 Hello everyone. Welcome to the Amit Sen Gupta Memorial Program today. So the program today is divided into two different aspects. The first is the announcement of the fellowship and also a presentation by the previous fellow. And the next part is a panel discussion on the issues of intellectual property rights. I will now stop sharing my screen and give it to Sarojini who would be starting the session. Over to you Sarojini. Thanks Gavya. This is Sarojini from Jensasthabhyan and People's Health Movement in Samma. Before we start, I would like to share the tragic news that father Stanswamy passed away today. Father Stanswamy was working on many issues, land rights, adivasi rights to many of you. It is indeed a black day for our country, the death of an unborn, 84-year-old man who was imprisoned, denied bail, not given medical attention in time, a patient with Parkinson's, not even allowed to have a start to drink. This is a cruelty of the highest order, rest in power for the Stanswamy. Our deepest condolences and I request all of you to remain silent for 20 seconds. As Gaageya said, now I would like to invite you all on behalf of the organizing committee that is Sita Naran, Shampa Sen Gupta, Raghunandan, Richa, Alka Naran, Indranil, Brahman and Gaageya. Of this event that we are organizing on the occasion of Dr. Amit Sen Gupta's birth anniversary. Thanks to news click for all the technical support. Amit Sen Gupta, a physician, health activist, scientist, a strong advocate of the right to health, appears to be the impact of neoliberalism on the health of the people. Always deeply insightful in his analysis of the global political economy and fearless in speaking through the power. He argued relentlessly about the contesting power structures and for building movement from the bottom up. Many of you are familiar with his work and his association with the people self movement and people science movement. Amit brought his enormous political organizational and leadership capacity to both these moments. He was one of the founders of people self movement, the largest health network in the world, Jansa Sabhyan and many and associated with all India people science network, daily social forum and BGVS. Amit wrote extensively on several issues varied in fact universal access to health and worked on issues of public health for political policy and intellectual property rights. Unfortunately, he left all of us a bit too early in 2018. Since his passing, the Amit Sen Gupta Memorial lecture and a panel discussion is being organized in his memory every year. And Amit Sen Gupta Fellowship was initiated in 2020-20. Orgit Sen Gupta and Amit and Tripta son, he will speak about it in a while. Today's program, we will have two segments, the announcement of the 2021 Fellowship Award and a panel discussion on issues related to IPR, which are very close to Amit. Yeah, in the middle of all the uncertainties and chaos because of the COVID pandemic. I often find myself thinking of Amit, particularly wondering what would I say or think of the evolving future of the global health with COVID. I found his responses in his writings, and especially when he said, if you create conditions where infections faster, they will come back to haunt you. Very true. Amit had thought of such situations and warned us about the threats to help at the global scale, posed by viral pandemics and epidemics, and he cautioned us not to view these threats as one of events. And prepare for more such challenges to global health, because there are structural reasons he spoke about these in the context of Sika, Ebola, each of which are relevant in today's COVID context. Amit said, in his words I'm saying, while new knowledge will need to be the cornerstone of the battle against the new challenges some global health. This knowledge is sought to be sequestered in a few hands, and to be utilized for private interests are the interests of a few powerful countries. He questioned the role played by many international institutions and rich nations, which have done little to transfer technology and build capacity in low and middle income countries for vaccine research and vaccine development. The recent campaign on the targeted waiver is a classic example. This comment on the H1N1 pandemic, alert a few years ago, was followed by the spectacle of almost the entire stock of vaccines against H1N1 being watered by a few rich countries in advance. The same is likely to be true for rapid diagnostic kits for diagnosis of Sika infection. All countries are at the risk of Sika virus spreading, but the current global power relations ensure that remedies will be available first to the rich and to the powerful. Doesn't it sound so familiar now. Amit also spoke about solutions. He said, the global responses to viral epidemics and pandemics show a mirror to the inequity embedded in system of global governance today. We cannot anymore fight this battle virus by virus. A global response will need to address the structural failures of globalization, where it unleashes new challenges at a global scale, but poses a response that is not truly international in character. The epidemic in all probability will run its course and die down after leaving the trail of death and destruction. This is what he said, not because we as a global community would have done anything right. But because of the nature of the virus itself, the more question is, will we have learned anything? Or will it be back to business as we should? These are the questions Amit posed in his writings, which you will find on many, many journals and many portals too. Amit's knowledge, critique and vision are so relevant today than in the past. And that is a reason for organizing committee to come up with this standard to remember his work, which is so topical and relevant to what we are all witnessing today. And I think that will be taking place in the second part. So now I will invite Aarish Sen Gupta to speak about Amit Sen Gupta Fellowship Initiative. Aarish, can you please? Yes. So thank you, Comrade Sarojini, for that wonderful introduction. And again, we should all begin with keeping the memory of Comrade Father's stance for me in mind. As he is the latest victim at the hands of the repressive apparatus of the state. And moving on to the topic at hand, I have been invited to talk about the significance and the idea behind the Dr. Amit Sen Gupta Fellowship. The idea behind this fellowship is simple, that it is common sense says that scientific research has nothing much to do with society and particularly the contradictions that exist within society. But when healthcare is being recognized now even among people who are to the right of things as a basic human right, because we are facing such a dire time of crisis, one must realize that the struggle for making health accessible to the large section of people is an essential political commitment that we must take up. And in that respect, this fellowship has been introduced so that academic research in health is done in order to make health accessible to the broader number of people, especially the working people of the society. And before inviting the recipient of the fellowship, Dr. Amit Sen Gupta Fellowship 2020, I would like to say that as today is also Dr. Amit Sen Gupta's birthday. So today, especially taking into account the situation that we are in, the words of another doctor come to mind. These words are of Dr. Ernesto Che Guevara, who said that I am not a symbol, but I am a member of a crumbling social order. As we can see, the social order is clearly crumbling and the achievements of people like Dr. Amit Sen Gupta should not be seen as a symbol, but as a member of this society and all his actions should be seen as that of a member of this society in order to change this society. And the effort and the struggle for which my father Dr. Amit Sen Gupta lived and fought is the same as Dr. Che Guevara as well whose words I just recounted. So keeping that in mind, I would like to invite Harindra, the recipient of the Dr. Amit Sen Gupta Fellowship 2020. Thank you very much. Namaste to all of you. My name is Harindra. I am a member of Jan Shastra Sahyok Ganyarish, from Bilaskur, Chhattisgarh. And I am a member of Jan Shastra Abhiyan Chhattisgarh. I would like to give a little introduction about my culture. Jan Shastra Sahyok Ganyarish works in two districts of Chhattisgarh, Bilaskur and Mungeli. We work in the Kota Block in Bilaskur and the Mungeli works in the Lowry Block. The Lowry Block is a tribal area within the entire ATR, where we reach our health facilities and we work in 72 villages. In Ganyari, we have a hospital called Undead Wedded, where we have a referral centre for all our sub-centers. We treat all the people there. There is a surgery there as well. And there is a delivery as well. And we also have facilities for the medicines. There would be a translation of Harindra's speech. So welcome everyone. I am Harindra. I am from Ganyari Block, Bilaskur, Chhattisgarh. One of the most tribal, one of the states of the country where a large majority of the population are tribal. And I work with an organisation called Jan Shastra Sahyok, which is part of people's health movement. Jan Shastra Sahyok works among the most tribal and deprived sections of the community. It runs a 100 bedded hospital in the Ganyari Block of Bilaskur district. And it provides