Waivers are key to Health equity due to IPR and lack of support for TRIPS being the major bottleneck. Covid empirics Prove. Removing waivers kills health equity.

Global justice is an element of normative global health governance dynamics that focuses on all the moral obligations from the world’s rich to the poor. Thus, global justice stands to redistribute wealth to the poor people to eliminate global poverty and other socio-economic concerns. The US Health and Human Services Secretary Xavier Becerra (while participating in WHA 74) said Universal Health Coverage is “a right and not a privilege.” Even public health has been prioritized and institutionalized, considering global health justice. Several programs, policy initiatives, campaigns have been launched, such as health for all and health equity. The International Covenant on Economic, Social, and Cultural Rights (Article 12) had acknowledged, “The right to the highest standard of physical and mental health.” It gives some directives for states to prevent, treat, and control epidemics, endemics, occupational, and other diseases. The Universal Declaration of Human Rights (Article 25) conceived health as a human right and postulated to achieve “a standard of living adequate for the health and well-being of himself and of his family.” The TRIPS agreement also underlined (Article 7) that the exercise of intellectual property rights should be carried out in a “manner conducive to social and economic welfare, and a balance of rights and obligations.” Furthermore, TRIPS Article 8.1 emphasized that the, “Members may, in formulating or amending their laws and regulations, adopt measures necessary to protect public health and nutrition” keeping these measures are in tandem with the TRIPS agreement (WTO, n.d). The WHO says, “the health is one of the fundamental rights of every human being . . . The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health” (Constitution of the WHO) (WHO, 1995).

The above discussion can be summarized as supporting the right to achieve the highest standard of physical and mental health as defined by the WHO. Moreover, to prevent, treat, and control pandemics or diseases for health security and to support or advocate health as a human right, we have to exercise the IPRs in a conducive way to support the social and economic welfare of all the global citizens (Chattu et al., 2021a). Hence, there is an urgent need to adopt necessary measures to protect public health, as health is one of the fundamental rights of every human being, and look through the prism of global justice.

The IPR is considered one of the major barriers to health equity. For example, more than 11 billion COVID-19 vaccine doses are needed to administer two doses to 70% of the total population. It is reported that until now, more than 8.6 billion orders have been placed (United Nations, 2021). However, the important point that has to be highlighted is that out of these 8.6 billion vaccines, 6 billion will go to the rich countries, and 2 billion only go to the developing countries wherein 80% of the global population have been living. Meanwhile, the developed countries, having only 13% of the total population, had procured more than half of the future supply of the COVID-19 vaccine contenders, which is far more than more they require (Oxfam International, 2020). Canada has enough COVID-19 vaccine doses to cover each citizen five times over, while the fate of 67 poor countries remains undecided. It is further substantiated by taking the example of Canada, which has reserved five times over, while the developing countries have not been able to vaccinate even with a single dose. These huge gaps in access have necessitated the waive-off of the IPRs. Besides, the WHO Chief has portrayed the ground reality as the “World Is Far Behind” in the context of reaching the level of UHC (WHO, n.d.-d).

Against this backdrop of bad to a worse situation of health equity, India and South Africa being the leaders of the third world, realized the gravity of the situation and had put up the joint proposal (IP/C/W/669) to waive off IPRs temporarily and enable to expedite the development of vaccines, medicines, and diagnostics for containment, prevention, and treatment of COVID-19 (Chattu et al., 2021a, 2021b; Singh and Chattu, 2021; WHO, n.d.-a). Moreover, the proposal covers all the medical products direly needed for testing, treating, or preventing COVID-19 must be included under such a waiver (McCann and Gamio, 2021).

India and South Africa have been using diplomatic channels either bilaterally, regionally, or globally to get through the proposal. Moreover, both countries have been using public health as part of the soft diplomacy of their foreign policy at the individual level. India has provided COVID vaccines to more than 100 countries through its “Vaccine Maitri” diplomacy (Mol et al., 2021). The patent diplomacy gradually began to bear fruit once it was supported by more than 120 countries, Nobel laureates, academicians, over 350 civil society organizations, activists, and international organizations such as Joint United Nations Programme on HIV/AIDS (UNAIDS), Unitaid (A global health Initiative founded in 2006), and MSF (The Times of India, n.d.). UNCTAD also supported the proposal and even urged WTO member countries to do the same. Congruently, the WHO wholeheartedly lent its support to the proposal and by the WHO Chief saying that “To ease international & intellectual property agreements . . . available to all who need them at an affordable cost.” India and South Africa take the lead further by arguing before the TRIPS Council that “Given the current global emergency, WTO Members must work together . . . distribution of medical products essential to combat COVID-19” (WHO, n.d.-a). Therefore, if the TRIPS waiver proposal is approved, the access to essential COVID-19 medicines, technologies, and diagnostics will improve drastically (Chattu et al., 2021b; Loyo et al., 2021; Singh and Chattu, 2021; Taghizade et al., 2021). Chattu et al. have highlighted that though it is easy to talk about inequalities and inequities and incorporate them into policies, the COVID-19 pandemic provides an opportunity for the world to demonstrate its solidarity for “Health for All” (Javed and Chattu, 2020).

Conclusion

From the above discussion, it is clear that the IPR is one of the major bottlenecks for health equity. India and South Africa have been making wholehearted efforts to garner diplomatic support for the TRIPS waiver. However, considerable states and non-state actors have been supporting the proposal, still miles to go ahead to convince the developed and pharmaceutical giants to extend their support for waiving off the IPRs. Gradually, these countries would or could realize that India and South Africa’s joint proposal is a major step in the direction of health equity, health for all, one health, UHC, health as a human right, reducing the out-of-pocket expenditure, and protecting humanity at large. As a result, the proposal has the potential to catalyze health equity and aid in the pursuit of global justice.

The acceptance of the waiver proposal would also result in mass production and fair distribution, making it available to everyone regardless of their status. It would also enable the developing countries to produce additional billions of doses in the minimum period, ensuring timely availability and accessibility everywhere across the globe. In addition, profit can be earned later on the generation sustains; therefore, the developed countries, international and regional organizations, and major pharmaceutical companies must support the joint proposal to protect public health. Monopolies on vaccines must be done away with sharing “know-how” with the developing countries for mass production and reducing the prices. Global justice will prevail once there is a fair distribution of vaccines and essentials. However, it is not impossible because, for the most part, states have provided public funds to pharmaceutical companies for research and development (R&D). The paper concludes by supporting the ideas of former Indian Prime Minister late Mrs Indira Gandhi while speaking at the World Health Assembly, where she rightly argued that “My idea of a better-ordered world is one in which medical discoveries would be free of patents, and there would be no profiteering from life or death.” Nations should strive to find solutions to ensure equitable access to the COVID-19 related drugs, medical supplies and vaccines while allowing for profit-making by the pharmaceutical industry.