“Donations are not the solution — developing countries have realized that we need the technology and the capacity to respond to pandemics ourselves,” says Maira Macdonal, Bolivia’s ambassador to the World Trade Organization (WTO).

She’s speaking to Global Citizen from Geneva where she has been advocating for international intellectual property and patent laws to change in order to allow her country to secure more access to COVID-19 vaccines.

The COVID-19 pandemic hit Bolivia shortly after a 2019 political crisis and a consequent economic downturn.

“It was hard to face the pandemic when it started after a crisis like that,” she adds. “But we’ve tried to do everything we can to fight it, and we’ve been very open about going to all the countries we can to get more access to vaccines.”

Reprieve in the form of higher vaccination rates couldn’t come soon enough — but with production worldwide under the strict control of a handful of pharmaceutical companies, the country is struggling to buy the millions more doses it needs, and money isn’t the only issue.

Bolivia, like many developing countries, faces structural challenges, but was able to contain the spread of the virus by applying lockdown restrictions and other precautionary measures recommended by the World Health Organization. The government targeted the outbreak by providing free mass tests, localised co-odrination, and free vaccination.

But as the pandemic raged on, it came under economic pressure to open up, leading to surging case numbers and the health system all but collapsing. Stories of desperate families travelling from hospital to hospital to find beds and oxygen for their sick relatives became more frequent, and health workers went on strike because of the pressure.

Thanks to the international vaccination sharing facility COVAX, and vaccine imports from China and Russia, Macdonal explains, Bolivia began a vaccine roll-out in February with 25% of its population having received at least one dose.

But that is far from protecting the entire population and doses are coming too slowly, so Bolivia has joined other low- and middle-income countries in supporting a call from India and South Africa for a temporary waiver on the full range of intellectual property surrounding the production of COVID-19 vaccines and other key medical tools, including patents, know-how, and trial data.

Currently, patented COVID-19 vaccines can only be produced by the companies that developed them. But almost all of the companies accepted vast sums of public funding to fast-track development of the vaccines and enable them to start manufacturing even before full results of the testing process were known — giving strong claims to public co-ownership.

Now, limited vaccine supply is seen as one of the major challenges standing in the way of ending the pandemic, especially as wealthier nations pre-ordered vast quantities of vaccine doses from different promising suppliers, leaving poorer nations with very limited access.

The path of least resistance for countries to access vaccines is for the World Trade Organization (WTO) to temporarily waive intellectual property rights for the vaccines, but discussions have already dragged on for months.

So Bolivia, alongside a Canadian drug manufacturer called Biolyse, are together looking to unlock more doses through a rarely used, cumbersome but lawful mechanism known as a “compulsory license”.

Biolyse says it can manufacture 15 million Johnson & Johnson COVID-19 vaccine doses on Bolivia’s behalf and export them, if they are granted permission from the Canadian government to manufacture the vaccine without the approval or involvement of the patent holder.

The company argues that this is possible if Canada were to add COVID-19 vaccines to a list of drugs that can be produced with a compulsory license using Canada’s “Access to Medicine Regime” — legislation designed to increase access to medicine in developing countries in emergency situations.

However, so far the Canadian government has stalled progress on granting this license after four months of attempts, according to John Fulton, the executive vice-president of Biolyse.

“There’s lots to say about this, but all I really have to say is that I’m being completely ghosted by the Canadian federal government with regards to even starting the conversation [regarding granting the license],” he told Global Citizen.

Fulton explains that Biolyse is one of a small number of companies in Canada that has a license to manufacture injectable drugs, and it’s current role is shipping frontline cancer medicines within Canada and around the world.

At the start of the pandemic they were close to completing a manufacturing facility on their site that could produce vaccines at high capacity, he adds, saying, “we could have been up and running within four to six months.”

Since the start of the pandemic, Biolyse has been calling on the government to allow them to use their manufacturing capacity to help produce vaccines for lower income countries, with Fulton sending an open letter on June 11 this year to Canada’s minister of innovation, science, and industry, Francois-Philippe Champagne, imploring them to do so.

To get a compulsory license, Fulton explains, you have to “find a country in need and you need a patented drug — and we have both,” but he says there has been a reluctance to start the process.

Bolivia is just one country being forced into the complex situation of pushing for a compulsory license. It’s something Ambassador Macdonal says her government is exploring down every possible avenue to increase its access to vaccines.

“We have been advised by wealthier countries to look at using compulsory licensing with individual nations rather than rely on a TRIPS waiver, but so far it hasn’t been successful,” Macdonal says. “[The Canadian government] tell us it will take time to be granted it, but they never say how long.”

NGOs, including Global Citizen, have called for more flexibility in the intellectual property laws governed by the WTO — known as the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement — via a temporary waiver to help end the pandemic and the measure is supported by some major economies including the US and France.

A motion to do this was tabled back in October 2020 but the WTO has only recently agreed to begin negotiations amid growing calls from developing countries.

“It doesn’t make sense for the entire world to be dependent on just a handful of pharmaceutical corporations that cannot make enough vaccines for everyone,” Oxfam Health Policy Manager Anna Marriott said at the start of the talks.

“However many millions of doses G7 leaders pledge to donate to COVAX, there will only ever be enough if more vaccines are being produced and the way to do that is to share the intellectual property and the technology,” she added.

An official from the WTO has also supported Biolyse and Bolivia’s effort to seek a compulsory license from Canada. Speaking to the Globe and Mail, Antony Taubman, director of the WTO’s intellectual property division, said it was “a very welcome step and one that may perhaps pave the way for other [WTO] members to make use of the system.”

Macdonal agrees that at this point any movement in the direction of helping developing countries secure supply would help — either through compulsory licensing or the TRIPS waiver. 

“We appreciate and understand the innovation [in producing vaccines] that developed countries are trying to defend, however, extraordinary times call for extraordinary measures,” Macdonal adds.

Success down this path could take many months or even years. But Bolivia is keen to pursue all possible means to protect its citizens from COVID-19, and for that it will need international solidarity.

And it is a path Bolivia is well aware they shouldn’t have to travel alone, with Macdonal adding: “No one country can deal with this situation by themselves, there has to be a global answer.”

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Defeat Poverty

Bolivia Could Unlock New Access to Life-Saving COVID-19 Vaccines — But Needs Canada to Grant a License

By Helen Lock