various kinds of preventive and primary care services along with maternal, child-related services and other health care needs allocated to the people for their other health care needs. Well, condition in Bilaskur district of Chhattisgarh before and after the emergency of COVID-19 pandemic for the year 20 and 21. So, my intention to take this topic was that when it was the first time there was a new problem. So, we were able to see that our health care system was a little weak in the first place. So, due to this, many services were closed and the lockdown situation came forward. So, due to the emergency of COVID-19, we were able to save so many diseases. For this, I will discuss with my colleagues and we will decide this topic. So, my topic, I wanted to look at all cause mortality in our Ganyari Block. Well, I looked at P and post-COVID situation. The health system in our region is not at a great shape. So, we wanted to see how the health system has responded and tried to avoid deaths with the focus of how many deaths could have been averted in the period. And I fine-tuned the topic based on the discussion with my colleagues at the hospital. When I got this fellowship, I had never done anything like this before. And I got the opportunity to do research in this fellowship. Because ever since I was born and raised there, since then, we used to work with the community to provide services to the community. And when I got the fellowship, I got a different kind of energy from it. How we work, how I can see it, how I can tell others that we are doing this work. And I also felt an experience that by doing this work, I will get a better result. And to do a research, I had never studied this. And it was different from my studies. And it was challenging for me how I will do it. But when I was born and raised there, my colleagues motivated me to do this work. So, I got a good opportunity. I have not been a researcher. And when I got the fellowship, I realized that this gives me a new opportunity to learn new skills and do things which I have not done so far. I've been largely involved in community-based and outreach-based activities, trying to mobilize people in improving health systems. And the fellowship gave me that opportunity to learn research skills. And I also got encouragement from my colleagues and friends who helped me shape my research at JSS. And it has been a great learning for me so far. I was able to tell the system that this thing is wrong here. Or I was able to do advocacy to ensure that we take data based on the data. Earlier, we would only take data and put it in the report and give it to our funders or supporters. But I was not aware of that. I didn't feel that much because my colleagues would make the same reports. But I realized that the importance of data is to see a study. If we want to give someone benefit from that study, if we want to provide it to the government, then what does data do? So I didn't get to learn that. Earlier, we used to collect field and program related data and hand over to the officials. I didn't realize how important data is. Through this work, I learned what is the significance of data. How it can identify health system problems and improve health system functioning. It has been a great learning. I got to see one thing from my topic. The pandemic that was going on, the local government came to know that because of COVID, people had to face so many problems that when the emergency was completely locked down in the night, they would have closed down India from tomorrow. We didn't even see that the health system had collapsed. All of a sudden, everything was shut down. For example, the middle level or upper level, it was a bit dangerous for them. They could have at least stayed at home and kept something for health. But the areas we work in in the morning, they go to earn money in the morning. They get to eat in the evening. They get to eat in the evening. The areas we work in, the government has imposed a lot of restrictions. When they work in the ADR, like the Tiger Reserve, they could have worked in the Basque before. They would have closed down a lot of things. They would have had to work in the Narega. But all of a sudden, if they did this, and the market was in a hurry, they would have created a lot of problems. Their social, social, health, and social situation was completely destroyed. The lockdown that was imposed suddenly had a debilitating impact on the lives of people. The people I am talking about in our Ganyarit district, are the tribal people who are generally daily wage earners. They will work through the day and find the resources to feed themselves. This lockdown actually had a horror restriction on the work they used to do, the markets they used to go to, the National Rural Employment Guarantee Act, where they could get some employment that was also stopped. There were severe restrictions on their livelihood options. This led to unprecedented trouble in their lives, in their food security situation, and access to healthcare. When I started working as a fellowship, when we used to go for data collection, during the beginning, there was a lockdown situation. Whenever we used to go to the field, no one would answer us in a right way. We had to face a lot of problems in the process of data collection. The police would not let us go. They would say, don't go. We had to take permission from the SDM, from the hospital and from the CMO. We had to face a lot of problems. The process of data collection was quite difficult. There were severe travel restrictions imposed by the authority. I had to take permission to access to the villagers and talk to them. Also, there were a lot of reservations regarding sharing the realities from the respondents and the villagers. When the lockdown started, we started collecting data. We collected the data, all the people who died, we made a verbal autopsy. For the verbal autopsy, all the people who died, we made a team with our three doctors. There were different specialists. My mentor was a doctor. My mentor was Dr. Yogesh Jain. The other doctors were Dr. Gajanan. The third one was Dr. Ramani Atkuri. They made the three panels and made the verbal autopsy. I used to show them how they died. They made their own opinion. We made an Excel drive. I used to put the data in it. They helped me. We collected the data. We used the team's expertise. The data collection could start only after the lockdown was reduced and the economy opened up. I conducted verbal autopsies with pauses of deaths and consulted my mentors and doctors including Dr. Yogesh Jain. They helped me understand what could be the possible pauses of deaths and I collected and analysed all that. I conducted the data collection. The first wave of COVID-19 didn't have as many COVID-19 deaths as we did. Due to the lockdown, there were a lot of diseases. We could have saved them as someone had a baby problem. They had HIV, had diabetes, and had sickles. We used to call them on a monthly basis and give them medicines. We couldn't come to the hospital. We used to provide them with medicines for 3 months. Due to the lockdown, they had to leave the village to get their medicines. We used to give them the medicines to go to the hospital. If they had to leave the village, they wouldn't let the police come. Due to that, we couldn't stop the deaths. I took some individual interviews. My study reveals there were severe restrictions imposed on accessing care. We didn't have many COVID-19 deaths during the first round of the first wave. There were many other deaths which could have been avoided if there were no travel restrictions. Many people couldn't come out of their village and access healthcare. Other causes of mortality increased significantly during the period. In my study, if we compare the number of deaths between 19 and 20, there were 303 deaths. In comparison, there were 3113 deaths in 2021. There were around 313 deaths in this period. I took 15 different interviews on the number of deaths in the last 133 deaths. We published some of them in our reports. There was a girl who was not even a year old. Her name has been changed. She is a 25-year-old girl. She is from Jagadwanda village in the interior area. Her parents also asked for help from her neighbours. They asked for a car. They took her there for 2-3 hours. They didn't get the car. They took her by bicycle. The nearest hospital, PSC Khurya, took her there for 2 hours. They took her to the hospital. The nurses told her that they wouldn't touch her. They would treat her from afar. She didn't get the car. She was taken to the hospital. Her mother thought that she wouldn't touch her. They gave her the syrups and sent her home. She was dead for 3 hours. They told her if she was treated well, she would have pneumonia. If she was treated well, she would have pneumonia. Very briefly, there was a 2-1.5-year-old girl who could there was a lot of delay in taking her to the hospital and that we lost a lot of crucial time. In the hospital also, she didn't get proper treatment. As the health provider said that there are not adequate guidelines that have come up. She was given a basic paracetamol and sent back home and she lost her life in some period. This shows how the deaths could have been avoided and how it has impacted people's lives. We have put some stories in reports in which there are TB, HIV, RSD, or