Incoming WTO Director-General calls for ‘third way’ towards scaling up manufacturing of COVID-19 vaccines

On Monday, 15 February 2021, the World Trade Organization’s General Council, “agreed by consensus to select Ngozi Okonjo-Iweala of Nigeria as the organization’s seventh Director-General” (Source: History is made: Ngozi Okonjo-Iweala chosen as Director-General, 15 February 2021). Dr Ngozi is the first woman and the first African to assume the helm of the WTO. An economist by training, she was a former Minister of Finance and Managing Director at the World Bank. Most recently, Dr Ngozi was the Board Chair of Gavi, the Vaccine Alliance and Special Envoy to the ACT Accelerator.

At her inaugural address to the General Council, Dr Ngozi called on WTO Members to reject vaccine nationalism. Instead she proposed a “third way” to facilitate “technology transfer within the framework of multilateral rules, so as to encourage research and innovation while at the same time allowing licensing agreements that help scale up manufacturing of medical products” (Source: Statement of Director-General Elect Dr. Ngozi Okonjo-Iweala to the Special Session of the WTO General Council).

She lauded companies including AstraZeneca and Johnson & Johnson for being “already head of the game” in terms of scaling up manufacture of COVID-19 vaccines in the developing world, noting arrangements to move beyond contract manufacturing into licensing.

AstraZeneca has licensed production in several countries, and has recently declared that it is willing to look at more such arrangements. Johnson & Johnson seems willing to follow suit looking beyond contract manufacturing to licensing agreements. The Serum Institute of India, which is set to manufacture up to 1 billion doses of vaccines, is a good example. Facilitating such arrangements will enable the WTO to support the WHO ACT-Accelerator.

Following her address to the General Council, the WTO convened a virtual press conference for the Director-General elect where the subject of accessing and scaling up manufacturing of COVID-19 vaccines came to the fore.

John Zarocostas, a veteran international correspondent, based in Geneva asked Dr. Ngozi to elaborate on her statements lauding the licensing of COVID-19 vaccines.

    John Zarocostas: “Good evening Dr Ngozi. I would like you to elaborate a little bit – how do you think this licensing for vaccines, and therapeutics, and essential medicines can be done in a few short months through the WTO given that in some licensing agreements, developing countries are ending up paying more than developed countries.”
    WTO Director-General elect, Dr Ngozi Okonjo-Iweala: “Under no circumstances should there be licences, licensing agreements that lead to developing countries paying more than developed countries. That is not at all the point. The point of having this is there should be volume, you know manufacturing in greater volume so indeed it’s more accessible and affordable. So any agreements that result in developing countries paying more, I think are not satisfactory, and we have to go back to the manufacturers of those commodities to make sure that this is not the case and that developing countries are not disadvantaged. Now, you know, I am not going to go into the weeds. I see how AstraZeneca has been able to do this and is talking to many more countries in Latin America and Asia about this licensing. Johnson & Johnson is doing some contract manufacturing in South Africa but, in a meeting I attended a couple of weeks ago, a week ago actually, they talked about also looking at licensing so in this licensing they are very aware that the objective is not to penalize poor countries by charging them more. No, it is to help them get access quicker. What we have in the world is an absolute shortage of supply and that is because the world has never manufactured – let’s take vaccines – never manufactured 7 billion doses of vaccines. I’ve been in the vaccines business with Gavi, you know, this has never occurred. So there’s a shortage of manufacturing capacity, and to the extent that these companies can work in developing countries, where there are possibilities, many developing countries have said they have the space and the capacity but they just want to come to agreement with these companies, and I think that that should be done and I think that that can be done at costs that are very affordable to developing countries.”

Xin Ling from Xinhua News Agency posed a perceptive question on how the WTO could prove its relevance to 21st century realities.

    Xin Ling: “The COVID-19 [pandemic] is a stress test to many governments but it can also be an opportunity for the WTO to prove its relevance to the 21st century realities. Dr. Ngozi, you were the chair of the board of Gavi. I wonder if you have any concrete plan on how the WTO contributes to the fight against the pandemic in a more proactive way especially against the so-called vaccine nationalism to ensure the free flow of vaccines across countries and their equitable distribution.”
    Dr. Ngozi Okonjo-Iweala:”I think COVID-19 is an opportunity for the WTO to have a success and show what we can do both in the short term and the long term. In the short term, I want to look with staff at the monitoring function to see how many countries still have export restrictions and prohibitions that impact on medical commodities and see how the rules – we have rules at the WTO that say look, if you want to have these restrictions, you have to notify, you have to be transparent, and you have to declare the period in which you phase them out because they can only be temporary. So this will be a top priority to see how we can encourage lifting of those by looking at what the monitoring function is showing us and encouraging countries to do that. That will mean a freer flow of these commodities.

