The people over profit mindset held by Big Pharma is driven by IP, and prevents accessible disease response globally.

Pharmaceutical companies were hailed during the COVID pandemic, for having produced vaccines in record time. However, it was their blinkered approach to profit maximisation that was primarily responsible for the gross inequity in vaccine access around the world. These companies struck secret deals with governments, prioritised high-income countries, sold vaccines at excessive prices, refused to share intellectual property, and monopolised supply. The original “zero draft” of the treaty recognises that “equity should be a principle, an indicator and an outcome of pandemic prevention, preparedness and response”. Although many countries provide lip-service to the importance of equity as a guiding principle for the treaty, they must translate this rhetoric into action. To achieve truly equitable access to health tools during a pandemic, countries must boldly challenge the orthodoxy of intellectual property (such as patents) laws at the root of the inequitable COVID-19 response, mandating pharmaceutical companies to share technology and know-how of life-saving drugs, particularly to ramp up manufacturing capacity in low- and middle- income countries. And the record of richer countries on promoting equity so far has not been good. In fact, countries in the Global North – US, UK, Canada, Australia, and Japan, among others – have consistently opposed provisions in the treaty that mandate action from companies or countries. A leaked draft of the negotiations is peppered with comments from country delegates that blunt the edge of the mandatory provisions with clauses such as “where appropriate and feasible”, “voluntarily”, and “on mutually agreed terms”. What we have learned from previous pandemics is that leaving global health dependent on the generosity of rich countries and pharma corporations in this way does not lead to improved access to medicines. In fact, three years into the COVID-19 pandemic, there have only been a couple of instances of pharma companies voluntarily licensing production to companies in the South. At the same time, radically new models like that of the mRNA Technology Transfer Programme based in South Africa face an uncertain future, as they wade through the thicket of patent barriers around mRNA technology. BATTLE LINES BETWEEN GLOBAL NORTH AND SOUTH These treaty negotiations have laid bare the geopolitical tensions between the Global North and South. Whereas countries such as Nigeria, Chile, Brazil, and Egypt support time-bound waivers of intellectual property rights, countries such as the US and UK oppose them. Another disputed issue between the two blocs is that of “pathogen access and benefit sharing”. Crucial genetic data – about the pathogens that cause infections – needed to develop new drugs comes from the Global South, and yet these countries are pushed to the back of the queue for these same drugs. It is perverse that the very people taking part in trials to develop these lifesaving medicines are last in line to get the finished vaccines. South African scientists compared this to a country making goods for the world and watching them be shipped to richer countries, while its own citizens starve. Similarly, the principle of “common but differentiated responsibilities (CBDR)” has been a bone of contention. The principle, originally applied in climate justice negotiations, means that states have different obligations when it comes to global challenges, and that these can vary depending on how wealthy a country is and how much it has historically contributed to the problem (so rich countries have greater responsibility to tackle climate change, for instance). Brazil, the Africa Group, Malaysia, India, and small island countries support applying such differentiated responsibilities in the pandemic treaty, but Japan, US, and the EU do not. PEOPLE OVER PROFIT We are not going to be any better prepared for the next pandemics if countries continue to put their national interests over global public health. Profit will not drive the vast and more equitable manufacturing and distribution effort needed to meet the challenge of a global health emergency. We should not promote the same old colonial model where richer countries control access to resources, as poorer nations wait, dependent on their charity. Without concrete actions to meet the health needs of people in poorer countries, the treaty will be nothing more than beautiful words on paper. The challenge of future pandemics will loom large at next week’s World Health Assembly. What is clear is that the new pandemic treaty needs to radically challenge the status quo and take on special interests that have led to profit, not people’s health, driving policy making.