maternals, we will put them in the report. In 2021, in COVID, the effect was not as much as the second wave that came in April. I have heard a lot of deaths in the village. I will try to submit the data from April to June. I hope I will continue to submit the data in 2021. In 2021-22, what was the condition before COVID and in the first wave, in the second wave, we will see the effect. In April-June, we had a lot of work due to which the report was not made. It is still half of the report. The report was not made in 2021 due to COVID. We are saying there were around 50 important case studies that we have developed and collected enormous amount of data. I want to continue this work and build up on the learnings from the previous election. In the first wave, there were not many COVID deaths. In the second wave, there were so many more cases. I will do my analysis and present results. As we all understand, due to the COVID period, a lot of challenges and delays were there in the data collection process. Thank you. Thank you, Harindra. We have a lot of important work and we have been able to learn a lot. I think you have done a tremendous job and it is not very easy working in those areas and picking up these issues. We wish that you will continue to do this and thank you once again. Rijith, would you like to announce the next award Fellowship awarding? Yes. First of all, I would like to thank Harindra Ji for that riveting account of the work he has conducted for the past one year. While you were speaking, I was going through the chat box and a gentleman had used the word militant research to describe the work you are doing which I think is very appropriate and actually it fits very well to the idea behind the introduction of this fellowship because people have this idea that the research is basically sitting in your office or sitting in your room with a pile of books but that is not the case. Your research is supposed to be a part of the larger process of developing the analytical tools which actually serve to finally subvert this system which is rotten to the core and that is the agenda behind research. With that, I would like to thank Harindra again and without wasting any more time I would like to call upon I would like to hand the mic to Shilpa Jen who is the recipient of the Dr. Amit Sen Gupta fellowship of the year 2020. Shilpa, are you with us? Hello everyone. I am Shilpa from Madhya Pradesh. I am associated Bharat Gyan Bighyan Samiti for the last 15 years that I have been selected for the Amit Sen Gupta fellowship this year as part of the fellowship I will be working with the social health activist Asha Asha are the backbone of the health system at the community level in a community level in India working is a part of the national health mission we have over a million Asha's working in both rural and urban in India the program in conceptualised Asha not as the work of the health system but as a bridge between supply side and demand side these Asha's are community volunteers not regularly regularly regularly paid by the health system health department but they get performance based incentive for specific kind of the action as decided by the health mission being the frontline worker at the community level they are facing different challenges as part of the Sen Gupta fellowship this year I will be doing an action study to understand the situation and challenges of Asha around health knowledge works gender economic critical issues especially during pandemic and the solution and ways forwarded for the same the study proposes to cover around 50 Asha's from both urban and rural areas of Bhopal, Madhya Pradesh the study will also include dear families, trainers facilitators block and district level program managers health system action connected to local body representatives and so on knowledge emerged out of the study can be used for improving the overall outcomes of the Asha program since I am one of the state level trainers of Asha program myself it will be relatively easy for the understand and support to save these issues pandemic these issues in a proactive manner thank you thank you very much Shilpa and now I would like to call upon thank you Arijit and I should also thank Indranil for doing the translations which is very useful congratulations Shilpa and it is an important issue and we know what is happening in the last 15 days the issues the Asha unions are raising about regularization and increase in the incentives and this is a topic which I am sure we all will look forward to your work with this fellowship I am sure the struggles will see some success very soon and we are all with you with all the Asha's front-line workers who are not regularized and then do all the work at the community level which is again incentive based which is very unfair in the entire healthcare system structure so we really look forward and any inputs or any literature any other studies we will definitely share with you Shilpa and it will be an honor to have you doing this work for us thank you very much so with this I would like to conclude the first part of the program today now we will move on to the panel which is on intellectual property rights and COVID-19 trading access to healthcare and I would like to invite Leena Minghani who is a global IP advisor MSF access campaign we are all familiar with our work and her area of work and expertise in innovation drug regulation and intellectual property she worked extensively on the people's campaign for the inclusion of public health safeguards in the patent in 2005 as its provision seriously affected the production of affordable generic drugs and its supply to the developing world more recently as part of the MSF access campaign team she has worked on really challenging monopolies of the multinational pharmaceutical industry that prevent access to generic drugs and more affordable vaccines combining her expertise on rights and IP she works with communities to address regulatory barriers in India to encourage supply of low cost generic medicines and other health technologies to MSF's medical projects and developing countries we welcome you Leena and I will hand over it to you now to moderate the discussion Thank you so much Sarojini and to people's health movement I hope you can hear me clearly so for the next few minutes say 40 minutes I'm going to be moderating a discussion on monopolies or intellectual property in COVID-19 I'm going to request all panellists to switch on the videos at least to start with the panel discussion so I just wanted to sort of highlight one very key point that we are here discussing about pharmaceutical monopolies in COVID-19 about 20 years ago when I started work I met Amit when we were working on intellectual property monopolies of what we call in layman's term patent monopolies on HIV and cancer medicines and at that point of time he was an advisor he was on the IP working group of Medicines for Frontiers and we developed a very close association challenging the patents on HIV and cancer medicines but most importantly I think to pay homage to Amit and to remember him is the fact that millions of people living with HIV actually hold antiretrovirals in their hands and put the pills in their bodies in very healthy lives because in 2005 Amit played a pivotal role in getting the right to challenge patents into the Indian patent law and that actually laid the foundation of the battle of AIDS activists to go to the patent office to challenge pharmaceutical monopolies and today millions of people around the developing world are receiving generic medicines produced in India but also in different countries and what we see today is a sea change in the way we viewed COVID-19 sorry, HIV AIDS so it's particularly emotional to be talking about COVID-19 without Amit because we probably could have worked all of us could have worked together on COVID-19 he built that solidarity he made us one tribe he brought us together despite our principal differences so I'm going to invite Vinita Bal to switch on her camera if I may so I can introduce her and ask her the first question of the panel discussion yeah so pleased to see you Vinita so Vinita is an immunologist and I was very excited to realize that she actually has expertise in T cell biology so this is exactly the kind of questions you would need in COVID-19 she has a long association with the health movement and she's been at the National Institute of Immunology she's a faculty today at the Indian Institute of Science Education and Research and my first question to you Vinita is this what you see globally is a polarization of the debate on biomedical innovation some developed countries and the policy makers are insisting backed by pharma that biomedical innovation cannot work without intellectual property there's a key driver of biomedical innovation for pandemics and we should have a stronger intellectual property regimes and of course you know that South Africa and India have asked for the waiver of all intellectual property for pandemic related medical products so what in your opinion drives medical research what are the drivers of medical research thank you Lina and I'm very happy that I am one of the participants in today's program and I'll take a small detour because after all it is Amit's birthday anniversary and unfortunately one of the urban maxos have passed away but we do need