The past eighteen months have exposed the world to an extraordinary challenge with unprecedented setbacks and devastating social and economic repercussions that have forced us, in the words of UN High Commissioner for Human Rights, Michelle Bachelet, to ‘learn [in order] to live’. Fortunately, we have done much learning and the pace at which the world has gained scientific knowledge about the SARS-Cov-2 virus has enabled the development of effective vaccines, which offer a glimpse of light at the end of the tunnel.
And yet, this scientific feat has not been matched by a commensurate effort in international cooperation and solidarity to ensure equitable global distribution of these live-saving vaccines. Instead, vaccine distribution has been grossly inequitable, resulting in terrible consequences for the enjoyment of human rights, such as the rights to health and to life, particularly in low-income countries. Of the 1.8 billion vaccines administered around the world, just 0.4% have been in low-income States, which explains the recent surge of infections in the world’s poorest countries and underlines once more the need, as repeatedly emphasised by WHO Director-General, Tedros Adhanom Ghebreyesus, to ensure equitable vaccine access and distribution. Vaccine nationalism must give way to vaccine multilateralism that privileges increased global vaccine production, removal of export barriers, upscaling of COVAX, and the sharing of excess vaccines.
Against this backdrop, the Universal Rights Group organised together with the Permanent Mission of Singapore and with the support of UNICEF and the Permanent Missions of Mexico and Norway, an event on the margins of the 47th session of the UN Human Rights Council to discuss ‘the human rights case for vaccine multilateralism’.
Vaccine inequality
By principle, ‘multilateralism’ relies on States cooperating, a fundamental tenet of the international system that lies at the core of the UN’s COVID-19 slogan ‘we are all in this together’. However, during discussions, Mr Rajat Khosla of Amnesty International, pointed out that in reality, we are not all in this together, as COVID-19 has highlighted and exacerbated health and social inequalities, while bringing to the fore the deficiencies in international cooperation.
This disparity and injustice are demonstrated in the fact that in May 2020, G7 countries were vaccinating their populations – collectively 750.47 million people – at a rate of 4.5 – 6 million people per day, while low-income States – a combined population of over 700 million – were only able to deliver 63,000 shots in arms per day. In this regard, High Commissioner, Michelle Bachelet, noted that States’ attempts to provide low-income countries with vaccines have been ‘compromised by both slow delivery, and manufacturing’, while their fast-paced efforts to vaccinate their own populations has not been translated into an equal fervor for helping others. She stressed however that this was not a fatality as ‘we have a once in a lifetime opportunity to leave behind global inequalities’, by endorsing vaccine multilateralism and viewing vaccines as a global public good.
Responding to this point, Dr. Mariangela Simao, WHO Assistant Director General for Access to Medicines, Vaccines and Pharmaceuticals, noted that, ‘in high-income States, younger age groups, who are at less risk of the disease, are already being vaccinated.’ She therefore rhetorically asked, ‘is there really a scarcity of vaccines?’, considering that in developed nations, there have been 3 billion doses administered, which is sixty times more than in less-developed States.
Following this line of thinking, H.E Umej Sing Bhatia, Permanent Representative of Singapore to UN in Geneva, suggested that many States had kneejerk reactions to the pandemic, prioritising their national concerns over the good of the international community. He remarked that ‘by coining the term ‘vaccine multilateralism’, we [Singapore] wanted to reframe the global conversation around vaccines, steering it away from vaccine nationalism, and instead focus on international cooperation and solidarity.’
‘No-one is safe until everyone is safe’
The slogan ‘no-one is safe until we are all safe’ has been supported and affirmed by many States over the past year but what does the statement really mean?
Dr. Simao pointed out that since COVID-19 is ‘a new virus; we are learning as we go forward and learning about how best to respond.’ State proposals of ‘herd immunity’, she said, have historically only been achieved through the use of vaccines, and ‘would only be sufficient when all local communities have reached a certain level of immunity; we have not yet reached this point.’ As long as viruses circulate in communities they will mutate, and each new mutation poses a significant risk to overcoming this global pandemic. Thus, a ‘me-first approach will not be successful… and we must ensure there is equitable access to vaccines.’
