News Brief: Big Pharma, Bill Gates Spin Against Generic Vaccines for Global South as Biden a…

Citations Needed | April 10, 2021 | Transcript

(Spencer Platt / Getty Images)


Nima Shirazi: Welcome to a Citations Needed News Brief. I am Nima Shirazi.

Adam Johnson: I’m Adam Johnson.

Nima: We do these News Briefs in between our full-length episodes when there is a take that needs to be hotted. Of course, you can follow the show on Twitter @CitationsPod, Facebook Citations Needed, become a supporter of our work through with Nima Shirazi and Adam Johnson, all your help through Patreon is so incredibly appreciated. We’re 100 percent listener funded but beyond all that crap, what we are here to talk about today is actually a follow up on an episode we did back in January about vaccine apartheid and I think that what we’re seeing now are some indications maybe over the past couple of weeks, that the Biden administration may be considering warming up to thinking about and then evaluating whether or not maybe they should think some more about supporting a waiver to TRIPS, the intellectual property regime that if there is a waiver would allow the recipes for effective COVID-19 vaccines to be shared beyond their proprietary privately owned corporate boundaries, and therefore other countries around the world would be able to produce vaccines to save — I don’t know — millions of lives. So Adam, we’ve been seeing this report about Biden maybe sort of kind of thinking about it for a little while now and we wanted to dig in a bit deeper.

Adam: Yeah. So there’s the ultimate moral chip shot, which is an effort to allow countries to manufacture vaccines for cheap so they can scale up much faster. As of now, most countries in the Global South that are poor, specifically to Africa, are not reportedly supposed to get vaccinated until mid-2024 and that’s even being generous.

Nima: There was a report just a couple months ago from CNN, that said that more than 130 countries have not even given a single shot to anyone in their population, while just about 10 countries have already disbursed 75 percent of all vaccines given. That was two months ago, I can only imagine that has increased since then. The United States has given upwards of 100 million shots to its population, that is a good thing, I want that to keep happening, please. The UK I think has purchased — what? — like 400 million doses, which exceeds by at least a factor of I think three their entire population. So there’s this idea of, you know, Global North hoarding but also distributing and that is good, but the hoarding part is bad, and especially not only the vaccines that are already being produced by Big Pharma, but certainly the intellectual property that is being held on to for very specific reasons. Later on the show today, we’re going to talk to Peter Maybarduk, a human rights lawyer and director of the Global Access to Medicines Program at Public Citizen.

[Begin Clip]

Peter Maybarduk: I agree that it is wrongheaded and cruel to say that countries can’t do this, can’t manufacture their own treatments, their own diagnostics, their own vaccines. With COVID we’re looking at a moment where there needs to be a tremendous infusion of short term energy and capacity in order to get billions more doses online timely to end the pandemic. So that isn’t just about the waiver, that is about an all hands on deck, everything we can do, including removing the intellectual property barriers.

[End Clip]

Adam: So 400 different organizations have called on the administration to stop blocking the COVID-19 WTO waiver which would suspend patent rights or severely loosen patent rights for drugs like Moderna and Pfizer. This includes Doctors Without Borders, Human Rights Watch, Oxfam, the Catholic Social Justice Network, Health GAP, a number of health organizations.

Nima: Super lefties. (Laughs.)

