Nondumiso Gumede was the third staff nurse to be vaccinated by Matron Maggie Pillay (left) during the rollout of the Covid-19 vaccine at Prince Mshiyeni Hospital in KwaZulu-Natal. Picture: Bongani Mbatha /African News Agency (ANA)
Nondumiso Gumede was the third staff nurse to be vaccinated by Matron Maggie Pillay (left) during the rollout of the Covid-19 vaccine at Prince Mshiyeni Hospital in KwaZulu-Natal. Picture: Bongani Mbatha /African News Agency (ANA)

Trapped between vaccine nationalism and neo-liberalism

By Opinion Time of article published Feb 20, 2021

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Ashraf Patel and Dr Alex Mashilo

The global Covid-19 pandemic crisis is the gravest global disaster of modern times. Sadly, it rapidly descended into the most rabid nationalistic form – Covid 19 vaccine nationalism and selfishness.

In his speech to the World Economic Forum 2021 Virtual conference on June 27, President Cyril Ramaphosa made a heartfelt appeal to wealthy nations not to hoard Covid-19 vaccines, but free them for the developing South.

For a leader of the AU and South Africa as a member of the G20 and BRICS to plead in this manner shows the stark unequal power relations of the rich developed world vis-à-vis the precarious position of the developing South.

Sadly, South Africa’s Covid pandemic response has been mired in mismanagement; from the personal protective equipment scandals, the mega International Monetary Fund bailouts which had no money for vaccine development, and now the great Covid vaccine procurement debacle of Oxford-astrazeneca being procured from the Serum Institute of India (SII) is an example of a patent-profit model.

The patent-profit model of Astra and Oxford is to develop new vaccines in response to new Covid variants (501.Y) – and then create new vaccines through new company Novavax (also owned by Oxford and Astra) in a grand new pharma-industrial complex. African nations are again becoming mere consumers of vaccines and locked out of any local innovation systems and capacity development.

It is diabolical that despite hosting a clinical trial of the Astrazeneca vaccine, South Africa was unable to secure a fair-pricing agreement. By not leveraging South Africa’s participation in clinical trials, authorities violated the well-established fundamental principles of post-trial access and benefit-sharing in research.

The country procured its first delivery of the Astrazeneca vaccine from the largest vaccine manufacturer in the world, the SII. A million doses arrived at a cost levied by Astrazeneca of $5.25 (about R107) a dose. This is more than double the $2.16 a dose paid by EU countries to Astrazeneca. On average, Western pharmaceutical corporations Moderna, Astrazeneca and Sanofi, have received upwards of a billion dollars each from their national health institutes.

Covid vaccine nationalism and patent profiteering have pushed nations like Tanzania and Madagascar to reject global Covid-19 vaccines. Perhaps it is decades-long fatigue of “developmental aid” and strings attached that has moved them towards a form of selfreliance and to seek indigenous solutions?

There are thus opportunities for African countries and societies in the developing South to experiment with forms of indigenous knowledge systems (IKS) that can address health challenges. It is also a form of resistance in the face of massive pharma-patent profiteering and invariable dumping of Covid vaccines into Africa that remains a risk in the years ahead. South Africa has an IKS policy, but where are the programmes?

Economist Ha Jung Chung, in his book Kicking Away the Ladder, provided ample examples of how rich developed nations kick away the ladder of development through trade and patent policies that lock in nations to agreements, while eroding national capacity. In this scenario, both India and South Africa, far from investing in national and local indigenous Covid vaccines, have become middlemen for global multinational corporations. Far from the Kicking Away the Ladder argument with regard to policy space, South African and Indian elites are wilfully agreeing to the Thatcherite dictum: “There is No Alternative.”

For instance, Russia’s Sputnik vaccine and China’s Sinopharm are examples of a model combining a developmental approach, whereby nations have the option of local manufacturing capacity – options more in line with localisation imperatives of the developing world.

Key areas for intervention:

1. Advocating for a public health patent system at the WTO

The AU should join South Africa and India in seeking a general waiver to the World Trade Organization’s (WTO) Trade-related Aspects of Intellectual Property Rights Agreement in relation to Covid-19 drugs, vaccines, diagnostics and other technologies. Nations such as Turkey, Mexico, Bolivia, Algeria and Hungary have all showed a remarkable approach to diversity in their Covid 19 pharma value chains, thus ensuring national policy sovereignty. Cuba has gone further with its Interferon model to boost the immune system that is relevant and effective.

2. Towards a national pharmaceutical corporation

South Africa needs integrated state co-ordination. In 2012, the Department of Science and Technology launched the Grand Challenge strategy – From Farmer to Pharma innovation plan. The Department of Science and Technology briefed members on the status of the Bio-economy Grand Challenge with particular reference to the Farmer to Pharma Grand Challenge; what the Bio-economy Strategy entailed; outputs of the Biotech Innovation Centres; and interventions in health, agriculture and clean technologies.

By 2030 the global population was expected to increase by 28%; 97% of that in developing countries. On the bio-economy, it was important to adapt to the changing local and global landscape, in order to decrease the burden of diseases and maintain sustainability.

Sadly, South Africa has invested resources in its national system of innovation and is in perennial policy development mode, but has lacked any big ticket development innovation outcomes.

In a globally competitive world moving towards a multipolar world order, there is more development policy space for middle-income countries to take advantage of achieving the UN Millennium Development Goals.

In terms of dealing with the Covid pandemic and its management, South Africa has, sadly, reverted to unequal power relations, subordinating itself to Northern economies and multinational interests. Do we have the vision and leadership to embrace alternative models?

* Patel is a digital economy associate at the Institute for Global Dialogue and Dr Mashilo is a member of the SACP’S Central Committee.

** The views expressed here are not necessarily those of IOL.

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