How nations can unite to make the pandemic treaty work

A stark reality of a pandemic is that no one is safe until everyone is safe.

Negotiations are on at the World Health Organisation to finalise the first global pandemic treaty and to amend the International Health Regulations 2005, for better sharing of cross-border information on outbreaks of infectious diseases with the potential for global spread, and to ensure equitable access to the resources needed to tackle the pandemic, including vaccines and treatments. Noble and appealing as the goal looks from a distance, like the moon, the closer you examine it, the grosser it looks. Rightwing politicians of many countries, notably the US, have been raising objections based on multiple fears: one, loss of national sovereignty, two, taxpayer money flowing abroad, and three, dilution of the intellectual property regime.

A stark reality of a pandemic is that no one is safe until everyone is safe. Given the globalized nature of business, research and development and the workforce, people, containers and packets travel across borders all the time, each cross-border movement representing a possible source of contamination/ infection. So, the choice is either to raise national barriers to shut down cross-border movement of people and things, or to cooperate across borders to detect, prevent and contain potential pandemics.

Impact of a Pandemic

The city of New York is home to people who speak over 700 languages. The share of international merchandise trade alone is close to 60% of global output. Imagine the crippling costs of shutting down trade, for fear of disease. India, for example, imports 80% of its energy, as oil, gas and coal. Imagine the consequence of removing these imports. Many countries depend on imports for food. Without wheat from Russia and Ukraine, there would be bread riots in many African countries, and hunger around the world as the price of wheat soars in traditional importing nations and the price of cereals crashes in traditional exporters, crushing the purchasing power of farmers. There would be shortages of drugs, surgical consumables, syringes, vaccines and other life-saving equipment, as the experience of Covid demonstrated.

So autarkic isolation is a bad idea. That leaves us with global cooperation as the only alternative. A crucial issue here is pathogen access and benefit sharing (PABS). China, after initial attempts at cover-up, after the outbreak in Wuhan, quickly sequenced the Covid virus genome and made it available to the rest of the world, so that people could get cracking on making a vaccine. Pathogen access worked well in that example. But what of benefit sharing?  A handful of companies of the rich world developed vaccines, and, later, some therapeutics. Access to these for the rest of the world proved extremely unequal. Even with such unprecedented success in swift development, trial and deployment of vaccines, millions died from Covid, before the world acquired herd immunity.

Development of mRNA Vaccines

One gain from the Covid pandemic has been deployment of the mRNA vaccine. RNA is part of our genetic material. The prefixing m stands for messenger. The mRNA vaccine encodes the instruction to the vaccine recipient’s body to synthesise the invading virus’s unique protein internally. The natural immune system then kicks in, and generates antibodies to surround and destroy the alien protein, although it was produced by the body itself. In the Covishield vaccine that most Indians received, the spike protein of the offending corona virus was introduced into the human body by packing it into an inactivated adenose virus and injecting the virus into the body. This type of vaccine is called a viral vector vaccine. Bharat Biotech’s Covaxin is a close cousin of the traditional inactivated virus vaccine; it contains, instead of the entire virus, a virion, a virus particle with its DNA and outer shell called capsid. Novavax, another high-tech vaccine from the US, contains the spike protein, synthesized from moth cells, and introduces it directly.

The mRNA vaccine is the most interesting, because it is a modular vaccine: you change the chemical message as to what protein has to be synthesized, and it becomes a vaccine against a new virus containing the protein in question. Its original shortcoming was that it had to be stored at ultra-low temperature, but now Moderna claims that its vaccines can be stored at -20 degrees Celsius, the freezer temperature of a household fridge.

Better Vaccine Distribution

The sensible thing to do is to build a string of mRNA vaccine production facilities around the world, ready to churn out large quantities of the vaccine at short notice. Who would invest in these facilities? A global trust managed by the WHO, with contributions from willing donors, could bear the cost in Africa and least developed Asia. National governments could partner with private parties elsewhere. What about the intellectual property (IP) of mRNA, already the subject of litigation between Moderna and BioNTech? The US government funded the original mRNA research, both at universities and, via its Defense Advanced Research Projects Agency (DARPA), at Moderna. It could buy out the IP or bear the cost of licensing it to all vaccine production facilities. Covid cost the world trillions, spending a few billion on mRNA IP would be a bargain.

How about the actual cost of vaccine manufacture, storage and distribution? It could be financed from the proceeds of a pandemic bond issuance. A pandemic bond, like a catastrophe bond, could abate, in full or part, in case it strikes, and offer a risk premium to regular bond yields to attract investors on the look-out for exposure of a sliver of their corpus to a high-yield instrument not correlated with normal business cycles. Regular Cat bonds have lots of takers, and there is no reason why pandemic bonds should fare any worse.

With the right imagination and will, it is possible for the world to cooperate on pandemics.