to continue our struggle many of us have been part of that support system in lesser or better fashion for the urban maxos and that also needs to be remembered and continued and let me say a few words about Amit I actually remember I used to be in Delhi I was part of a women's group called Saheli and first time I ever met Amit was in Saheli office and many of you might have seen the condition of Saheli office it is not one of the most pleasing places to meet I was quite impressed by what Amit was saying and thereafter that was the early days and thereafter in many other fora I kept bumping meeting Amit and of course there was a friendship which got established and I also remember discussions and what we call used to call as science group in Delhi where there would be exchange of various issues and of course camaraderie which developed over the years now that I am in Pune and also Amit is not there so I don't know what happened to the science group but nevertheless so instead of talking about his expertise in ITR I thought I would give this personal touch where I met him personally and we became friends in fact during this pandemic period or just preceding the pandemic period I lost two good friends and both of them were in different circles who moved in different circles in the area of public health both had extensive expertise and their inputs in the pandemic would have been really really invaluable for policy making as Sarojini also said earlier Leena also mentioned and we know that and of course one of them was Amit and another one was a senior pediatrician public health expert and what happened was I do feel the loss about a year ago when pandemic started I was I shared this with my close friends and of course we agreed that both of these people in different ways would have been so important in today's situation and even now 15 months later I continue to have the same opinion I'm sorry I went on a divergence but it is not possible not to talk about Amit before getting into the details so about the biomedical research and well yeah I may have a slightly different opinion from what is a prevailing notion that there has to be a very strong IP drive IP regime for good research in my opinion actually the biomedical research and innovation associated with it I would locate it primarily in India because my experience has been primarily in India but good science drives any research innovation and it is nothing to do with only industry there are many academicians who are very keen on pursuing areas of their interest and quite often the innovation is a byproduct of what they are doing and that is why sometimes it's very hard especially in academia to do a focused research which say for example tomorrow will help in preparing oneself of preparing ourselves for the next pandemic which sounds like a very disappointing statement possibly but I don't think academic research can be focused pharmacy based research can be more focused but not academic research in biomedical field as I would put it so in that sense but one has to remember that during current pandemic many scientists globally as well as in India reoriented themselves to do research which would be useful in the pandemic and of course it was not pre-planning so it felt like there was a delay in their initiating these research but at the same time we needed diagnostic we needed cheaper measures for diagnostic facilities and so on I wouldn't say Indian scientists have actually come out with the products but there was government funded research which encouraged such biomedical innovations and Albit as I said they began late they were not in anticipation of the pandemic but the pandemic normally tend to continue for 2-3 years so in some sense even their research would be contributing to managing pandemic rather be focused on pandemic preparedness so that's the distinction that I would like to make and maybe later if there is a possibility I would also like to talk about what the plans are because this pandemic as you know the development of repurposed drugs was fast there was all relatively speaking not that we have great repurposed drugs for taking care of SARS-CoV-2 there were also very rapid, relatively speaking very rapid development of vaccines and that also in a sense was useful so this is something that has contributed to again calling it pandemic preparedness is not necessarily the best usage of the word but still I feel what was the experience of scientists about MERS and SARS which were there in the last 20 years that had helped that has helped and in less than 200 days in about 200 days there was a vaccine which was made available even this was a phenomenally rapid progress but it seems we probably need to be even better prepared and what are the plans for that is something that maybe I would talk about it later because I remember you had told us not to talk too much I'm sorry about it, thank you. No I'm going to come back because you used very exciting words about plans ahead so that's obviously something that we are all interested in so I'm going to ask Dr. Sun Kim to also switch on her camera and I'm going to take up some of the things that Vinita said as we go ahead establishing the background to this discussion so I'm just going to introduce Dr. Sun Kim and I hope I can see her, I can't see her so I would very much like to see her while I'm introducing her so I'm just going to introduce her. Oh great. So Dr. Sun Kim is based in Seoul, South Korea I watch a lot of South Korean series I have to tell you this so I'm very excited to actually meet her along with my son and I just wanted to say this that when I went to South Korea I met a lot of activists and researchers and I was completely blown by the kind of work that South Korean institutions and companies were doing on diagnostics and biologics so Dr. Sun Kim is currently the director of Health Policy Research Center at the People's Health Institute in Seoul, South Korea her interest lies in looking at production pharmaceutical production and how it can be aligned to health and politics so Dr. Sun Kim if I may ask you my question to you is this that looking at the tremendous investments and support that the South Korean government has given for both research and production where do you see this support and investment being aligned to people's needs in developing countries and do you think they make treatments and diagnostics and biological medicines and vaccines more affordable for people in developing countries and what needs to change if that is not happening? Thank you Lina for the question so you can hear me well now so to respond to the question briefly at first so for the last year during this pandemic PH in Korea has published several issue briefs one was about what kind of public support either financial or regulatory to the COVID-19 diagnosis kids industry and one was about the public funding of the R&D of the COVID-19 therapeutics and vaccines and the last one was about the public contract manufacturing facilities for biological that are producing the COVID-19 vaccines either for vaccination program or for clinical trials and with there was severe lack of democratic public control over the public sector as well as the private sector and that this led to the public resources to the public and private sectors not to serve to the equitable availability and affordability for the vulnerable at local and for the low and middle-income countries so South Korean government has never officially supported the trips waiver nor the SIPPAP the technology pool and we are here the page in Korea has been relentlessly relentlessly insisting that not only for the South Korean people but also for everyone everywhere all the COVID-19 technologies which are being heavily supported by all kinds of public measures should be equitably provided and sharing IP and know-how either regarding the development or production of the technologies will be the first step and we believe the intervention by the page in Korea could ensure the government and the companies to be more accountable with more public control over the industry and I can provide problems in detail further if needed regarding the lack of public control over the industry just to add to what you just said and maybe you want to respond to what it is is that Gopas also here and some people maybe from the women's movement some of us got together to work on a biological medicine called Trastosumab which was Russia's monopoly until a few years back and we were contacted to a surprise by South Korean companies who said they could produce Trastosumab, they had already produced it but were waiting for the patents to expire similarly for the pneumonia vaccine you know companies contacted medicine so on saying we are ready to produce the PCV13 but we are blocked by Pfizer's patent on PCV13 despite these experiences South Korea continues to support a very strong intellectual property regime what do you think we can do to change that about COVID-19 one because when it comes to biological medicines South Korea is of course a very important manufacturer so what can we do in the movement to support your work in the people's health movement to change South Korea's position on intellectual property so it is quite hard to answer the question we have been struggling to persuade the government as well as the public that Waving IP is not a bad thing for