The EU should continue to oppose an extension of the WTO IP exemption to therapeutics and diagnostics
By Philip Stevens, Executive Director of Geneva Network, a think tank focusing on international innovation policy.
Covid vaccines have been instrumental for taming the Covid pandemic. Less well-known are the novel treatments that have been invented over the last two years which can help prevent or treat Covid amongst those most at risk, including the elderly and those with other medical conditions.
For instance, a new antiviral called Paxlovid can reduce hospitalisation of high-risk patients by 89% when administered in the first few days of symptoms. Paxlovid is a course of pills taken at home over several days.
Sadly, these lifesaving medicines are not getting to all those who need them, particularly in low- and middle-income countries. Some say the answer to this problem is to override the intellectual property rights of such new medicines so that local companies can make them cheaply and distribute them rapidly.
In response to such thinking, World Trade Organization member states in Geneva are debating a proposal from India and South Africa to adapt the global treaty that governs intellectual property rules – the TRIPS Agreement – to temporarily suspend intellectual property rights for these medicines.
The wrong path to take
Allowing multiple companies to manufacture copies of the patented medicines would speed up access, the proposal suggests. Although it may sound logical to some, such an approach would be a mistake. The European Union is one of several WTO members sceptical of the proposal and with good reason.
Firstly, the real barrier to access to these medicines is distribution, not supply. According to Airfinity, 11o million doses of Covid treatments have been made so far, against estimated global demand of 50 million across all countries.
Access to doctors and health facilities is limited in many regions. Infrastructure can make delivery of any supplies difficult. Public health systems often lack resources.
Another reason for the lack of demand for therapeutics is that some of the worst affected countries have been testing at very low rates relative to the scale of Covid infections.
Low and middle-income countries have testing rates well below EU member states, and testing volumes have fallen globally since the Omicron wave peaked in early 2022.
Taken together, these kinds of issues prevent treatments getting to patients even when supplies are plentiful.
Correcting these imbalances is a matter of health systems policy, not intellectual property as envisaged with the WTO TRIPS discussions.
Solutions already exist
The other problem is that the producers of these medicines have already used the IP system to enter into licensing agreements with many manufacturers. Five generic companies in 12 countries have agreed licenses via the UN’s Medicines Patent Pool to manufacture generic Paxlovid, providing access to about 53% of the world’s population across 95 low and middle-income countries. Other companies have created separate licenses for their Covid medicines.
Voluntary licenses are the best way of rapidly transferring technology to partners as they allow for an orderly and safe transfer of technical manufacturing know-how, much of which needs to be taught in person.
This is particularly true for more complex medical technologies such as novel Covid vaccines and novel Covid treatments, many of which are complex biological products. If IP is confiscated, there is no incentive for cooperation in technology transfer, meaning delays and potentially dangerous errors.
And crucially, voluntary licenses also preserve the incentives to invest in future innovation, important should there be another pandemic. The importance of this cannot be emphasised enough.
Waiving IP at the WTO does not address any of the main barriers to Covid therapeutic access such as poor testing, and health system weakness. It would undermine current and future R&D and derail existing manufacturing partnerships.
A major function of the WTO TRIPS Agreement is to create a global level playing field of enforceable IP rules, allowing companies and countries to compete equally in the production and trade of knowledge-based goods and services. Creating exemptions of IP-rules for potentially broadly-applicable categories of technologies fundamentally undermines the raison d’être of the TRIPS Agreement, raising the real possibility countries could exploit the waiver expansion to further their own industrial policy goals at the expense of EU member states.
The IP system has delivered for Covid and will be important in any future pandemic. The European Union has shown leadership at the WTO during the Covid pandemic pointing out the futility of IP waivers for vaccines. It should continue this work and ensure the integrity of the global IP system is preserved.