In 1998, the South African Pharmaceutical Manufacturers Association joined forces with 39 drug companies to sue Nelson Mandela’s government for suspending international trade agreements that protected patents for HIV antiretroviral drugs.

At the time of the trial, it was estimated that one in nine South Africans had contracted HIV, and the cost of providing the patent-protected drug was well beyond the reach of the 4.7 million people in the country who needed it.

Defending his decision to bypass the WTO agreement intellectual property protection, Nelson Mandela noted in a TV interview: “I think pharmaceuticals exploit the situation that exists in countries like South Africa – in the developing world – because they charge exorbitant prices that are beyond the capacity of an HIV-positive person. ordinary. This is completely wrong and must be condemned. “

“The government has every right in this situation to resort to generic drugs and it is a big mistake for companies, for pharmaceuticals, to sue the government,” Mandela continued.

By deciding to ignore patent laws, Mandela made a moral decision that saving lives was more important than protecting private property rights. Pharmaceutical companies retorted that if developing countries could actually steal their drugs, there would be less incentive for them to search for new drugs in the future that could also save millions of lives.

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Twenty-three years later, history is repeating itself. In October 2020, South Africa and India noticed that an overwhelming number of pre-purchase agreements for COVID-19 vaccines were being negotiated by rich countries, meaning those countries would get the vaccine by first. The two countries have appealed to the World Trade Organization and asked for a temporary suspension of patents for all drugs and technologies related to COVID, so that the developing world can produce vaccines on their own without having to depend on handouts. of COVAX or donations from rich countries. .

It turns out they were right to be concerned. According to New York Times COVID data tracker, 74% of all COVID-19 vaccines went to high and middle-income countries, while less than 1% went to low-income countries. Following booster injections were administered in rich countries as single injections in poor countries. All the while, lower-middle-income countries suffered the highest estimated surplus mortality rate virus.

The pharmaceutical lobby was immediately unleashed against the proposal from South Africa and India. One of their arguments was that even if they gave up their patents, there weren’t enough manufacturers in developing countries to make the vaccines – and, they argued that even if there were. , it would take centuries for the technical transfers necessary to set them up and run. This is probably not true: this week, Doctors Without Borders identified 120 manufacturers in Asia, Africa and Latin America with the technical requirements and quality standards necessary to produce mRNA vaccines.

But setting aside the technical arguments of who can do what, a more important question is not who should be allowed to produce the vaccine – but who has a moral right to own it in the first place.

The COVID vaccines used in high-income countries have been developed largely – in some cases entirely – with public funding. The AstraZeneca vaccine was invented at the Jenner Institute at the University of Oxford with 99% public funding. Moderna received 100% of its funding for the Operation Warp Speed ​​vaccine, and the Pfizer / BioNTech vaccine was funded with nearly half a billion dollars from the German government. Pharmaceutical companies have also invested huge sums of their own money in vaccine development, without which they could not have produced the vaccines so quickly.

But imagine that the public has invested nothing and that only a small handful of multinational pharmaceutical companies have taken the risk and invested millions of dollars to develop the vaccines. Pharmaceutical companies are certainly entitled to a reward for their investment and the great service they render to humanity in providing life-saving drugs.

But how much should this reward be? Are a few millions enough? How about a few billion? Pfizer announced he would earn $ 33.5 billion revenue from sales of its vaccine this year. Even after withdrawing a share that drug companies say will be reinvested in the development of new drugs, Pfizer shareholders are left with billions to fill their Christmas stockings.

Western society has long enshrined the right to private property; as the old saying goes, possession is 9 / 10th the law. Pharmaceutical companies clearly have the right to sell their goods – in this case vaccines – to whomever they see fit and at the price they see fit. Yet Western societies are also governed by the principles of the Enlightenment, including a right to “life, liberty and the pursuit of happiness”. So what happens when these rights collide? Should someone’s right to “life” mean that they have the right to take someone else’s private property? Representatives of the pharmaceutical lobby would probably say no, while advocates for global health would probably say yes.

Because I’m home alone with my eight year old daughter and desperately trying to avoid watching the first Harry Potter movie for the hundredth time, I decided to take her attention away from the TV inside him. asking how she would solve this moral dilemma. She replied in a typical childhood fashion: “Pharmaceutical companies are not very, very nice, and if sick people need the vaccine, they should go to the police and make the drug companies give them the vaccine. . ” I guess any daughter of a leftist journalist is likely to produce the same answer to this ethical dilemma, but I’d be very interested to hear how the children of Pfizer’s C-Suite would react.

Children are usually pretty good at answering black-and-white philosophical questions that lack nuance. Voldemort is bad, Harry Potter is good. Killing people is wrong, just like stealing mom’s white chocolate bar. The public has invested billions of dollars. Millions of lives are at stake as well as hopes and dreams of returning to “a normal way of life”. While pharmaceutical companies are being robbed of their rights to their private property for COVID-19 vaccines, the same is not true of drugs for HIV or diabetes.

Fortunately for policymakers, their jobs are not currently threatened by children of primary school age. But delegates to the WTO are essentially asked the same question, but with many more nuances that can easily derail the central question of how the global community should organize to respond to a public health emergency. It has been well over a year since the WTO council responsible for intellectual property agreements was invited to consider South Africa and India’s proposal for an intellectual property waiver. So far, nothing tangible has happened. If delegates aren’t sure what to do about the waiver, perhaps they can seek advice from their children, as their moral compass is likely to be stronger.

Another fun question to ask her children is how much money people should give drug companies in return for taking the vaccine and distributing it to poor countries. My daughter said, “Maybe five or ten euros.” For her, that’s a lot of money.

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