 Hello and welcome to Newsweek. Today, we have Professor Satyajit Rat and we'll be discussing first the WTO round of discussions again on the question of waiving various intellectual property rights by those who hold it. In this case, particularly vaccines, but also a whole range of now pharmaceutical products which are available for treating virus in the early stage, monoclonal antibodies, for example, as well. So there's a whole range of things which actually we should be discussing, not just simply vaccines, which of course are the more public face or what the debate is all about. Satyajit, to ask you the brutal frank question, do we really need waiver of patents on vaccines? Because under the Doha round, actually we could use compulsory licensing if we want. So why is this not looking at compulsory licensing but looking much more on the trips waivers, new waivers that is being demanded, which is, of course, what was started by South Africa and India. And rightly so, because we're talking of a range of other issues as well, including reagents, including other things. But just for vaccines, why do we need this waiver? So there are two issues here, I think. The first issue is what will be ostensibly pointed out. And that ostensibly pointed out issue is the fact that vaccine manufacture for all the vaccine platforms, the mRNA platforms, the adenovirus platforms, quite certainly, and even the protein platforms, involves transfer not simply of access to patented information and material, but also access to specialized reagents and the confidential information associated with the manufacturing process, the manufacturing technology and process. Effectively, the more complex the manufacturer is, the more likely there are to be trade secret components. And since vaccine manufacturers are fairly complex process in industrial terms, there's a fair number of trade secrets. And therefore, simply countries declaring compulsory licensing, except in rare instances, may not actually lead to successful manufacturing production. So negotiations are going on. The other component, of course, is that there is an implicit acknowledgement all around that the doha accords and declarations are not being held as the starting point. Instead, the starting point is the far more modest text that was proposed two years ago. And that seems now to be even more focused and watered down. And the last point I would like to make, before I hand it back to you for commentary on the political economic issues involved, is let us be clear that these things have been discussed for almost two years now without an outcome in the middle of a pandemic which in the interim has killed millions. And that itself underlines a substantive failure of the process. And it's also interesting, Satish, when you talk about it. Initially, we had a few of the European countries who shed crocodile tears about wars, only if it happens in Europe, not anywhere else. But at the same time, they do not seem to have too much sympathy or never had shown too much sympathy for the victims of COVID-19 pandemic, particularly in the third world countries. Because if you look at the European Union, they have been at the forefront of the opposition to any weakening of the intellectual property rights. So that has been their position from the beginning. And of course, the United States initially, but in the Biden, they said, yes, we are willing to wave off. But what appears now is that the wading off is really a facade behind which the basic controls of the technology will still stay. So we come back to Bill Gates' understanding that only when we support transfer of technology can these countries, which are really poor, underdeveloped, don't have science and technology, like India, for example, can they really manufacture such vaccines without us? They can't do it. So that's the nutshell what is being talked about. But it's also what we understand from what we see of the proposals. They're also restricting India, Brazil, and China, the three countries which are intermediate level countries who could then, even if they got a waiver, could perhaps manufacture these things themselves, then they are not allowed to do so. And it becomes particularly interesting that all of these processes that we are talking about have not been developed by the private companies, but have been really developed out of government grants, other grants being given. They come from public money. And the governments which have given these grants want really monopoly profits there for their vaccine companies. And as we know, the largest money spinner for the vaccine companies has been the COVID-19 vaccines, whether it is modern or which never had a successful product, or the other vaccine, which is what is widely being used in the West, because that's also one of these mRNA vaccines. And there again, the major profits have come from essentially this year or last two years really come from this particular vaccine. It started the BioNTech vaccine, the later on became, I'm sorry, what is the company? Pfizer. It started the BioNTech vaccine. Now it's being called Pfizer vaccine, because Pfizer bought international rights for it, of course, not in competition with BioNTech. So how do you look at this? So interestingly, this entire effort over the last two years, which is effectively a matter of trying to do something about the stable door after the horses disappeared over the horizon. But this entire process, even at its own glacially slow pace, is directed at a very narrow set of waivers and exceptions to be granted. And to be granted, as you point out, to very, very specific countries that will desperately need active tech transfer aid in order to be able to manufacture. So countries like India, China, Brazil have not been excluded by name. But by imposing the condition that countries which export more than I think a 10% threshold will not be eligible for these waivers. All of this is essentially in conjunction with the slow pace of negotiations. And the commercial damage limitation exercise to all intents and purposes rather than a public health facilitation exercise. If we look at the final figures even today, Africa has got less than 20% of its population fully vaccinated. Well, we have seen in advanced countries a more than 100% vaccination, meaning that people have got the two doses plus they have the third booster dose and some places also the fourth booster dose. And starting now to also go down the age groups. That's not no longer, there's the adult population, children as well and even younger children. So this is a very dismal outlook for the world that after looking at the AIDS epidemic what all was said that we should not repeat the experience of the AIDS epidemic where Africans were really denied a life saving medicine. South Africa had to fight a long court battle against companies which said, you can't import from India life saving AIDS drugs. You should instead import from us even if you can't afford it and even if your people can't afford it that's just too bad. So in spite of the warnings that this should not be repeated we seem to have repeated in the game. And now I guess we are all into looking at Africa getting quote unquote heard immunity the way Boris Johnson wanted for England. Basically yes, but let me point out that rather than putting this at the door of profit making companies alone what we should keep in mind is that so-called democratically elected governments across the world have been complicit in this entire profit oriented shift of the social commons of public health as a social group. And that is the far more worrisome prospect going forward the complicity of democratic governments in the privatization of social group rather than simply companies doing what they will do which is maximize their profit. So the other part of it that we've discussed this enough earlier as well that the more we do this the more we