the South Korean companies or industry or the people or the government but a good thing is South Korea as well as the world as a whole especially during this pandemic but one thing is that it is a kind of ideology a kind of beliefs especially by the government officials in the government to believe that we should protect the IP especially under the context that some of the South Korean companies are developing their own vaccines or therapeutics and even one company has already developed their own therapeutics one therapeutics already and even though it is not that effective for the treatment the company and the shareholders of the company and the South Korean government which has supported the development of the therapeutics so much are just concerning about the negative impact after Waving the IP of COVID-19 technologies especially with this specific technology and then any kinds of future possible impacts to the South Korean companies and as well even because the South Korean industry in the past compared to the small molecules we didn't see that kind of advantage competitiveness of our company or industry or our country better than other countries but under this biological industry the era of the biologicals the government and the industry and the companies have found out that we may be a kind of leader of the world in this sector as the biological industry doesn't need that big population to meet the demand of the market or it doesn't need to have that big size or scope of the plants so one thing is the ideology and the other one kind of proofs or something like an example from especially not from the low and middle-income countries but from one of the high-income countries that Waving IP or shaving IP or know-how could be a good thing for the people in their local setting for for solving the problem at the local as well as the global so we in South Korea should light on the fact that the Spanish government and its National Research Council has pledged to support the CPEP as well as to share their know-how with regard to the COVID-19 technologies thank you so much and May in that sense we may think about any kind of possibility movement with others absolutely so I would like to highlight that there are all alliances between South Korea and India activists because we fought for a matter of nib and the nibs played a huge role in cancer treatment and I would also like to sort of play a tribute to Heesob who passed away from cancer this year and he was just such an immense in South Korean civil society I just wanted to sort of come back to your discussion about the role of South Korea in the whole issue of manufacturing and as we move forward and probably come back when you spoke about ideology and we're going to touch upon ideology with the fourth speaker so I'm going to ask Dr. Hani Sirag to put on his video and hopefully he'll put it on before I introduce him so that we can see him when I start the introduction so Hani Sirag has been associated with the People's Health movement for a very long time he was the convener in 2009 and now is on the steering committee Hani is someone who's in the department of internal medicine in the University of Texas in the United States and perhaps is watching first hand what's happening in the United States and I like to invite him to switch on his video. Thank you very much Lina. Yeah, great so Hani you just heard Vinita talk about 200 rays and we've got a vaccine and my question to you is this that the current issues about inequity the response for example of the UK and Canada and the EU is charity is donations it's all the problem with pledges and donations do you think that this is an equitable solution to the issue of shortages and disparities on the C19 vaccines and what can social movements do about it because we are at a point where we've just been hit by the COVID wave in Nepal in India we're watching this happen in Africa and of course we've seen that in Latin America as well and we've seen huge disparities for example in the United States where they're starting to vaccinate adolescents why we haven't even vaccinated the elderly and healthcare workers in many low income countries so do you think that the issue of charity and issue of donation will solve the problem and more money to coax will solve the problem in an equitable distribution of the COVID-19 vaccine Thank you very much Lina I would like as well to take two minutes to talk about Amit in the beginning Amit for me is a very close friend and somebody I worked with him for a very long time I knew him since year 2000 when we were in Savar in Bangladesh for the first People's Health Assembly and I would say since year 2006 we worked together very closely and I would say for many many years we've been on daily communication Amit for me is a teacher a very close friend and a comrade who continued to defend people's right to health to medicine to doctors in his life it's very emotional to talk about intellectual property right without Amit being with us we learned a lot from him in this topic Amit contributes significantly to People's Health Movement through his writings his mentoring many many people including myself and achieved a lot with Amit and I think that without Amit the People's Health Movement couldn't be that large and that popular in many countries so thanks Amit for everything you did for us back to your question of course it's not it's very far from equity we talk about the donation and charity in distribution of the vaccine but this is not very surprising if we recall the whole setup of global health and health systems and many other things under the current dominant ideology and governance in global health so the idea here is should we accept this or not and what are the alternatives if we do not as people if we do not accept this and this is for me the main issue so the the way I understand it it's it's the whole this cannot be separated from the economic governance and the capitalistic regime so we cannot separate this and we cannot expect that the distribution of the vaccine or the dealing with COVID-19 is going to be separate or is going to be something different we are seeing the same thing we expect that Pfizer and Biotech are going to have $26 billion sales out of COVID-19 vaccines and Moderna will have around $19 billion sales so this is the very classic case we are facing so what are the solutions the solution is public production if we continue negotiating with these companies to try to reach somewhere in the middle we will not because if we wanted to have equity in health this means that big interests need to be challenging need to be changing we will not reach somewhere in the middle it doesn't work for me so how to have public production this needs models, needs examples needs lots of investment public investment in these areas honey I am going to interrupt you now and ask you this very important discussion that is happening between the north and south at the moment a lot of northern policy makers and activists are talking about let's go out and get the technology from big pharma and the US and developed countries while you are talking about models of local production models of using local science and greater role from governments in the south to boost local production of vaccines and therapeutics that we need has this happened in the past have we done this in the past and do you think we can do it for COVID-19 well in the past we have experienced that instead of just to continue negotiating the waiver of IP and negotiating different modes of prices we have the use of flexibility of trips by certain countries it was at a very high cost things are changing and these governments are not the same as now but I see the way to do that is to have more examples to have more countries are using the flexibility of trips without negotiating without discussions the more we do it the more we get used to it so because here the negotiation is not equitable as well because the negotiation between south and north we are asking them to be better to give vaccines to countries in the south this will not will not happen voluntarily because they do not have any pressure to do that except for the moral drives which I don't think we need to rely on that so the idea unless there are something more than moral drives we will not move forward and as you said yeah so when you said about pressure that brings me and I'm going to be coming back to each of you all who were in the panel brings me to my fourth speaker Kim Gopakumar and we're going to pose some of the elements of what Sun Kim and Ani have raised to Kim Gopakumar so if I can ask you to switch on your camera that would be fantastic excellent so Gopar promised to send a few lines he didn't so I'm just going to make them up so Kim Gopakumar is the legal advisor of the third world network in my words I would sort of describe him as one of the smartest strategist I've seen in the business of pharmaceuticals and intellectual property he has had an immense impact on access to medicines with the work he's done with the lawyers collective with the third world network and the people's health movement so I'm going to pose my question to Kim Gopakumar Sun Kim basically said ideology intellectual property is ideology and Ani basically said that we need pressure so that brings us to the issue of the TRIPS waiver and if you can sort of