    Secondly with respect to vaccines, I’ve said that vaccine nationalism does not pay. I’ve been in politics in my country, I’ve been a minister so when this type of thing happens, it’s very natural for leaders and politicians to want to take care of their own population, there’s nothing wrong with that. The problem we have is that the pandemic is a problem of the global commons. So taking care of your population and being nationalistic with respect to vaccines wont work this time because even if you get all of them vaccinated and there’s a country down the road that hasn’t done that, it will come back in the way of variants.

    So one of the things that one would like to do is to work very hard to see what the WTO can do under the TRIPS Agreement to use all the flexibilities possible to allow countries to manufacture available vaccines so there can be more for poor countries quickly. And this this will also be a great support to the COVAX Facility which Gavi and the WHO have put together. Actually, the WHO, Gavi, and CEPI have put together what is called the ACT Accelerator which I mentioned in my speech which is designed to speed up availability of all these things to poor countries so how can WTO support that by exercising, Members exercising these flexibilities. AstraZeneca is already licensing, not contracting, licensing the production of its vaccines all around the world in many developing countries. The biggest facility is in India, the Serum Institute of India which can produce a billion doses of vaccines. So more of those approaches which I call the “third way”, I think that’s what we need to focus on and that’s [what] WTO can actively encourage and support.”

Giorgio Leali from Politico submitted this following written question.

    Giorgio Leali: “What can you as Director-General, what role do you play in trying to find consensus between WTO members on the issue of protection of intellectual property rights while you increase the supply of coronavirus vaccines?”

    Dr. Ngozi Okonjo-Iweala: “I want to be very proactive. I won’t be shy in saying that because I think this is an issue of lives – we are losing lives in countries all over the world, but if don’t act more lives will be lost. What am I am going to try to do is meet with members on all sides who are having these arguments about intellectual property issues and try to if we can find, and again I come back, I’ve named it the “third way” simply because I think we can find a way to be very conscious that we need to encourage research and development because if you don’t we wouldn’t have more investment even into looking at the variants of this so I feel that there’s a way to do that. At the same time allow greater manufacturer and that’s what I refer to in the last one – the licensing – I mean the interesting thing is that the pharmaceutical companies are already ahead of us so I think we should just look at what they’re doing and support them to do it with our rules. And if we exercise the necessary flexibilities under the TRIPS Agreement we can do that.”

Laurent Sierro from the Swiss News Agency posed a specific question on the TRIPS waiver.

    Laurent Sierro: “You mentioned the TRIPS Agreement, but there is also on the table a proposal for waivers to IP for therapeutics and diagnostics and vaccines. You didn’t mention that so far so does that mean so does that mean as the new DG you won’t give so much impulsion to try to tackled the deadlock between members on that proposition?”
    Dr. Ngozi Okonjo-Iweala: “No, on the contrary, on the contrary, I am saying it will be a top priority for me, but what I am saying is that instead of the arguments and the deadlock, we can actually break the deadlock. And I am hoping that I will engage on this as quickly as possible. I am not saying it’s going to be easy, but I would like to sit with the members on each side and be able to listen to what they have to say and find a way to persuade them to come to agreement. What I was saying is that, look, under the TRIPS Agreement, perhaps we can find sufficient flexibility. What developing countries are looking for is how can they get access to these products quickly and at an affordable price so that poor countries are not standing in line like they did with H1N1 where rich countries bought up all the vaccines and there were none or [like in the HIV pandemic] where they they stood in line for a few years. If we all agree on the objective…that poor countries should not wait in line and wait long to get access because it’s not even in the interest of rich countries then we can try to figure out a way to do this. I would like to broker this by listening to both sides – what I call a “third way” in which without impinging on intellectual property, looking at the flexibilities that are available which I think will allow us to manufacture and produce those vaccines, therapeutics, and diagnostics, by working with the manufacturers of these, the pharmaceutical companies – I think we can do it.”