Adam: Sort of mainline normie liberal groups, including several members in Congress, including Bernie Sanders, Elizabeth Warren, Mark Pocan, Ro Khanna, you name it, they realize and I think every health expert realizes that or that isn’t on the payroll of Bill Gates or the US government, that this is a no brainer in terms of scaling up production very quickly, and getting these vaccines out as soon as possible. Even using selfish criteria it is good for the United States that the rest of the world is vaccinated because, as we all know, the course of the pandemic doesn’t know borders, right? So now we are, there’s an enormous amount of pressure being put on the Biden administration to adopt this WTO waiver and then there’s a counter pushback coming from two fields. There’s the Big Pharma intellectual property enforcement lobby, which is very much supported by Bill Gates whose entire personal fund is based on intellectual property, that’s how Microsoft makes its money, and that is, of course, projects like Intellectual Ventures, which is basically a glorified patent troll farm, which goes around suing people for infringing on his patents is something he’s invested, something he thinks will breed innovation. His entire worldview, ideology and bottom line are predicated on the premise that intellectual property is sacrosanct above all and cannot be stopped. So the Gates Foundation, which is obviously tremendously influential in global health policy has explicitly opposed the IP waiver they were asked by South Africa’s Mail & Guardian, South Africa is one of the major countries begging this WTO waiver to take place, and they wrote, quote, “Gates argued that lifting patents would not make any real difference. ‘At this point, changing the rules wouldn’t make any additional vaccines available.’ That’s because, he claims, there are only a handful of manufacturers in the world with the necessary capacity to make the vaccines, and these are all at capacity already.” This has been refuted by those advocating for the waiver, including Doctors Without Borders, who says that there are a lot of countries in the Global South who, and again, to be clear, the waiver is not a magic bullet, the waiver would also necessitate assistance from pharmaceuticals, which Biden can pressure them to do to help with technology, copyright and other issues about scalability, but it would be part of a broader whole of government effort to make these technologies both legal and doable from these organizations and there’s a huge pushback from the US Chamber of Commerce crowd, from the IP enforcement crowd, from the Bill Gates crowd to do what they cleverly do very well, because they can’t come out and say, ‘IP is sacred,’ because that’s means that profits are sacred above human lives, right? So that’s like Bond villain evil, they can’t say that, so what they’re doing is they’re doing a very clever workaround by saying, well, there’s two arguments now that are front and center, there’s number one, it’s moot, doesn’t matter, they can’t do it anyway, which we just talked about and this is great, it’s a clever little cop out because it prevents you from having to address the core substance of what you’re doing, which is arguing for the sanctity of intellectual property regimes, and two, which is becoming increasingly common, and I think will be the most popular one moving forward is a national security argument. So on April 8, 2021, Josh Rogin, the sort of resident hardcore neoconservative at The Washington Post, wrote an article called “The wrong way to fight vaccine nationalism.” He’s making the argument that this would be a win for China, that giving away intellectual property rights would be a win for China —

Nima: Always.

Adam: Because one thing it’s also important to note is that there are national security implications to allowing poor countries to manufacture their own vaccines, which is to say you cannot use the grossly named vaccine diplomacy to leverage over them concessions. There’s a report that Joe Biden, in exchange for delivering some vaccines to Mexico, told them to clamp down on Central American migrants before they get to the border. So —

Nima: It’s just a blackmail regime.

Adam: Yeah, it’s a blackmail regime. And this is something that national security hawks are desperate to maintain no matter how much these progressives’ hearts bleed. So I’m gonna read from this Washington Post report April 8, 2021, quote:

Now, hundreds of nongovernmental organizations and dozens of Democratic lawmakers are pushing the Biden administration to support the proposal. But many warn the move would result in the United States handing over a generation of advanced research — much of it funded by the U.S. taxpayer — to our country’s greatest competitors, above all China.

Nima: (Gasp) Dun dun dun.

Adam: Right. So it goes on to say that this would weaken the US in relation to China because it would be giving over our trade secrets or IP secrets.

Nima: Let me just remind everyone that for the past fucking year there’s been a global pandemic with millions of people dying.

Adam: It’s a Cold War, it doesn’t matter.

Nima: Oh , right.

Adam: So he would go on to write, quote:

If and when this does get to Biden’s desk, he will also hear from national security officials who believe that waiving TRIPS would result in the forced transfer of national security-sensitive technology to China, a country that strives to dominate the biotechnology field as part of its Made in China 2025 strategy. Once countries such as China have this technology, they will apply their mercantilist industrial models to ensure their companies dominate these strategically important industries, potentially erasing thousands of U.S. jobs.

So when in doubt, there’s two things you can go to: you can dismiss it altogether, you can fearmonger and one thing they’re also doing, Nima, is they’re laying the groundwork for a trope that was popular from the IP crowd, including, by the way, very much Bill Gates and Al Gore, who was protested by as we noted in our episode on vaccine apartheid from January 27, that when Al Gore was running for president, he was protested by the gay rights group ACT UP for not allowing cheap generics to go to South Africa for AIDS and HIV.

Nima: Which when they did wound up, again, saving millions of fucking lives.