describe what the waiver is but most importantly if you can tell us that you think today intellectual property is more ideology than public policy what do you think is it aligned to people or is it all about post-truth it's ideology therefore we need to do it thank you Leena so before answering similar to all the previous speakers let me also take a minute or so to recall my personal as well as the organizational affiliation of working with I mean so it's around more than 14 years and mainly we never meet in Delhi but mostly meet outside and spend hours together discussing various issues and daily meetings were always over but one of the work Amit was doing around 2018 actually it started around 2013 as part of the TrastizoMap campaign and what really prevents the generic production of biologics so 2018 there is a small booklet written by Amit on biologics access to biologics so this booklet was discussed in an expert meeting in Geneva followed that meeting the experts around seven scientists including Dr. Sanjith Redd signed and sent a memo to WHO to asking for a reform of the WHO's biosimilar guidelines so unlike small molecule when it comes to the approval of the biosimilar that let us call it as a generic biotherapeutics like TrastizoMap etc so the generic company is supposed to do the clinical trials and this involves a lot of money and time so scientifically there is not much backing for this kind of regulatory prescription so this was the most contentious issue and this was followed up with the scientific memo two months ago the WHO published its draft version of the new guideline and it said that phase three trials will not be required for a biosimilar guideline there are more issues to resolve there but I think now we are in a much more strong position if we push it one more push jointly I think the rest of the monopoly protective mechanism can go and it can be you can say that you can democratize the regulation of biosimilar and it can enhance access so this one of his work he was doing 2018 and the beginning of yeah towards the beginning of 2018 and so this is in a way reaching a logical conclusion and this was also initiated and he got into this work around 2012 I guess 2012 in a meeting which was organized by again MSF, GWN and JSA in Delhi discussing about access to medicine so this is sort of I thought I recall the work I was doing and you know it is somewhere the work which is reaching the logical end so having said this or definitely intellectual property it is a public policy tool but it is more I mean it is a public policy tool but more of an ideology so if you look at innovation there are many tools in your toolbox to induce innovation or to realize innovation as Vinita already told that scientists is always driven by the challenges or the scientific monopoly waiting for he or she can enjoy later, not that it is resolving the issues where the society might be waiting for or the scientific community might be waiting for so there are various ways in which a person or a company or a society we try to resolve these issues so there are various tools for that intellectual property was the tools which in a way provides a monopoly so that the person who can invest or the company can invest the money without the fear of somebody else will freeride on that and will reduce the or undermines that innovation so this was the original sort of or what I would say that you know well sold justification for the protection of intellectual property we know that what we reading theory does not work in practice so all its justification let us agree for the moment but still this mechanism often failed to deliver so in the pandemic is one of the important area where the intellectual property rates cannot deliver in the past and in the present time too as Honey mentioned had it been patent or the intellectual property regime is the good tool to deliver and induce innovation then there will not be no need of a public funding for vaccines all the vaccines around 95% of the public money that is around roughly around $95 billion went to the development of vaccines you know various vaccines so that shows the state is the main driver of innovation and having said this but now the the first justification for innovation was that okay if you allow people to free rate the money which I invested would be undermined so therefore I need a patent protection or I need a monopoly but now there is no such justification there is no score for such justification because it's a public money it's a public good but still the companies nor the governments are not ready to give that monopoly power so that means there is something where you know else is the justification so that is basically an ideological justification to protect patent and protect patent or intellectual property regime and one more sentence I'll end Lena during this process in the last 30 years there is a concerted attempt to rewrite the history or erase the past history saying that you know intellectual property is the only driving force for innovation but historically there is no evidence and historically there is no link between IP and development it is always people emulated the technologies developed by elsewhere and then moved to their own innovation and invention so this is the value chain and this is what happened globally throughout the history but they want to you know erase that history by saying that IP is the only one so this history is now being interrogated through the waiver demand and the support it is getting from people as well as the members of the WTO member countries just very quickly and then I have to go to Vinita and look at questions as well what I really wanted to ask you Gopah is this that it's a technology transfer we heard a very heated debate about technology transfer when I joined the intellectual property area the TRIPS agreement said this will facilitate technology transfer that was the deal if you talk about the agreement and the deal on the table was that you introduce intellectual property system and technology will flow to your countries for the diseases that affect you has that happened and since that has not happened and if that has not happened are we giving off all intellectual property not just for COVID-19 but for all pandemics and perhaps for other diseases of public and health interest so what is your take on technology transfer has the deal that was made in the TRIPS agreement in early 90s has that promise been kept I think TRIPS came into force in 1995 so we are around 25 years down the line so this is a good period to assess what was the promise and what did we get after 25 years and if you do that stop taking then I think this is a high time to reform the international intellectual property regime including the TRIPS agreement because it failed to not only to transfer technology to developing countries but also failed to bring the investment in the research that meant to address the health issues faced by our own people or our own country so now the actually intellectual property regime through the TRIPS agreement what did it do is that it prevented access to substantial percentage of the global population to protect the profit of a few companies in a few geographical area that is in the north first and second it completely dried up any kind of R&D financing for the those kind of diseases which require long-term research and which also the market is with the people with the low buying or purchasing power so those areas they don't make any investment because the logic of patent regime is that I invest in R&D then if I have the success I enjoy the monopoly I charge a very high price to recoup my past failures my present R&D expenditure and share for the future R&D plus my profit so all this to be done from one single medicine and this is a high price okay this if you develop a medicine for a TB if you charge that high price nobody is there to buy or even if a sickle cell areemia if you can have that innovation but nobody is going to access so these companies never bother to invest so we need to take up these issues and speak against this highly highly what you call a oppressive regime which sort of denying access to not only medicine but the right to science everybody has the right to progress from the science and its application so that has been denied through the troops agreement sorry yeah just a second yeah just a second I just wanted to go to Vinita to ask her before that I just wanted to flag like there is one question in the Q&A it may be late with the you know your I'll do it I'll take a look at it thanks so coming to Vinita and then I'm going to take a look at the Q&A and really exciting you know Gopas saying rethink R&D and move it away from aligning with IP so I'm just going to ask you Vinita you said plans and you know very exciting to hear plans because that means there's some public policy in the making but I just wanted to ask you this question align to plans as well that a lot of people are talking about mRNA technology and in the context of you know perhaps that only the west can do it and developing countries just don't have the wherewithal to do it what do you think about that and what are those exciting plans yeah yeah well first answer to the mRNA technology there is an Indian company which is also making mRNA based vaccine and that company is located in Pune where I happen to