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The United States and other wealthy countries are standing in the way of low- and middle-income countries seeking better access to COVID-19 vaccines, health-equity advocates say.
South Africa and India have led an effort at the World Trade Organization (WTO) to waive drug companies' exclusive rights to manufacture their vaccines during the coronavirus pandemic.
Countries with major pharmaceutical industries, including the United States, several European countries and Japan, have opposed the waiver. WTO, the global trade regulating body, operates by consensus, so the proposal fails without unanimous support.
"It is shameful that U.S. policy is prioritizing profits over life, and doing so in the name of the American people," Emily Sanderson, senior grassroots advocacy coordinator for the activist group Health GAP, said in a statement.
The pharmaceutical industry says patents are not the biggest barriers, however. Supplies and expertise are the major limitations, executives say. But the industry says novel partnerships already in place will meet the demand for vaccines.
Vaccine rollout has been highly unequal so far. While deliveries are accelerating in many higher-income countries, "there's over 100 countries where not a single (dose of) vaccine has been delivered," said Matthew Kavanagh, director of the Georgetown University Global Health Policy & Politics Initiative.
U.S. President Joe Biden announced plans Thursday to vaccinate enough Americans by July 4 to get life nearly back to normal.
Meanwhile, COVAX, a World Health Organization-backed program to improve vaccine equity, plans to vaccinate just 3% of participating countries' populations by then.
Manufacturers in waiting
Advocates say more people would get vaccinated if drug companies would relinquish control of their products.
"We know that in India, in South Africa, in Senegal, in Thailand, there are producers that within six months could start making vaccines if the information about how to do so was shared with them," Kavanagh said.
Plus, he added, the vaccines were developed in a large part with public funding from taxpayers in the United States and Europe, which should limit drug companies' rights to them.
The conflict has echoes of the fight over HIV/AIDS drugs two decades ago. Over the vigorous opposition of drug companies and their host governments, several developing countries broke patents to produce lifesaving antiretroviral medications at much lower cost than the companies were charging.
It ultimately opened the door for developing-world manufacturers to produce low-cost generic drugs that have helped control HIV/AIDS.
Many say those lessons should be applied to COVID-19.
"If a temporary waiver to patents cannot be issued now, during these unprecedented times, when will be the right time?" WHO Director-General Tedros Adhanom Ghebreyesus wrote on Twitter earlier this month.
Supply bottlenecks
But the pharmaceutical industry says revoking intellectual property will not get more shots in arms.
"The bottlenecks are the capacity, the scarcity of raw materials, scarcity of ingredients, and it is about the know-how," Thomas Cueni, head of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), told Reuters.
"A better approach is to continue the intense collaboration already taking place between companies, governments and other partners around the world," Megan Van Etten, senior public affairs director at the Pharmaceutical Research and Manufacturers of America (PhRMA), an industry trade group, said in a statement.
Rival companies have teamed up to increase supplies of COVID-19 vaccines.
Earlier this month, Merck announced it would help to manufacture Johnson & Johnson's vaccine in a deal brokered by the Biden administration. Sanofi is producing shots for Pfizer-BioNTech after its own vaccine suffered a setback. And AstraZeneca partnered with the Serum Institute of India, the world's largest vaccine maker, to boost supplies of its vaccine.
All told, the industry plans to manufacture 10 billion doses of vaccine this year, which would in theory be about enough to immunize the world's entire adult population.
Pharmaceutical companies say intellectual property protections were how the industry was able to produce safe and effective vaccines against a novel virus in less than a year.
"Undermining the very policies that have helped research companies move so quickly against the pandemic won't provide relief for people and will leave us all less prepared to confront future public health threats," PhRMA's Van Etten said.