As India faces a catastrophic COVID-19 outbreak, five top Democratic senators wrote to Pfizer, Moderna, and Johnson & Johnson, seeking global access to vaccines, including technology transfer.
"COVID-19 has infected over 148 million people and killed over three million globally, with hundreds of thousands of new cases and thousands of deaths being reported daily," the five senators wrote in identical letters to the CEOs of Pfizer, Moderna and Johnson & Johnson on Wednesday.
Senators Elizabeth Warren, Edward J Markey, Tammy Baldwin, Jeffrey A Merkley, and Christopher Murphy said India is a major producer of the Oxford/AstraZeneca COVID-19 vaccine and has exported over 66 million doses globally since January 2021.
But in the midst of the recent surge of COVID-19 cases, India is struggling to vaccinate people fast enough to quell the outbreak, they said.
"Though Pfizer, Moderna, Johnson & Johnson, and other companies have developed safe and effective COVID-19 vaccines, the uncontrolled spread of coronavirus poses significant risks to global vaccination efforts: as the virus proliferates, it is evolves increasing the risk of a variant developing that renders vaccinations ineffective," the senators wrote.
Frequently Asked Questions
A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.
There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.
Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.
According to the letter, copies of which were released to the press, there are several steps that vaccine companies could take to expand access to the vaccines globally, including in India.
One of them being that these companies could affirmatively decide to share technology, such as vaccine recipes and manufacturing information, with partner companies to expedite production, it said.
This technology transfer could take place voluntarily, they suggested.
Meanwhile, the World Health Organization (WHO) has set up multiple mechanisms through which technology transfer could occur, including through its "COVID-19 Technology Access Pool" (C-TAP), which calls on "the global community to voluntarily share knowledge, intellectual property and data necessary for COVID-19" and its mRNA vaccine technology transfer hub, which seeks to "expand the capacity of low- and middle-income countries to produce COVID-19 vaccines and scale up manufacturing" by facilitating the transfer of technology and intellectual property to those countries.
Experts have also called for the US to support the temporary waiver of some Trade-Related Aspects of Intellectual Property Rights (TRIPS) rules proposed by India and South Africa at the World Trade Organization (WTO) which would temporarily lift certain intellectual property barriers and allow countries to locally manufacture COVID-19 diagnostics, treatments, and vaccines.
The Biden administration has not taken a call on it yet.
"Though wealthier countries, including the United States, have successfully secured vaccines and have made significant strides in vaccinating their populations, many middle- and lower-income nations have less access to vaccine doses. A recent study estimates that unequal global vaccine distribution could result in a gross domestic product loss of USD1.2 trillion annually for the global economy," the senators said.
In three identical letters, the senators said India is facing a humanitarian and public health crisis, with over 350,000 new COVID-19 cases reported in a single day earlier this week.
Amid the recent surge of new cases, India has paused export of vaccines, but it is still struggling to vaccinate people quickly enough to quell the outbreak, the letters read.
India's Serum Institute the nation's largest vaccine manufacturer can reportedly produce only 70 million AstraZeneca doses a month, and even when AstraZeneca shots are combined with India's second approved vaccine, there are not enough doses to meet the demand or the need, the senators said.
Currently, a little more than one per cent of India's population is fully vaccinated allowing the contagious B.1.617 double mutant COVID-19 variant to spread widely, they said.
The senators listed steps the three companies could take to increase global vaccine access, including sharing technology, such as vaccine recipes and manufacturing information, with partner companies.
"This technology transfer could take place voluntarily, underpinned by open, non-exclusive, and transparent agreements done in collaboration with the World Health Organization (WHO)," they suggested.
The senators also asked a time-oriented series of questions to Pfizer, Moderna and Johnson & Johnson.
These include if they are opposed to the TRIPS waiver. If so, have they engaged in lobbying activities to convey its opposition to the USTR, WTO, members of Congress, or the White House.
The companies were also asked about alternative mechanisms, other than the waiver and entering into voluntarily licensing arrangements, they might have considered to rapidly expand global access to COVID-19 vaccines.
Observing that India has asked Moderna, Pfizer, and Johnson & Johnson to seek licences to distribute their vaccines in the country as a means of expanding supply, the senators asked the three companies if they have plans to apply for an emergency-use licence for their vaccines in India.
"If so, when," they asked.
Seeking information on what current barriers are preventing expanded access to vaccines in India and the rest of the world, the five senators asked if they have plans to enter into conversations with companies based in India for the purpose of manufacturing vaccine doses there.
"If not, why not," they further asked.