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As Wealthy Nations Debate Giving Booster Vaccine Shots, Calls Grow for Global Vaccine Equity

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As the debate over booster vaccine shots heats up in the United States, global health leaders have issued an urgent call for global vaccine equity. The WHO reports vaccination rates on the African continent fall far below its target for 70% of the population of all countries to be vaccinated by mid-2022. “The science is not completely behind the need for booster shots yet,” says Zane Dangor, special adviser to the foreign minister of South Africa, who has called on the U.S. to come up with a proposal for allowing other countries to manufacture vaccines. “This is an emergency that affects all of us because variants are coming from areas where there are large numbers of unvaccinated people,” adds infectious disease specialist Dr. Joia Mukherjee.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman, with Nermeen Shaikh.

As the United States marks a deadly milestone — one in every 500 residents has died of COVID — scientists at the Food and Drug Administration have expressed skepticism over a push by the White House to authorize third, booster doses of Pfizer’s COVID-19 vaccine. An FDA committee meets Friday to discuss the need for vaccine booster shots.

This comes as health leaders have issued an urgent call for global cooperation on vaccine supply and access to end the worst pandemic in the last hundred years. WHO Director-General Dr. Tedros Adhanom Ghebreyesus said Tuesday vaccination rates on the African continent are far below the WHO’s target for 70% of the population of all countries to be vaccinated by mid-2022.

TEDROS ADHANOM GHEBREYESUS: So far, just two countries in Africa have reached the 40% target, the lowest of any region. As I said last week, that’s not because African countries don’t have the capacity or experience to roll out vaccines. It’s because they have been left behind by the rest of the world. More than 5.7 billion doses have been administered globally, but only 2% of those have been administered in Africa. This leaves people at high risk of disease and death exposed to a deadly virus against which many other people around the world enjoy protection.

AMY GOODMAN: This comes as heads of state are set to attend the U.N. General Assembly next week. And on Wednesday, President Joe Biden will host a virtual global COVID-19 summit to, quote, “call on chiefs of state, heads of government and international organizations, business, philanthropic, and non-governmental leaders to come together to commit to ending the COVID-19 pandemic.”

For more, we’re joined by two guests. In Johannesburg, South Africa, Zane Dangor is with us, special adviser to South Africa’s foreign minister. During an event Tuesday hosted by Public Citizen, he called on the U.S. to come up with a proposal for allowing other countries to manufacture vaccines. Also with us, Dr. Joia Mukherjee, infectious disease specialist, associate professor of global health at Harvard Medical School and chief medical officer for Partners in Health.

We welcome you both to Democracy Now! Zane Dangor, we want to start with you in Johannesburg. You have the big debate brewing in the United States. In fact, on the front page of The New York Times today, “U.S. Booster Policy Is in Flux as Dissent Mounts.” Apparently, top people at the FDA are quitting over the push for booster shots. We have that, while you have the rest of the world — some countries barely having access to a vaccine. South Africa and India have been on the forefront of demanding that the large vaccine companies, like Moderna and Pfizer, share their recipes and technology to allow other drug companies to be able to make these vaccines available to everyone. Explain what you’re proposing and your view of this debate over a third shot for U.S. residents.

ZANE DANGOR: So, on the first one, South Africa and India, in October of 2020, made a proposal at the World Trade Organization for certain provisions of the trade-related aspects of international — of property rights to be waived for the duration of the pandemic. So it’s a temporary call for a waiver on IP rights and exclusive use to allow for what is called idle capacity in other parts of the world to be given the technology and know-how — the recipe, as you called it — to manufacture more life-saving medications, including vaccines, so that a more efficient response to the pandemic is possible.

This proposal has been supported by over 150 countries and, since May of 2021, also supported by the U.S., through President Biden’s announcement and the administration’s support for the initiative in Geneva. This proposal does not change the international property rights regime. It basically just calls for changes to the manner in which companies can license it in —

AMY GOODMAN: We can hear you fine.

ZANE DANGOR: And companies can access the licenses and the know-how to ensure that we do reach the target of 10% by the end of September and 40% of the global population by the end of this year and 70% by the end of 2022. As of now, the major blocks to this process is the fact that the European Union is not supportive of it, and that is very significant in the context of the WTO as the European Union speaks on behalf of all European countries at the WTO. And we’re hoping that President Biden and others could use the summit this week to persuade more members to support it, the waiver, in particular the European Union.

With regards to the booster shots, I also coach the Vaccine Manufacturing Working Group, which is linked to the World Health Organization. And we’ve been discussing the movement in high-income countries towards booster shots and the impacts of that. There are two. The one is that it will continue the skewed distribution of vaccines, where you have most of the high-income countries almost completely fully vaccinated or have reached their targets towards population immunity, whereas countries in Africa, you know, their percentage is less than 3%.

There’s another component to this, is that as we — the pressure on the materials used to manufacture vaccines comes under pressure. So, the kind of glass vials that vaccines are packaged in will come under pressure with the calls for booster shots, because booster shots lend themselves to single use of these glass vials. So, there’s quite a bit of the — in terms of the value chain that comes under pressure.

Secondly, the WHO itself, the chief scientist of the WHO and others have actually expressed the view, based on evidence, that the science is not completely behind the need for booster shots yet. So, if the science is not behind the need for booster shots, then the risks associated in moving towards this, in terms of continued skewed access, the potential for new variants to emerge when you have large numbers of the global — the world’s population unvaccinated, needs to be evaluated by the U.S. and other countries that are thinking about moving towards the use of booster shots. Booster shots is a euphemism for third and fourth doses. So you’re moving towards third and fourth doses, in some cases, when, in many parts of the world, people haven’t had access to the first dose of a vaccine. Thanks.

