Patents vs Access to Covid Vaccines in Africa : An Example of Axiological Degeneracy

The cindynic approach to the Risk-Conflict-Development complex puts humans back at the heart of vulnerability reduction strategies. Thus, actors of the situations are observed according to five basic dimensions, including the ethical or axiological dimension. The deficits highlighted in these dimensions are vulnerability factors: ethical degeneracy is one of these deficits, perfectly illustrated by the difficulty of access to anti-Covid vaccination in Africa.

In Cindynics terminology, degeneracy means lack of priority: Cindynics originally come from the engineering world, which is why this term was borrowed from quantum mechanics where there is degeneracy when different wave functions have the same energy level.

Cindynics are not axiologically (ethically) neutral: their raison d'être is based on respect for life and the environment. The relativisation introduced by second-order Cindynics raises the question of the smallest common set of values on which they could be based, while also recognising diversity and the relativity of other values: The Universal Declaration of Human Rights can provide this set of common values.

On one condition: to have a non degenerated reading of this declaration, in other words, to understand that this set of values is ordered. For example, article 3 establishes the right to life. And paragraph 2 of article 27 establishes the right to intellectual property. A degenerated reading would be to consider that the right to life would not take precedence over the right to intellectual property. This is a key question when it comes to the issue of access to medicines and vaccination, especially against Covid, in Africa and in southern countries.

When the WTO was created, the TRIPS agreement signed under intense lobbying from northern countries forced signatory countries to adopt legislation recognising the patentability of medicines. Thus, India, which could previously provide drugs at affordable prices for southern countries had until 2005 to transpose the obligations of this agreement into national law. Both NGOs, such as Doctors Without Borders, and the WHO criticised this transposition. Resistance from civil societies led to the Doha declaration which aims to reduce threats to access to medicines and authorises compulsory licenses allowing a country to produce itself a foreign medicine for its own population. In this context, industrialised countries like the United States are getting around these difficulties by imposing even more restrictive bilateral agreements (the so-called “TRIPS+ˮ standards) to some countries. This practice was notably condemned as "immoral blackmail" by French President Jacques Chirac in 2004.

Compulsory licenses prevented southern countries with insufficient or no manufacturing capacities from accessing these drugs at affordable costs: an amendment was formally built into the TRIPS Agreement on 23 January 2017, after two-thirds of the WTO members finally accepted it, so that countries with manufacturing capacities and producing drugs under compulsory license can export them to countries without such capacities.

In September 2020, the Director General of the WHO denounced vaccine nationalism, affirmed the need to ensure access to anti-Covid vaccination in southern countries, and announced the establishment of the COVAX mechanism (a component of the ACT-accelerator), which aims to guarantee equitable global access to vaccines. The COVAX mechanism only guarantees access to anti-Covid vaccination for 20% of the African population, while the goal is to vaccinate at least 60% of this population.

In November 2020, developed countries had struck deals with pharmaceutical laboratories for a number of vaccines monopolising most of the world's production capacity until the end of 2021. A group of southern countries therefore pressed the WTO to lift the patent protection on anti-Covid vaccines, given that production capacity is unused in developing countries, and the current WTO mechanisms do not allow these capacities to be used quickly.

On February 3, 2021, Médecins sans frontières denounced the opposition of some WTO members (US, EU, UK, Japan, Switzerland, Brazil, Canada...) to this patent waiver, and called on developed countries not to block this patent waiver during the Covid-19 pandemic.

At the end of January, Pfizer, Moderna, and AstraZeneca announced production problems and a reduction in deliveries to the European Union, which in turn is the victim of underproduction resulting from the patents it defended. As a result, European officials, such as Marc Botenga or Fabien Roussel, are also starting to request the patent waiver during the Covid-19 pandemic, while some players nevertheless persist in believing that the current WTO exceptions are sufficient.

Meanwhile, Africa is looking to Russia and China for more vaccines. Regarding health diplomacy, these two countries are therefore benefiting from the situation, as Russia extends its influence in Africa following the sanctions imposed after the annexation of Crimea, and China must obfuscate the censorship that it imposed at the start of the epidemic, thereby slowing down the international response.

The European refusal to suspend patents during the pandemic is reminiscent of a strange French geopolitical movement, which somehow handed over the Central African Republic to Russian influence and to the operations of Evgueny Prigozhin and the Wagner group by suggesting to CAR leaders that they should get arms from Russia.

A further risk is thus highlighted: an axiological degeneracy can also have geopolitical consequences.