This final installment of the article addresses what needs to be done after there has been rapid output of safe innovator vaccines (see Part I for scaling and Part II for safety). Typically, large vaccine companies own, or can partner with, vast distribution networks to get innovative vaccines distributed globally. Governmental and non-governmental organizations can help vaccines penetrate even farther. Patents are not the reason why these networks are currently being underutilized. In some cases where innovator companies have already increased vaccine supply, their efforts have been undermined by governments prioritizing their own countries' interests. The innovator companies' hands are tied by contracts or laws that prevent vaccine export. Governments can loosen these contract restrictions and laws, if they choose to do so. Ethics experts are debating the extent to which vaccine-rich countries should share and when. Licensing innovator vaccines further could help fill global distribution networks while diplomatic negotiations try to free up vaccines for countries most in need. As noted in prior parts of this article, licensing and technology transfer from innovator companies is faster and safer than overriding patents and waiting on "home brew" solutions to arrive.
The US government has stockpiled about 60 million of doses of the AstraZeneca vaccine that has not yet been not approved in the US, and that a top public health official has said may not even be needed there. The US government does not intend to release these vaccines to other nations until the US FDA has approved the product, which is prudent, but does not appear to consider the urgency of the global need. The benefits of increased vaccine supply are only realized when shots are in arms, not sitting on shelves. Perhaps let other countries that already approved the vaccine receive and decide whether to deploy these unused doses. There are also calls for the US to share other vaccines.
The Canadian government said that it intends to take 1.9 million doses of vaccine from the WHO COVAX initiative for third world vaccine (as Canada is entitled to do), even though Canada has lined up tens of millions of doses from other sources. Canada is also eyeing requesting a share of the US AstraZeneca stockpile, despite the more urgent, deteriorating situation in other countries, such as Brazil and India. The Canadian government's plan for its excess vaccine doses remains unclear, and may involve a hybrid of deferring delivery and donating to other countries. Some other countries have already committed to giving excess vaccine doses back to COVAX. Calls for Canada to do more are growing.
When diplomatic negotiations do not provide fair vaccine access, patents become a scapegoat, and patent overrides become a desperate do-it-yourself solution. No country should have to resort to "home brew" out of frustration, when licensed, safe vaccine supply should be available. Diplomatic logjams must be resolved, and nationalism must give way to global cooperation. This includes both sharing the increased supply of innovator vaccines, as well as increasing the licensing out of innovator vaccine manufacturing knowledge to others that can manufacture. Equitable access to vaccines is essential before the world can move past COVID-19.
1 Some of this supply has been delayed by the Indian government preventing the Serum Institute of India from exporting AstraZeneca vaccine.
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