NERMEEN SHAIKH: Zane Dangor, also, just to be clear, it’s less than 1% of people in low-income countries who have been —

ZANE DANGOR: Yeah.

NERMEEN SHAIKH: — fully vaccinated, and, as you said, 3% on the continent of Africa. Now, South Africa already has a technology transfer hub in place. Could you explain what’s happening there and what needs to be done to increase manufacturing capacity?

ZANE DANGOR: So, one of the first hubs — it’s the first global hub to be established for mRNA research. And this hub was established as part of the initiative from the WHO. And after a robust call for interest, South Africa was chosen as the first of these hubs. MRNA technology was the chosen technology in the first instance because it lends itself to rapid scaling up of manufacturing. And this is why it’s called an mRNA hub. But we might move towards other technologies, and the WHO can speak on that with a lot more eloquence.

But the challenge we have is that the late-stage technology holders — the rights holders for late-stage technology, which is the proven technology, which is, at this stage, your Pfizer and Modernas, have decided not to cooperate with the WHO in supporting the hubs through technology transfer. And this delays the process, which means that South Africa will either have to use unproven technology or invest in its own mRNA technology.

But, you know, the idea of this hub is that it will become a training hub. So, the companies involved, which are both located in Cape Town, the one who would be investing in training the first spoke, which is the first South African company that will distribute it, but will also be able to train other hubs and manufacturers across Africa. And as we heard yesterday from some of the leaders on this initiative, it may even be able to train manufacturers in other parts of the world, in the Global South, as well.

So, the hub is one of the key measures — and not just South African hub, but other hubs across the world — is that you’re not going to get security of supply, for this pandemic and following pandemics, if we don’t change the economics of life-saving medication. And that is where it’s produced and where it’s consumed. You know, so, Africa only produces 10% of the vaccines that they consume, and none of the vaccines related to COVID. There’s full and finished capacities across Africa, but none that can actually produce the vaccine using the active pharmaceutical ingredients. So, this is the idea of the hub. It’s really to change the asymmetrical nature of vaccine and other life-saving medication, the manner in which it’s produced and how it actually gets distributed, because the lessons from this pandemic is, only if you’ve got regional security of supply will everybody access these life-saving medications equally.

NERMEEN SHAIKH: Dr. Joia Mukherjee, you’ve called the idea of third booster shots here a terrible idea morally. What do you think the U.S. needs to do to boost vaccine supply? And what would you like to see happen at Biden’s summit next week?

DR. JOIA MUKHERJEE: Yeah. So, thank you so much, Amy and Nermeen, for having us on. And it’s a pleasure again to speak with Mr. Dangor on the same show.

You know, we were very happy that the Biden administration was willing to waive the TRIPS, the intellectual property, in this limited way, yet that is a tiny step in the cascade that we are demanding. So, first is getting actual agreements written with the WTO, with the manufacturers, so that this can — the technology can be transferred and those patent waivers mean something. That’s really important. There is still no formal language, and we’re demanding that.

The second, though, is money. There is no way to massively scale up the manufacture of vaccines regionally, as Mr. Dangor has said, without a lot of money. And we need to think about this as a moment of global collaboration. To me, this is a test. Can we get two shots to the entire world? If we can’t do that, we don’t have a prayer at the collaboration needed for things like climate change. And this is an emergency that affects all of us, because variants are coming from areas where there are large numbers of unvaccinated people.

And so, we need the leaders of the world to sit down and follow the lead of the Global South, leaders like the President Ramaphosa and others, who have called for this now for months and months, since November and December. And we were told, “Well, it would take at least six months to do it.” Well, had we started to transfer technology, invest in the supplies, invest in the training in November, we would be manufacturing those vaccines now.

So we’re just livid at these small steps, because what we need is the patent waiver and the language, then we need the transfer of technology, that’s written down and is happening, and then we need the funding to make this real. And if we don’t do that, we are not going to get out of this. Right now we’re working on charity donations from this country or that country. It’s not going to solve this giant public health crisis that affects all of us.

AMY GOODMAN: And what about Public Citizen’s report — 

DR. JOIA MUKHERJEE: So, we are — yeah.

AMY GOODMAN: — that contends the Biden administration could unilaterally share the recipe for Moderna’s —

DR. JOIA MUKHERJEE: That’s right.

AMY GOODMAN:COVID-19 vaccine with the world, because it funded much of the research?

DR. JOIA MUKHERJEE: Yeah, absolutely. So, the United States has — we have language in the law that says if the U.S. government has contributed monetarily to the development of a product, we can use it then in our national interest. And what we’re asking President Biden to say is that vaccinating the world is in our moral interest, our global interest, but it’s also in our national interest. The Delta variant that’s spreading came from another country, a very poorly vaccinated country, India. So, you know, we — this is all within the legal framework that’s within the WTO.

And what’s creating this idea of booster shots being bad for the Global South or impoverished countries is the scarcity that’s created by greed and profit, because if we had the money, we could make the vials. If we had the money, we could make the lipid nanoparticles. If we had the money, we could build the factories. So, this really needs to be financed, as war is financed, you know, out of whole cloth. We cannot do this without really significantly ramping up. And we heard this in the AIDS crisis, as well: “We can’t make the meds because the raw materials aren’t there.” It was all moot as soon as the money flowed.

AMY GOODMAN: Dr. Joia Mukherjee, we’re going to talk more about this next week, infectious disease specialist, associate professor of global health at Harvard Medical School, chief medical officer for Partners in Health. Thank you for joining us. And Zane Dangor, special adviser to South Africa’s foreign minister, speaking to us from Johannesburg.

Next up, we look at the first country in the world to recognize bitcoin as legal tender. What does it mean? We’ll look at El Salvador. Stay with us.

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