Geneva's trailblazing week: Ngozi Okonjo-Iweala "fresh eyes" at WTO
Newsletter Edition #31 [The Weekly Primer]
We are happily swept over by the optimism generated by the appointment of Ngozi Okonjo-Iweala as WTO top boss. It will be fascinating to watch if and to what extent this path-breaking change in international Geneva transforms not only international trade policy but also global health.
We do believe that a single individual can sometimes be a catalyst to challenge institutional power and dynamics. Riding on both meritocracy and a strong feminist leadership, the new director-general will undoubtedly leave her mark within WTO and the wider politics of international trade.
We hope you like today’s curated edition.
(A small stylistic issue that we would like to state: we have decided to drop honorifics in this newsletter. This is not meant as a disrespect for authorities we write about, just a practical and conscious editorial choice following trends elsewhere. And in global health, the title “Dr." is ubiquitous!)
Here is a link to the event organized last week by the Third World Network on COVID-19 Vaccines: Understanding Issues of Access and Intellectual Property, where we spoke about the role of the COVAX Facility and what it would take for it to deliver on the promise of equitable access. Fellow panelists also discussed specific IP provisions in vaccine contracts. Check it out!
We look forward to bringing you our analysis of the week on Friday.
In the meantime, over the next two weeks we will be switching to a paid format for our deeper analysis on Fridays, with our Tuesday editions continuing to remain free.
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I. WHAT WE FOUND INTERESTING
We highly recommend you watch this press conference where Ngozi Okonjo-Iweala, gives a glimpse into the vision, determination and confidence that she brings into this new role. There are also indications on how she evaluates issues relating to the Appellate Body impasse at the WTO and the use of voluntary licensing to increase manufacturing of vaccines for the pandemic. She has articulated “a third way” in the context of the discussions on the TRIPS waiver proposal, essentially suggesting the use of TRIPS flexibilities.
Also, here is a recent article by WTO’s new chief [January 2021]: Trade in the Time of Pandemics in Think Global Health
DG selection process 2020: Presentation to the General Council – Dr Ngozi Okonjo-Iweala, Nigeria - Image credit: WTO/Jay Louvion
What you cannot miss this week:
A report by the Pharmaceutical Research and Manufacturers of America (PhRMA) in its submission to the 2021 Special 301 Report of the US government. An important reading that actually helps us understand the relevance of the TRIPS waiver proposal at WTO. This report puts in perspective why the discussions around intellectual property are now coming to a head at this stage in the current pandemic.
“The World Health Organization (WHO) today listed two versions of the AstraZeneca/Oxford COVID-19 vaccine for emergency use, giving the green light for these vaccines to be rolled out globally through COVAX. The vaccines are produced by AstraZeneca-SKBio (Republic of Korea) and the Serum Institute of India….
..The vaccine was reviewed on 8 February by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), which makes recommendations for vaccines’ use in populations (i.e. recommended age groups, intervals between shots, advice for specific groups such as pregnant and lactating women). The SAGE recommended the vaccine for all age groups 18 and above.
The AstraZeneca/Oxford product is a viral vectored vaccine called ChAdOx1-S [recombinant]. It is being produced at several manufacturing sites, as well as in the Republic of Korea and India. ChAdOx1-S has been found to have 63.09% efficacy and is suitable for low- and middle-income countries due to easy storage requirements…”
Kai Kupferschmidt got Peter Ben Embarek to talk after he landed in Geneva, fresh from the much-scrutinized mission on SARS-CoV-2 origins. Embarek is WHO program manager and mission leader to China. See the persistent line of questioning by this journalist - hallmark of a great reporter.
The Newest Diplomatic Currency: Covid-19 Vaccines: New York Times
This story is about the geopolitics of South Asia seen from the lens of COVID-19 vaccines diplomacy.
“The coronavirus vaccine — one of the world’s most in-demand commodities — has become a new currency for international diplomacy.
Countries with the means or the know-how are using the shots to find favor or thaw frosty relations. India sent them to Nepal, a country that has fallen increasingly under China’s influence. Sri Lanka, in the midst of a diplomatic tug of war between New Delhi and Beijing, is getting doses from both.”
