depends on the EU for the second dose [European Commission, Beating COVID-19: Scale-up of vaccine production in Europe,
April 8th].
Breton refers to 53 production sites for Covid-19 vaccines in Europe. 26% of the facilities are located in Germany. Together with the Netherlands and Belgium, the three countries host 40% of the sites, which in some cases produce more than one type of vaccine. In fact, at least thirty or so plants are owned by companies working on behalf of third parties (CDMO, Contract Development and Manufacturing Organization), of around ten nationalities, mostly German, Spanish and American.
The EU, writes Breton, is an industrial power that is and intends to remain a global player,
rejecting vaccine nationalism.
The European Commission has, however, since last January, made exports of vaccines subject to authorization. The EU, comments The Economist, is torn between its reputation as champion of open markets
and the needs of internal supply [March 27th].
There is an ongoing struggle between the metropolises over health. The production capacity of vaccines, as well as the organisational efficiency in carrying out vaccination strategies — a precondition for a less or more rapid economic recovery — is a measure of the overall strength of states in the global competition.
Lotta Comunista, April 2021