Causing more than 2 million deaths globally, the coronavirus pandemic has exacerbated inequalities, revealed the fragility of health care systems, and highlighted the need for equitable access to health services around the world.
And with the development and rollout of several COVID-19 vaccinations comes the reality of vaccine hoarding and inequity, particularly for countries in the Global South.
To address exactly that, Lara Dovifat, an advocacy and campaigns advisor for Doctors Without Borders (Médecins Sans Frontières), is leading the International Access Campaign. Based in Berlin, Dovifat works with an international team that calls on pharmaceutical companies to reduce their pricing and increase accessibility. Prior to the pandemic, the campaign spent two decades lobbying for affordable drugs, including treatments for tuberculosis (TB) and snakebites.
Currently, the campaign is focused on ensuring pharmaceutical companies do not hold monopolies on COVID-19 treatments, so that barriers such as finances or location do not interfere with people’s ability to access life-saving services.
Portrait of Lara Dovifat
Portrait of Lara Dovifat
Global Citizen caught up with Dovifat to discuss why countries in the Global South are bearing the brunt of this inequity, how she’s working to put public interests before private profits, and how Germany, which has nearly 100 clinical trials, measures up when it comes to monopolizing pharmaceuticals.
When it comes to COVID-19, what are the issues you’re seeing in terms of equitable access to equipment, treatments, and vaccines?
What we see now is a system failing to deliver medical tools to those who are in need. This is not something new. We’ve seen over the years that the system of medical research and development does not support those who are in need.
The COVID-19 vaccines were, in a large part, funded by public money — but in the end, private companies put patents on them and they’re the ones now in the driver’s seat, deciding the price, what they will produce first, and to which capacity.
Billions of people will not access the vaccine this year. Researchers estimated that 9 out 10 people in low-income countries will not get the vaccine in 2021. This is such a failure of the global community — and my colleagues and I are working to make sure no one gets left behind.
How has the global conversation around vaccine access changed over the last year?
In the spring of 2020, politicians across the world spoke about global solidarity and treating the vaccine as a global public good. For a short amount of time, I was hopeful the vaccine would change the status quo and the pandemic would challenge our system in how we allow access to medical tools. But almost a year into this pandemic, I’m devastated because governments are not treating the vaccine as a public good and are not acting in solidarity.
Rich countries are hoarding vaccines and stocking up supplies — enough to vaccine citizens several times, and other countries are left behind without any access. This is vaccine nationalism. We have to make sure that people at risk, frontline workers, and humanitarian workers are vaccinated, otherwise we will not overcome the pandemic. It’s business as usual, and those who can pay the most can access the tests, treatments, or vaccines.
Are there specific countries or regions where you’re focusing your lobbying efforts, and any areas of particular concern when it comes to equitable access?
It’s the standard power relationship between the Global North and the Global South. Companies that hoarded vaccine supply for 2021 are in the Global North, so we’re looking at countries like Germany, US, Canada, Japan, and Australia. On the other hand, we’re seeing countries on the African continent who don’t have any chance to access the vaccine this year.
In 2018, organizations in the EU filed an opposition to Gilead Science's patent on the hepatitis C drug sofosbuvir. The appeal aimed to end the abuse of medicine patent systems by pharmaceutical corporations for their own profits, Lara Dovifat said.
In 2018, organizations in the EU filed an opposition to Gilead Science's patent on the hepatitis C drug sofosbuvir. The appeal aimed to end the abuse of medicine patent systems by pharmaceutical corporations for their own profits, according to Lara Dovifat.
On a global scale, how are countries lobbying for equitable access to COVID-19 vaccines?
There is a proposal that was put forth by India and South Africa at the World Trade Organization, suggesting a waiver for intellectual property rights on coronavirus tools such as masks, test, treatments, ventilators, and vaccines. This landmark request would relieve low-income countries from enforcing patents on medical tools.
Yet, countries that already secured COVID-19 vaccines, like Australia, the US, and European countries, are blocking this proposal, which would help other countries make medical tools more affordable and I think it’s such a scandal.
On one hand, they're using their money to buy vaccines that other countries are not getting, and on top of that, they’re even blocking a policy proposal by middle- and low-income countries. I’m coordinating a campaign to make sure there are no monopolies during this pandemic. A patent or intellectual property should not block the way to treatments or any other medical tools.
Countries in the Global North are opposed to a proposal that would waive intellectual property rights on coronavirus tools such as masks, tests, treatments, and vaccines — making them more affordable for countries in the Global South.
How has Germany handled the issue of public interests versus private profits during the pandemic?
Sadly, we are seeing Germany follow a similar pathway to other rich nations. They’re a strong supporter of intellectual property and are supporting private companies. Germany has purchased more vaccines than they need.
The German government and public institutions helped develop parts of the vaccine and put a large amount of public funding into the vaccine development, but there are no strings attached to the funding.
In this pandemic, even politicians are not allowed to look at the contracts and see the price of a single dose, and see the cost of the vaccine’s development, and be in a position to compare prices.
We’re seeing this globally and in many cases, countries are negotiating blindfolded with companies. Governments simply don’t know what another country paid for a vaccine or treatment. In some cases, middle-income countries paid more for a vaccine than high-income countries simply because they’re not allowed to share contract details.
What does it mean for people’s lives and livelihoods to have delayed or no access to health tools during a pandemic?
Delayed access to COVID-19 tools will lengthen this crisis mode for many people across the world — of lockdowns, not being able to work, or move freely. In lower- and middle-income countries, it means people who can’t work cannot afford food and education.
It’s devastating, and in these countries, the health systems are not as resistant, so the consequences of a pandemic are a disaster. There is a disruption of basic health services, such as TB or HIV/AIDS medications and treatment programs due to lockdowns and delivery issues.
You’ve seen politicians backtrack on their word regarding global solidarity and vaccine access, but is there any hope this may change once again?
Over time and with pressure, we see some countries questioning the status quo. In Germany, we see the opposition, the Green Party, really questioning the government on how they can justify putting the interest of private companies before people’s lives.
I think, over time, it will be harder for high-income countries to justify their behaviour. I'm hopeful that at least we can influence public debate on why we have patents in a pandemic which are blocking access to life-saving tools.
If 2020 has taught us anything about global health, it’s the importance of vaccines. The World's Best Shot is a profile series dedicated to sharing the stories of vaccine activists around the world.
Disclosure: This series was made possible with funding from the Bill and Melinda Gates Foundation. Each piece was produced with full editorial independence.