Adam: Right. So they made one of the arguments that was central to the IP enforcement lobbies argument was that basically they were too poor and too stupid to recall. There was even a West Wing episode where there’s a big dramatic moment where Toby’s like, ‘They can’t get cheap AIDS drugs, it wouldn’t make sense because they don’t have wristwatches, they can’t tell time because you have to take a cocktail every hour.’

Nima: It’s so racist.

Adam: Yeah, and so this is being seeded now in Western media because obviously if the poor country can’t really, that they’re just a bunch of bumbling idiots anyway, then why even bother waving the patents.

Nima: Right. Why even bother sharing the recipes for the vaccines when they can’t do anything with it anyway because they’re savages who don’t have science labs or smart enough people or the resources to do that. Now of course, even if that were true, which it is not, but even if that were true, the idea that the Global South is resource poor in certain ways, then, of course, you know, might indicate a question of why that is, which then we get to the, you know, centuries of colonial extraction and deliberate under development that may be why, but again, so many of the countries that are being talked about in this way do absolutely have the capacity to take this on, to create generic versions of these drugs that can save millions and millions of lives and the reason this is being opposed, again, is to maintain not only profit motives, not only this idea of, you know, national security, but also as we’ve previously discussed, just the corporate and political benevolence of Global North countries and companies, right? And so it’s this idea of, ‘Look, we can donate more vaccines after we make them and someone buys them and then gives them, gifts them, bequeaths them to these countries.

Adam: So The Washington Post on April 4, had a headline, “Ivory Coast is falling behind its vaccination schedule. Health workers fear thousands of shots could expire.” It’s basically about how the local population doesn’t want a vaccine and they’re not really giving it to them.

Nima: So they’re sitting there expiring, and that even the, you know, largest of the donors is being wasted, right? Being wasted by a local population.

Adam: April 6, 2021, an Axios headline reads, “Vaccinating Africa: Countries struggle to deliver the few shots they’ve got,” where they basically say that a bunch of shots are going bad. Now, of course, there are logistical hurdles to getting shots out in poor countries, but it’s very clear that these articles are being planted and are being promoted in a certain way because the assumption is that the issue is not that the US is not giving away, because here’s what’s going to happen, there’s going to be a situation where people say, ‘Wow, Africa is not vaccinated, and it’s the year 2023. Why is that?’ Oh, they’re gonna go back and say, ‘Oh, there’s these reports that they had a hard time getting it out, they were corrupt, wasteful.’ Because if you pathologize the Global South it’s like the sort of corruption narrative, right? Well it is the corruption narrative, if you pathologize them as being morally weak, then that justifies the gross inequities we see and so there’s an incentive, there’s an institutional incentive, either deliberate or subconscious, or just based on racism.

Nima: Because then mass death can be seen as a moral failing as opposed to a policy choice.

Adam: Yeah, because if you read these articles, it’s not that the Global North is not providing enough resources, it’s not that we’re not giving enough money, it’s not that we’re not providing the logistical know-how or whatever, we’re not even allowing them to manufacture their own drugs or go to other countries in the Global South, they manufacture their own drugs, because obviously every country is not gonna manufacture their own, but they can have partnerships with local countries that do or approximate countries that do. That’s not the issue. The issue is corruption, too poor, too ignorant, conspiracy theorists, this is why you see a lot of articles about Black people not being trusting because it’s a way to sort of preemptively do this domestically, Black people don’t trust the vaccine, and that therefore justifies going to the low vaccination rates of the Black population, right? The goal is to sort of preemptively rationalize what we all know is inevitable, which is that there’s going to be horrific inequities in distribution because at this point, I think it’s fair to say, a lot of people have foreclosed on the possibility of permitting generics to be manufactured in the Global South and now what we do, the way you move up the ranks of global health policy now and the way you move up the ranks of the of the Gates world, which obviously funded most of the health policy now, which is you don’t touch the sacred cow of IP, you’ve come up with more and more clever ways of looking like you’re trying to fix inequities but without getting to the core issue, which is that these countries are not permitted to make their own drugs. So what you have is you have an increasingly convoluted system in place to come up with, as Josh Rogin does in his article, he offers, so here is the alternative to the TRIPS waiver, right? And it’s sort of like how there’s a whole industry around you can’t advocate single payer so there’s a whole industry around exotic ways of, ‘Oh, no, it’s the ACA and you go to this website, and you click on this, and you get to compare markets,’ and the more clever it is, the more clever you are, why don’t we just make it fucking free like they do in other countries and make it simple? ‘Oh, well, that’s not an option that’s off the table.’