live these days so it's not an impossibility even in academic fields this is being done so that's not something so in terms of technologies we I mean Indian scientists or Indian technologists are not that far behind and if you let me I would want to make three quick points and one of them is about future but that's also based on the other points that I want to make the first one I wanted to make was about how India is talking Indian government is talking with two faces it is challenging IP regime which is something that we are actually enthusiastic about that you know vaccine should be made available to everybody anybody and so on and so forth but at the same time this same government which developed the so-called co-vaccine that we know of which was the virus was isolated in one of the academic institutes in the country that was straight away handed over to an Indian but a private sector company why was it given an exclusive license at that time why did we why was the government not thinking about non-exclusive license now they are thinking about some public pharmaceuticals getting money and funding for producing the same vaccine that the Bharat biotech is producing but this is sort of you know arriving late on the scene and so on but I wanted to say this because on one side this and on the other side that the major one of the major failures in this pandemic has been that if one takes the WHO as quote-unquote neutral territory I mean I am not going into the details but the solidarity trial co-vax all of these fell flat on its face in many instances because of you know non-cooperation, no money and very many problems which were there so do we need to strengthen those kinds of efforts is one point that I wanted to make without getting into the details but the second point is the last point that I want to make is also that there has been a book or a report I should say which was released on 12th of June 2021 and it was about 100 days mission to respond to future pandemic threats. This is a report which has come out and it is trying to concentrate on reducing the impact of future pandemics by making diagnostics therapeutics and vaccines available within 100 days of WHO or whichever agency actually declares the pandemic or epidemic whichever it is. So there are multiple details even in that report and without going into it because it's hard to go through it because of the time but I wanted to flag these points so that other people can read about it and or discuss it. I'll stop there thank you Thank you Venita I think we really need to have a session on the report and discuss how it goes. There's an interesting comment from Chi Koon who put it on Q&A and chat as well and she says of course campaigning for intellectual property waiver is important and she said equally investing in indigenous or domestic production is equally important. She highlighted how Cuba despite being isolated has done a tremendous job in producing medicines and vaccines and having said that I just wanted to sort of highlight the comments that honey made you know I live in India and I've heard this many times that you know we should in the global movement of access I've heard this many times that a lot of effort needs to go towards convincing the companies to do technology transfer and while you sort of honey sort of highlighted the fact that perhaps we should just do it our way because it's almost impossible to convince them. So honey you are basically saying that we take the longer route the more difficult route and in some sense what Vinita said that we'll arrive at MRNA vaccine and do you think we'll lose too much time doing that you think it's just doable by 2022 when the waves are coming one after the other. I'm just being the devil's advocate over here yeah. Thank you very much. I think that what we're trying to do is to use their own tools to overcome the problem so they are much more stronger than us when it comes to the protection of intellectual property rights so this is the regime that they developed and we are using the same tools to get rid of it so it's again it's as if we're trying to change from inside which is something I do not believe in so much we cannot use the same tools that the regimes having and try to change it. We can watch them, we can have tactics but at the end unless we have a different solution it's not gonna work and you asked about examples for that. One of it might not be very much inspiring but the example of Egypt of dealing with Hipsi I think it gives us lessons I mean the Egyptian government played a kind of a game with Gilead and they accepted to purchase the new medicine for Hipsi with 900 dollars in the beginning which still was very very high price for people in Egypt but it ends up that Gilead was very relaxed and when they applied to have the license in Egypt the paperwork was not completed and it was refused but meanwhile during this time there was preparation for the local manufacturer and right now the selling price of genetics is around 20 dollars so this reduces the prevalence of Hipsi from 15 percent in population from 15 to 55 to almost zero so we're talking about something that happened so the idea here if we talk about the intellectual proprietary as Gopa said it's not evidence it did this protection made difference in the innovation and when we talk about the ownership of these companies to the license of a new innovation this is actually a huge myth because if you look at production of any medicine it does not depend on shareholders getting the money out of it so at the end if you look at it who is getting the benefits it's not the scientists it's not the money that invested in by governments and public it's not to the development of the science across history it's for shareholders and good example of that right now who paid for the development of the vaccine in Moderna is a very recent company 11 years old so it does not even have the long experience as Pfizer others and had huge amount of public investment paid by taxpayers and now they are selling the vaccine so again here we continue trying to change things from inside I don't think it's going to work and we need more combustible license use like what happened before in Thailand in South Africa, Brazil and the other but the idea is to do it collectively so the south solidarity is the main thing it needs to be done on a very massive scale and here we will win land and negotiation is going to be completely different everybody was expecting that this pandemic will offer opportunities for more equitable distribution life after post pandemic will not be the same as before but actually those who are putting the rules right now those who are benefitting from if you look at who paid the price of the pandemic the poor not only in the south but everywhere in the US who paid the bill of people with color the poor and migrants I'm just going to then throw out something that comes out from all of this Vinita spoke about honey spoke about doing it indigenously and domestically and Egypt doing it really well Vinita spoke about the fact that you've got a plan in place which needs to obviously be looked at and what I really wanted to sort of highlight is the exclusive licensing and the high prices today we are paying $10 for each vaccination give or take a little more I just want to ask we pay a few cents for the other vaccine so how much is actually pharma making if any of the panelists really want to answer maybe because the last I remember the pneumonia vaccine was the most expensive vaccine that the Indian government had ever paid for developing country governments had ever paid for which is $10 and here we are paying an equivalent price for almost all the vaccines so while we pay a few cents for the other vaccines so how much is pharma really making and how much do we really need to also reduce cost and supply to increase supply and reduce cost so we can vaccinate more and more people against the pandemic so if anyone wants to answer that question among the panelists but maybe Vinita you want to have a stab at a manufacturer who is talking to me said it will be 10 rupees very soon if there is competition so what do you think of that statement are we paying $10 too much do we need to do more about the pricing as well and not just the supply $10 is certainly too much because Serum Institute Chief Adar Phunawala had said that when 200 rupees I am so sorry not dollars 200 rupees was the price at which Covishield the Indian AstraZeneca version was being bought by the government there was no loss that he was incurring so obviously even in 200 rupees per dose there was some profit and his argument was that this profit is not enough to invest further to expand the basket that Serum Institute of India has so that's another matter but that is why as Gopal was saying or somebody else was saying that earlier that are these moral ethical issues that we are going to impose on people or companies who are made for profit that looks ridiculous in a sense if they are made for profit they are private companies we need to put pressure so that their profits come down is all that one can think of and the alternative is what I was suggesting made a reference to earlier that public sector pharmaceutical companies which have been trashed in India 10 years ago when Ramados was the health minister at that time three different three or four different