Decolonising public health: India’s COVID crisis is a global one

Nandini Chatterjee, Dora Vargha, Rebecca Williams
University of Exeter

In a  widely criticised interview with Sky News on 25 April 2021, the IT billionaire and philanthropist Bill Gates Jr. responded to a question whether he supported sharing the ‘recipe’ of the Sars-COV-2 or Covid-19 vaccines with manufacturers worldwide, with an emphatic: ‘No.’ No, he said, because there ‘are only so many vaccine factories in the world, and people are very serious about the safety of vaccines.’ Moving the production of a vaccine from Johnson and Johnson’s to a factory in India was already novel, he said, and could only happen because of ‘our grants and our expertise.’ Intellectual property was not holding back anything in this case, he said, because it wasn’t as if there were ‘idle vaccine factories with regulatory approvals, that make magically safe vaccines.’

It would appear from this account that most of the world was a place empty of funds and expertise, waiting for the largesse of saviours such as Bill Gates Jr.  and appropriate guidance to be able to protect their own health in a scientific and safe way. Looking at the story of the Oxford-AstraZeneca vaccine with some more attention, however, produces some rather more complicated stories.

On 23 November 2020, an Oxford University-based research team led by Dr Andrew Pollard declared a breakthrough in developing an effective vaccine against Covid-19. The team had been working furiously for months, backed with UK government funding and public donations. Oxford University then announced a permissive protocol for licensing COVID-19 related IP to third parties under ‘these exceptional circumstances.’ Of the 5 points of guidance offered to organisations seeking licences to use Oxford University’s IP (or recipe for vaccine), one was: ‘The default approach of the University and OUI regarding (1) will be to offer non-exclusive, royalty-free licences to support free of charge, at-cost or cost + limited margin supply as appropriate, and only for the duration of the pandemic, as defined by the WHO.’

Such an approach is not unprecedented. In the 1950s polio epidemics swept through the globe, and in the midst of outbreaks two rivaling vaccines were developed by Jonas Salk and Albert Sabin, both without patent. When asked about this, Jonas Salk famously remarked ‘Would you patent the sun?’. It seems that the decision for the Salk vaccines lack of patent might have been a practical one, as it would not have been possible by contemporary standards, regardless of Salk’s moral stance. Sabin’s decision was an openly political one: the vaccine was a result of international collaboration between researchers of the two opposing sides of the Cold War, and this scientific exchange was greatly celebrated at the time. Of course, Gates is right that a lack of patent doesn’t automatically mean immediate access and capability of vaccine production everywhere in the world. It took years for many countries, in war-ravaged European states, up to half a decade to establish infrastructure, skill and procure materials (including live animals) for domestic vaccine productions of the Salk vaccine. However, many others had the capability, while standards of production were developed by the WHO, and this, in the end, dampened the dire global vaccine shortage in both the short and long run. More importantly, the lack of patent did not hinder national or global vaccination efforts. 

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