Nima: Right. That’d be a logistical nightmare.

Adam: And this is a situation where liberals — Biden can’t even blame Republicans, he can do this unilaterally. He doesn’t even have that cop out, right? The sort of, ‘Oh, the big bad Republicans said no.’

Nima: Joe Manchin doesn’t get to decide this one, by the way.

Adam: Right. And so there’s a very specific PR media narrative, which is mostly to ignore it. There’s been a couple op-eds in The New York Times but, you know, for the most part, CNN has not talked about this issue at all, not that I’ve seen. I looked at MSNBC, MSNBC, of course, has not talked about this at all. Supposed progressive network who’s deeply concerned with racial justice has not talked about one of the most urgent racial justice issues, which is that in case anyone hasn’t noticed, the vast bulk of people being vaccinated right now are white. The countries that are getting vaccinated are white-majority countries and that is not an accident that exists because the WTO was specifically set up to protect white majority owned capital, that is why the WTO protesters objected to it because that’s clearly what it was from the beginning, the enforcement, the strict hardcore enforcement of IP regimes even at the expense, the manifest expensive of human life was always going to lead to this conclusion. So here we are in a mass pandemic, where I think even your kind of starry eyed liberal would say, ‘Well, clearly, in this case, we have to sort of make an exception, right?’ This is an extraordinary circumstance, you have whole cities, whole states shutting down, you have trillions of loss in the GDP, all these once in a lifetime, catastrophic events, clearly, this would be an opportunity. ‘No, yeah, sorry. Hold on, I gotta go, I gotta reverse engineer the reason, it’s gonna help China.’

Nima: ‘I got a memo, co-signed by Bill Gates and Henry Kissinger, that says we can’t do that.’

From left: Bill Gates and Henry Kissinger.

Adam: ‘Yeah, it’s gonna help the big baddies in the Orient and also, it’s not really relevant anyway and also, Africans can’t distribute it anyway.’ And so those are the sort of reverse engineer excuses we’ve come up with and now of course, activists are still pushing for this, because it’s, it could really, really speed up timelines. You know, one of the things we try to do in the show, Nima, as you know, is just establish the stakes. This is actually a matter of life and death. Every day that goes by we don’t do this, I think it’s fair to say, that it’s cost thousands of lives.

Nima: Without a doubt, and changing this rule, allowing for this WTO waiver, would be game-changing.

Adam: In addition to some of the logistical help, it’s not enough just to do the waiver, which activists are very clear to point out.

Nima: Right, exactly. It’s not a, this isn’t the only thing that will do it, this isn’t the thing that then makes the pandemic go away, but this would be a huge thing and that’s why I think there’s so much pressure from those who have been working in this space for so long and we are lucky to be able to talk to one of them on our show today. So we will be joined in just a moment by Peter Maybarduk, a human rights lawyer and currently the Director of the Global Access to Medicines Program at Public Citizen. Peter is going to join us in just a moment. Stay with us.


Nima: We are joined now by Peter Maybarduk, thank you so much for joining us today on Citations Needed Peter.

Peter Maybarduk: It’s great to be with you.

Adam: So per usual on the show, I want to talk by kind of establishing what the current state of play is. On April 8 2021, there has been what appears to be increased momentum on this topic to get the White House to support a TRIPS waiver to allow other countries to not infringe on the quote-unquote “intellectual property” of vaccine makers. 400 plus progressive groups, 100 members of Congress, including Doctors Without Borders, Human Rights Watch, The Center for Constitutional Rights, etcetera, etcetera, Bernie Sanders, Elizabeth Warren, this is far from being a fringe position and yet there has been complete mum from the White House on this issue, for reasons that we speculate, I think, not without cause at the top of the show, we speculate as to why that is, I want to sort of talk about from your perspective, what you see the trepidation being on the part of the White House or maybe not even trepidation, maybe they just sort of believe it, or don’t really want it, what you think the current state of this campaign is and what its likelihood of success is.