companies were completely shut down and that is something that we are also paying for that there isn't enough infrastructure so whether it is pneumococcal vaccine or whether there is massive production of co-vaccine which is required all of this could have possibly taken a different direction than where we are now so of course it is history but we cannot afford to forget this history and I gather pharmaceutical which was one of those companies which were also shut down is getting funding from the government of India to sort of rejuvenate itself how far it will go whether it will be useful in this pandemic if not maybe in the next pandemic I hope not but I hope so if you know what I mean So Sun Kim coming back to you and I see that there are lots of comments in the chat section please if there is a question I am finding it difficult to moderate and look at the question but I think Sun Kim I am coming to you because you made this issue about governments looking at pharmaceutical production and research purely industrial policy and not looking at it from the points of rights and access and of course healthcare and India and South Korea seem to be following similar policies in the end domestically so what are some of the things whether as the health movement perhaps documented or any other way that we can actually show the alignment between South Korean and Indian policy or in other countries versus actually public access So at least in South Korean context I believe that most people do not aware about the existence very existence of the public manufacturing facilities that are owned by the governments so even though there are several public contract manufacturing facilities which are not public pharma but just contract manufacturing facilities for to produce some biological vaccines for the private pharma based on the contracts with them so in South Korean context we do try to make the public aware about the existence and the industrial drive by the government to make those facilities only serve to the private profit for the public health needs and we do try to make the public aware about how much how many production capacities that they have and how can we shift those capacities not to serve to the industrial purpose but to serve to the public health needs and to try to make them imagine about the possibilities, another possibilities like in Cuba or in other countries with public manufacturing facilities to make those facilities, those public facilities to serve to the public health so actually the examples of India or other countries have been kind of how can I say some kind of hopes for civil society in South Korea to make the public aware about the very possibility of making that happen and I see that some kind of, I heard from some of the Indian colleagues that the state-owned pharmaceutical undertakings in India have been some kind of decreasing and some kind of have lost some kind of public attention and has been lots of privatized based on the neoliberal ideology by the and drive by the government but in South Korea as the government and the industry sees some kind of possibility to make the industry be prosperous, be a kind of global leader in the biological industry, the government has been pouring lots of public resources to build those kinds of facilities to serve to the private industry so we may kind of imagine some kind of possibilities to exchange those two very different or kind of opposite experiences between the two and make some examples to the opposite side from the opposite side to public aware about some kind of another possibility. Absolutely and I think I would just say this that we need to unleash South Korea's power in biological medicines and vaccines I've seen it firsthand when I went to South Korea and it was just tremendous to see that and our struggles are in a way common between the South South issues even though South Korea of course is a high income country I'm just going to sort of throw this in we have 10 more minutes we have 7.45 now. Yeah, thanks I was just coming to Alexia's sorry about being study on the chat box I just wanted to say that Alexia's sort of highlights that vaccines and medicines and diagnostics for COVID-19 need to be public goods has that promise been kept and Gopal coming back to Alexia's Benos's comment if you've seen it have governments kept that promise and are they willing to negotiate on the trips waiver I think it is more as I said earlier it is more of a more of an ideological issue rather than an objective assessment the public health informs us that you know we need to vaccinate the people at the shortest possible time to reach a maximum number of people then only we can have a kind of hope for a resilient response to the COVID-19 but as of now we know that we are running behind all the targets even the vaccine producers these monopoly companies they are failing to fulfill their own promises of you know producing they promised X number of doses in the month of March to be delivered but they reach only 8% of what they promised and they are running behind it but still not ready to give up the monopoly so now there was since 17th of June there were five rounds of negotiation happened and today also there is a negotiation so it became very clear during the negotiation what I heard from some of the negotiators is that of course it's I'm not any of the negotiations but it's a kind of a information from some of the negotiators is that it is the European Union which is blocking and US is sitting and watching the game and we are ready to support the waiver and you people talk it out so it is basically you is blocking and you saying that the only barrier is compulsory license and then they have three suggestions to move forward on that these three suggestions are already in the agreement everybody follows that there is nothing new about it so it is the EU versus rest of the WTO membership there are countries like South Korea or Japan Australia, Canada they don't like the idea of waiver but they are less vocal after the announcement of US support to the waiver proposal but US support also limited to the vaccine but US has not opposed till date the extension of the waiver to cover other therapeutics or diagnostics so as of now this is the state of play the idea behind the Europe's resistance is to delay any kind of decision on waiver and therefore by that time either the waves may go away or there might be some more vaccines may come more vaccines will come from more companies other companies not from the monopoly they don't want to break the monopoly they hope that more vaccine companies may introduce their product so this is what is happening right now and they are finding all kind of justification to scuttle the progress to have a consensus on this issue I think this is the time there is a what we what we could see is that it's a people's power the people's pressure which changed many countries positions including US historic moment so if you continue to pressurize I think you also will change in the coming days and countries like India as we pointed out has a double stand but there is a historical reason also like past pressures and all playing that but we need to pressurize and we should ask the government to change this double stand and say whatever you know you are talking you should do it domestically you should do the work that so that is what we should do yeah thank you Goppa for giving us a state of play and pointing us in the direction of mobilizing on EU and particularly perhaps Germany who is being very nationalistic about mRNA there is a reason also just for a second I mean just one sentence who invested behind the German vaccine the German investment fund so that is one of the reasons for Germany's adamancy on to maintain monopoly over people's health and oppose the waiver henceforth yeah so I just wanted to sort of say this I want to thank the panelists but most importantly I wanted to highlight that Zafrullah has put out a very important comment about collaboration among scientists in different countries including Russia, Cuba, India any other countries Latin and other countries where there would be more collaborative efforts Zafrullah actually helped PHM post the meeting in the year that Amit passed away and they did tremendous work to keep the meeting going and I think in some ways I remember the last minute stress that just get the PHM meeting going I would like to thank every one of you as a panelist I'm sorry if I missed someone's comment on the chat it's really difficult to keep your attention here and look at chat at the same time so I don't fall into the categories of women who multitask clearly so on that note and remembering Amit and looking at Orijit's eyes and you know just remembering Amit immediately thank you so much for having me as the moderator and I would like to thank all the panelists and if anyone has a burning question please take it up to the panelists offline thank you over to the organizers yeah thank you Lena thanks so much very insightful discussion and you have very important insights in today's context yes global solidarity is more important organizations definitely resonate the vision of Comrade Amit in the context of the topic of the day we will continue to carry forward Comrade Amit's vision of strengthening the people's government and building these global solidarity thank you