New York Times
Inside The Serum Institute of India. Read on.
“Some people think the reason that rollout has been slow in many countries is because the developers who hold the patents on the vaccines have licensed too few manufacturers to make them. Do you agree?
No. There are enough manufacturers, it just takes time to scale up. And by the way, I have been blown away by the cooperation between the public and private sectors in the last year, in developing these vaccines. What I find really disappointing, what has added a few months to vaccine delivery – not just ours – is the lack of global regulatory harmonisation. Over the last seven months, while I’ve been busy making vaccines, what have the US, UK and European regulators been doing? How hard would it have been to get together with the World Health Organization and agree that if a vaccine is approved in the half-dozen or so major manufacturing countries, it is approved to send anywhere on the planet?
Instead we have a patchwork of approvals and I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April.”
The timing of such an interview could not have come at a worse time - already the billionaire is ensnared in the debate around his role in the commercialization of the Oxford-AstraZeneca vaccine.
“If there is a credibility gap in listening to Gates on this subject, it comes from the suspicion that he lives in a world so far removed from the rest of us as to raise large blind spots. It’s a small thing, but in a 2014 Rolling Stone interview, Gates mentioned a lunch with Charles Koch, the libertarian billionaire who made huge sums from the oil business and for decades lobbied to reduce US environmental regulations. “He’s a very nice person,” Gates said in that interview, “and he has this incredible business track record.” Koch, along with his late brother David, spent decades funding climate deniers. Gates’ regard for him seems vested entirely in his success as a businessman; no matter how philanthropic, at some level the billionaire class is loyal primarily to itself.”
Its not over till it is over. This story shows how all the pieces that must come together in addressing the pandemic effectively - an efficient local administration alone, may not help.
“With Kerala now accounting for nearly one in two active COVID-19 cases in India, experts say Kerala is a victim of its own early success in containing the spread of the disease, which meant fewer people developed immunity.”
Little Vials, Big Crime: Criminals primed for onslaught on Africa’s vaccines: Health Policy Watch
This is a complex story with a sub-text which raises questions on certain trade routes. This is also about the wider issue of illegal networks, and not falsified medical products only. Nevertheless gives a picture of real challenges on the ground - in the underbelly of the vaccines distribution and logistics.
“..Sources at international anti-crime agencies argue that Africa’s strong trade routes with China and India are going to allow criminals to introduce shipments of falsified vaccines into supply chains…”
Health Policy Watch
This story illustrates this back and forth between companies and regulators, hurting both.
“While the Russian developer continues to insist its approval is moving ahead at the European Medicines Agency, the regulator responsible for assessing data for all new COVID-19 vaccines in the EU, an unusually public spat over whether the Sputnik V team actually filed its first load of data to support a license throws into question just how far they are in the application process.
According to the EMA, there's no confusion: Sputnik has absolutely not filed an application.
The agency “has to date not received an application for a rolling review or a marketing authorization for the vaccine ... despite reports stating the opposite,” the EMA stated Wednesday.
Yes we did, retorted the Sputnik team on Twitter, publishing a screen grab of a submitted file.”
FROM THE JOURNALS / REPORTS:
A hugely important story by Hristio Boytchev.
“Reporting information from single anonymous sources that turns out to be false could erode public confidence in the vaccines that are crucial to controlling the covid-19 pandemic.”
(A useful analysis on the vaccine candidates for COVID-19 and a “traffic-light system signalling potential for achieving global vaccine immunity.”
II. WHAT WE ARE WATCHING:
WHO: Member States Virtual Informal Consultation on Strengthening WHO Preparedness for and Response to Health Emergencies (organized by the European Union): 16th February
WHO: NSAs Virtual Informal Consultation on Strengthening WHO Preparedness for and Response to Health Emergencies (organized by the European Union): 19th February
Book Launch - Global Health Diplomacy: 19th February
III. TWEETS OF THE WEEK
On Bill Gates and climate change.
Sequencing capacity in the developing world:
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