Citing inequitable access to vaccines, India and South Africa have called for waivers on provisions of the TRIPS Agreement for vaccines against COVID-19. President Biden has agreed to support a waiver. The clamour for vaccines free of IP restrictions is growing.

A separate World Health Organization (WHO) program called C-TAP is seeking to secure licenses for vaccine production. But no company has joined it yet.

The demand for more vaccines in SE Asia is huge. 600 million people need them and under 5% have had them so far. In the Philippines the Coalition for People's Right to Health issued a statement asking the Philippines government to support the waiver. They state that a TRIPS exemption may be a "first step to incentivizing or revitalizing national industrialization".

Unfortunately, manufacturing COVID-19 vaccines is not solved by IP access alone. Production of vaccines is highly complex and only a handful of companies in SE Asia can even make them. Secondly, regulators still have not approved many of them; so making them doesn't ensure they can be used. As seen in the US, their short shelf life means a very efficient system is needed to avoid doses going to waste. Thirdly, distribution and storage is not simple as most need refrigeration to different degrees.

The actual process of vaccinating hundreds of millions of people itself is complicated. McKinsey have produced a detailed analysis of the issues in low and middle income countries here. Many governments in the SE Asia region are doing well at rolling out initial vaccine programs, but the complexity of scheduling, processing (which requires a large IT infrastructure too), as well as staffing, training, will become more and more challenging in large general populations and especially in remote corners (eg. islands) of the region. Procuring production or vaccine stocks is one part of a much larger and more complex process.

There is a second commercial issue. It is clear that some pharma companies in the region would like to pursue the removal of IP barriers in order to use these products to build up a vaccine manufacturing capability for the future. In effect to leap frog having to invest and develop products on their own. No doubt international vaccine companies are concerned about this commercial risk to their own future.

Waiving IP on vaccines does not guarantee delivery to populations; it is one step only, out of dozens that a country needs to solve. Apart from a TRIPs waiver, compulsory licensing and import and other parallel import options (which pharma companies are permitting with different pricing) also offer solutions to delivery of large volumes of vaccines. The real issue is the global capacity for vaccines was never going to be enough for a quick roll out. The delivery of medicines needs more than just IP to be effective.

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