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Europe’s refusal to share COVID-19 vaccine technology threatens to overshadow a major gathering of European and African leaders this week.
Europe wants to use the meeting — which has been delayed by 16 months due to the pandemic — to advance relations on several fronts, including trade and digital connectivity. But access to vaccines will be high on the agenda. African leaders are furious that the continent received mere “crumbs” from wealthy countries’ overflowing plate of vaccines, leaving their populations much less protected against the virus.
They will be looking to the two-day summit between the EU and African Union for evidence that Europe is serious about tackling what South African President Cyril Ramaphosa has blasted as “vaccine apartheid.” And Europe shows no sign of moving on what is a central issue for many African leaders — loosening access to intellectual property on vaccines.
“They hoarded vaccines, they ordered more vaccines than their populations require. The greed they demonstrated was disappointing, particularly when they say they are our partners,” Ramaphosa said in December. “Because our lives in Africa are just as important as lives in Europe, North America and all over.”
The coronavirus pandemic has put health policy front and center of relations between the two continents — in particular, Europe’s refusal to waive vaccine patents to allow jabs developed by its companies to be produced elsewhere at lower cost. It has also revealed just how reliable African countries are on the rest of the world for vaccines.
With the inability to produce its own, Africa has ended up at the back of the queue for lifesaving coronavirus jabs. The figures speak for themselves: Less than 12 percent of the African population is fully vaccinated. That compares with about 71 percent of people in the EU.
While Africa’s estimated excess mortality rates are lower than Europe’s, the economic impact of low vaccination rates and the inability of African governments to provide the same level of financial help to struggling citizens as their European counterparts has pushed up to 40 million people into extreme poverty.
The disparity has driven a major push to increase manufacturing capacity on the continent — to ensure that when the next pandemic hits, Africans won’t again have to rely on the West’s largesse.
The EU is keen to show the world that it understands. The bloc has pledged €1 billion towards efforts to increase manufacturing capacity, as well as donating around 145 million doses to Africa.
Draft documents seen by POLITICO outlining the EU’s vision for the summit, which gets underway on Thursday, underscores the bloc’s desire to support “full-fledged African health sovereignty, in order for the continent to respond to future public health emergencies.” That echoes the African Union’s own playbook. The organization’s chair, Senegalese President Macky Sall, said on February 5 that its ambition was “to ensure our pharmaceutical and medical sovereignty as quickly as possible.”
But observers are skeptical the EU’s proposals are sufficient. The proposals also largely sidestep the elephant in the room — the fact that African countries have spent months failing to convince the EU to support a request to waive intellectual property rights for coronavirus products.
Not an alliance
The dispute between the two unions is evident from the first line of the African Union’s draft preferred summit declaration text. Gone is the suggestion from the EU of an “Africa – Europe Alliance.” Instead, the African Union, a grouping of all 55 countries with a combined population of about 1.3 billion, calls for a renewed “partnership.”
“Alliance is geopolitically a very heavy term,” said one person involved in the African Union’s discussions on the text, explaining the pushback. Going into the summit, hopes aren’t high. “People are not expecting that much, frankly, and not just on the health issue, but more broadly,” this person said, requesting anonymity due to the sensitivity of the matter.
For its part, the EU’s proposals on vaccines are two-fold. “It’s not only about sharing of the current vaccines, but also more broadly about vaccine manufacturing capacity and how we can support it in the long term in Africa,” said one EU diplomat. Commission President Ursula von der Leyen has said that at least 450 million doses would be shared with African countries by the summer. Speaking on a visit to Senegal a week before the summit, von der Leyen announced another €125 million in funds to help with the vaccine rollout.
More broadly, the EU’s draft proposals highlight its support for vaccine manufacturing efforts; harmonizing regulatory systems and technology transfer. However, the EU diplomat admitted that the proposals are being refined with some details still to be ironed out.
For now, critical observers haven’t been won over.
“What’s currently on the table falls well short of the level of ambition needed for the EU and for this summit to really capitalize this new partnership of equals that we keep hearing about,” said Emily Wigens, EU director at ONE, a campaign to end extreme poverty and preventable disease.
Trust between the two has been badly damaged by the pandemic, said Wigens. “The onus is really on the EU to use this summit to show that cooperation and solidarity aren’t dead,” she said.
There are aspects of the draft documents — such as the focus on Africa’s health sovereignty — that are a positive sign, said Dimitri Eynikel, EU policy adviser for the Doctors Without Borders Access Campaign. “But then in reality, if you look at the details, it largely comes down to recycling what already exists and providing a little bit more detail,” he said.
‘By all means possible’
At the heart of the matter is technology transfer — the EU’s draft text mentions voluntary licensing, which is when vaccine manufacturers agree to share the know-how for making a vaccine. So far during the pandemic that’s been limited.
As yet, none of the companies behind the coronavirus vaccines approved in the EU has agreed to involve African partners in the full manufacturing process. Instead, the focus has been on the final stage — filling and packaging the vials.
African countries would like Western pharma companies to go much further. In October 2020, South Africa and India — backed by the Africa group — proposed that intellectual property rights related to vaccines be waived to enable wider production. A waiver wouldn’t do anything to compel companies to share their knowledge of vaccine production but it would protect manufacturers from potential patent infringement claims if they wanted to produce a vaccine on their own.
While the EU may prefer to keep the discussion on lifting intellectual property rights to meetings behind closed doors in Geneva, it’s clear the African Union isn’t going to let that happen. In the African Union’s draft declaration, circulated on February 8 and seen by POLITICO, references the dispute.
The African Union is clear that the immediate concern is access to vaccines “by all means possible.”
The question is whether the summit could be the platform for the EU to propose a new compromise. French President Emmanual Macron seemed to suggest this in remarks to the European Parliament in January.
Macron said he hoped EU leaders would agree to a global license for coronavirus vaccines, clearing the barriers to gaining the capacity, intellectual property and technology Africa needs to manufacture its own vaccines.
At the time, negotiators in Geneva were confounded by the French president’s remarks — no such proposal had been presented at the WTO. As it turns out, a global license could in fact be a rebranding of an existing proposal from the EU to focus on the use of compulsory licensing of vaccines, said three sources briefed on the French proposal.
If that’s the case, it’s unlikely to go down well with African leaders. In the eight months since the EU put its counteroffer on the table at the WTO, countries have yet to reach a compromise.
What’s clear though is that vaccine equity will be a key barometer of the summit’s success. Ultimately, if the summit “fails to make progress on the issue of IP and technology transfer … I think it would be a major disappointment,” said ONE Campaign’s Wigens.
Additional reporting by Barbara Moens.
This article is part of POLITICAL‘s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. E-mail [email protected] for a complimentary trial.