In this regard, H.E. Thomas Wagner, Deputy Permanent Observer of the European Union Delegation to the UN, emphasised that, ‘these are not just words’, and equitable access to vaccines must be ensured and backed up by actions if we want to have a speedy recovery from the pandemic.
As a leading donor, Wagner reiterated that the EU has been a key player in vaccine multilateralism by supporting international efforts (donating 3.2 billion euros to COVAX), assisting their partners in achieving ‘universal health coverage’, and supporting States with technical assistance to set up vaccine manufacturing capacity.
Waivers
To transform words into actions, States must provide concrete support that addresses the root causes of vaccine inequality. Certain States, such as India and South Africa, have made pleas to the WTO to temporarily waive intellectual property rights on COVID-19 vaccines, a request that has since been endorsed by US President Biden in a step towards vaccine multilateralism that was hailed by the African Union as ‘a remarkable expression of leadership.’
The High Commissioner welcomed steps taken towards a waiver of the TRIPS agreement but pointed out that while IP waivers are an effective method of tackling vaccine nationalism, the benefits would not be immediate due to manufacturing requirements involving scarce raw materials, a specialised workforce, and new infrastructure and technology. Ms. Bachelet therefore urged States to pursue other options in addition to waivers.
H.E Thomas Wagner of the EU similarly suggested that there are ‘alternative avenues towards the goal of equitable access of vaccines’, including by collaborating with the pharmaceutical industry to increase manufacturing, as well as removing all export restrictions and donating excess doses.
COVAX and vaccine sharing
Under international human rights law, States have an obligation to cooperate to ensure human rights are fully realized in all nations, including by providing assistance to ensure the realisation of the right to enjoy the benefits of scientific progress. This was recalled by Mr. Rajat KHOSLA, Senior Director for Research, Advocacy and Policy of Amnesty International, when he highlighted that in accordance with the International Covenant on Economic, Social and Cultural Rights, ‘the Committee has highlighted that pandemics are a crucial example of the need for scientific international cooperation to face transnational threats, and that all people should have access to the applications of scientific progress without discrimination.’
One positive example of international cooperation can be found in the COVAX initiative, which is working to ensure a fairer global distribution of vaccines and has, according to Ambassador Bhatia, shipped over 190 million doses. Describing this as just a ‘drop in the ocean’, he insisted that it is ‘imperative to fine-tune the structures of the mechanism.’ In this regard, Dr. Simao suggested that the reason COVAX did not do more last year, was that they lacked sufficient funds. This, in turn, led to 130 million AstraZeneca doses not being delivered to India, causing catastrophic impacts on the right to health.
‘The lesson learnt so far is that sharing is good’, says Simao. ‘Sharing’ refers here not only to vaccines, but also the sharing of information on variants. The latter, Dr. Simao stressed has been successfully undertaken, enabling most States to keep a ‘real time track’ on the virus. However, vaccine sharing has not been done in the same timely manner, she lamented.
When asked why China chose to take on the important role of distributing vaccines to low-income States, H.E. Chen Xu, said that his country did not deliberately choose this path, but that it was a ‘natural continuation’ of their policies and practices and the result of a deeply embedded value within Chinese culture of taking care of both ‘one’s own and the most vulnerable’. They have thus offered 450 million doses to developing nations, in an attempt to realise the Sustainable Development Goals, and ensure nobody is left behind.
On the other hand, according to Howard Solomon of the US Permanent Mission to Geneva, the United States have pledged to purchase and donate 580 million doses worldwide through the COVAX system, while highlighting that millions of dollars have already been offered in assistance to low-income States. Solomon pointed out that this financial assistance has ‘no strings attached’, meaning ‘vaccine donations do not include pressure for favours or concessions; we are doing this to save lives and end the pandemic.’
But the international community cannot solely focus on vaccines, proposed H.E. Tine Morch Smith; States must also strengthen health systems around the world. She suggested that a ‘broader perspective’ of ‘health multilateralism’ is necessary to not only cooperate on vaccine distribution but more generally ensure that health systems are more robust and resilient.
Conclusion
The High Commissioner, Michele Bachelet, concluded her statement at the HRC side-event with some realistic pragmatism: ‘it is time to realise that this pandemic is far from over and it won’t be the last pandemic we face.
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