expose everybody including the people in the advanced countries who supposedly they are protecting well we actually really open them out to future variants and we already have seen two major variants which have spread in the world after I mean this would be the third if you include the alpha variant as well as not the original virus then we get alpha then delta which is really a huge hit in terms of everything including people dying, trade, everything. And then we now have Omicron and we have the Omicron variants which seem to be quite different from the what the earlier Omicron variant was. So we are going to open ourselves again and again to new variants coming up and therefore this seems to be retrogressive in global terms because the global economy has taken a huge hit because of COVID-19 pandemic. It is absolutely regressive as a public health response not to do inclusive aggressive vaccination coverage with community informed participation. And both components of this have been lacking and I will fault governments, democratic governments once again for not reaching out to communities informing and empowering communities to participate in vaccination programs as much as I will fault what we've been talking about which is the supply side shortages of vaccine delivery, particularly vaccine deliveries to remote locations and sites across much of the poor areas of the world. I must however point out something else that's beyond vaccination in the context of the question you asked and that is vaccination, especially vaccination based on 2020 strain information which is what our vaccines are quite efficiently it prevents serious illness and death even by today's strains, including by Omicron strains. There's been some loss of protection but not a dramatic loss of protection. However, transmission prevention is nowhere near efficient by the vaccine for today's virus strains. In other words, Omicron has spread across the world in vaccinated populations quite efficiently because vaccination even though it prevents serious illness does not particularly efficiently prevent transmission. It does but not very much. As a result, declaring that the pandemic is over which governments across the world have tacitly or even explicitly done, including here in India has led to the fact that we have ceased to behave with any care or caution at all none of us is using masks. No government has taken on a public health responsibility to provide efficient reusable masks to its citizens. This has never been done in the pandemic and now of course we've ceased to think that the pandemic is still active and therefore we even more don't worry about masking. Unless of course it takes China into account which is trying a very different philosophy. Absolutely, but the fact of the matter is that this is resulting in a very large pool of viruses that are circulating, virus strains that are effectively growing out there and making it easier and easier for new variants to keep popping up which is what is happening in the Omicron lineages. One word about China. Yeah, sorry, as you said, just about the introduction. As you said earlier, in fact, you've told us a number of times that vaccine escape is what is obviously the evolutionary path for the virus since most people, a lot of people are vaccinated. One point of view about the Chinese effort. Now the Chinese effort makes sense in some ways from the Chinese point of view where they may not be able to handle for their vast population, huge numbers of sudden seriously ill people and therefore they have gone in because they can throw technology and social support for extended lockdowns and testing at this problem. They've adopted the zero COVID policy. This may not be practicable for other countries. The problem I think that the Chinese approach is facing is paradoxically the same one that we are talking about namely that this is not a national problem, this is a global problem. And so long as the world is bringing up virus variants, China's borders are going to be battered steadily by newer and newer and newer variants. And the Chinese policy is going to run no matter how successful their zero COVID approaches are over the short term, they're still going to run into better and better transmissible variants. And therefore the bar for their success is going to keep rising. Again, this is not to say that the Chinese policy is right or wrong, but to underline the fact that we need a global inclusive thought out integrated policy that treats public health as a global social good. Last point, we did not discuss apart from vaccine the other issues, but whether you take, particularly if you take the small molecule which is also what is now being made available for the people who are to fall in. Though as we have said various riders, it has to be, if you want to have an antibiotic, it has to be early, it has to be taken in the first two, three days, not beyond the three days, definitely. And the monoclonal antibodies are not working against, of course, the newer variants. Taking all of that into account, at least for the small molecules, of course, we have the old not-piped into drugs also being used and some of them seem to have some antiviral properties too. Do you think that is also an active area that we could encourage people to take out compulsory licenses and use them? Well, it's certainly very much part of what I would consider an integrated global response to the pandemic. And therefore making available, especially the oral antiviral drugs under compulsory licensing, drugs such as molnupiravir, drugs such as paxilovid, there are one or two more that are in advanced stages of development. All of these will very, ought to very much form part of the conversation, but the current texts are somewhat hazy about whether they are properly part of the conversation or not. Again, underlining the fact that this entire discourse is beset by commercial considerations and profit considerations rather than a full-throated endorsement of public health across the world as a social government. Essentially protecting markets and profits as the objective under the cover of providing some relaxation because of the pandemic seems to be the thrust that we are talking about at the moment. And even this is, doesn't seem to be a vigorous rearguard action to will by the countries which are most affected by it. And that doesn't seem to be there. So in some sense countries like India, South Africa, Brazil seem to be co-opted into this policy, though it was originally South Africa and India who raised the flag in WTO. It seems that our response now has become much more, shall we say, weak in the response that this draft really warranted. We don't see the kind of battle that India, for instance, or Brazil fought, or South Africa fought during WTO. So that's a political commentary, not really a health commentary, I guess. Satyajit. Yes, but unfortunately that's how it looks. Satyajit, thank you for being with us and exploring some of these issues which really are not barely health or dealing with COVID-19, but really dealing with the political economy of health and the larger issues thereof of society. Thank you very much. This is all the time we have today for our discussions on COVID-19. We'll come back to you with this and other discussions and maybe broaden it out to involve Satyajit on discussing about global health in general, not simply COVID-19, because after all we now have monkeypox which is roiling at least the communities that are looking at it, particularly communities like you Satyajit who look at immune responses and so on. And we also seem to be seeing other issues that are coming up. We did also discuss perhaps WHO's discussions about where the COVID-19 originated from, even if it is merely a historical footnote. Thank you very much. This is all the time we have for NewsClick today. Do keep watching NewsClick and do visit our website.