Peter Maybarduk

Peter Maybarduk: I think that we’re going to win. I think that the Biden administration is going to change its position and that that will be an historic victory, because the grip of the pharmaceutical industry on Washington has been very powerful for a long time, and as you know, has been translated into power in these trade negotiations and sort of an international regime that restricts what countries are able to do and how countries are or are not able to protect their own people and choose to protect their own people even at these most serious of times. I think that power dynamic is changing because people see how wrong it is as evidenced by the progress of this sign on letter so far. This is a moment for humanity to rally to a common cause and we should not be concerned about patents while so many people are dying. The simple moral equation, I think it is widely understood that everything we can do to shorten the pandemic, everything that we can do to empower countries to design and distribute medical tools of all sorts, we’re not talking only about vaccines, we’re talking about diagnostics and treatments and protective equipment, is worth doing and for those who sort of worry about incentives and compensation, there are pretty simple answers. It’s not necessarily the case that everything needs to be a taking. Where there have been meaningful investments in research and development we can pay royalties, we can compensate firms for the very significant innovation they’ve put in, where they’ve put it in, but of course, we also know that these have been publicly funded technologies in many cases and the public deserves a proper return on its investment that includes the ability to free the technologies to make them open so that countries can manufacture and distribute and take care of their people.

Nima: I like that idea that as publicly funded innovations, the public also gets to choose who to share that with. Everything you just said Peter is so optimistic, and it is so actually uncharacteristic of what we do here on Citations Needed. So I really do appreciate hearing that, it’s extremely refreshing to hear, because it’s just so different than what we usually hear. To bring us back to what we usually do, which is making everyone sad, can you talk to us a little bit about what you often see as you work through the intellectual property enforcement kind of field and how big pharma in this case, as is so often the case, consistently argues that regardless of whether there’s a waiver for TRIPS — which has been in place since what? 1994? — regardless of that, we have heard, we’ve seen in op-eds, we’ve seen it stated as a matter of just normal fact in certain news reports, that even regardless of this waiver, poorer countries would still not have the capacity or the ability to actually manufacture the vaccine. So even if this information is shared, we have often heard it really wouldn’t even matter. This winds up kind of playing into this savior complex. So we get to retain on the, you know, the Global North gets to kind of be the benefactor of the Global South, again, what have you seen in your work that may dispel that sort of both kind of big pharma lobbyists, but also frequent media narrative that I think we see and read a lot?

Peter Maybarduk: I think we recognize that the waiver is not the only thing that’s needed right now. We also need significant investments in manufacturing capacity and we need the exchange of know how and the sharing of vaccine recipes, we need that affirmatively, we need leadership from the US government and others to help get it done. So the waiver is part of a package but I agree that it is wrongheaded and cruel to say that countries can’t do this, can’t manufacture their own treatments, their own diagnostics, their own vaccines. With COVID we’re looking at a moment where there needs to be a tremendous infusion of short term energy and capacity in order to get billions more doses online timely to end the pandemic. So that isn’t just about the waiver that is about an all hands on deck, everything we can do, including removing the intellectual property barriers. But over the next few years, I think we expect many of these technologies to be engineered a variety of helpful ways all over the world with capacity that exists in many countries and that process will be more successful if there aren’t these monopoly restrictions, but rather, scientists and manufacturers are free to build on one another’s progress. technologies like mRNA are pretty adaptable and if we make them as open as possible, if we share all the information that we have, then in five years, we could be living in a world that’s much more prepared to deal with the next pandemic, which will come, where we have manufacturing capacity all over the world that can quickly be retooled to deal with emerging threats that is accountable to local health priorities and that is consistently improving. So I think the waiver helps us get to that world and it’s just something we should all be working for as much as we can.

Adam: Yeah, the opposition has been doing a bit of strawman-ing, they say ‘Oh, the waiver is not really going to be enough.’ It’s sort of a distraction I believe. I believe one Financial Times column said it was a sideshow. But there is a shocking amount of public health officials, those who are not directly, frankly, on the payroll of the Gates Foundation, and other kind of IP fetishists, who say why would you foreclose on an avenue of getting the vaccine out there based on a kind of a priori assumption that capacity is impossible because it doesn’t make any sense from a public health perspective? I mean, again, the organizations we listed on this are completely mainline groups, this is not like a fringe, radical left-wing cause, this is extremely mainline public health groups who are saying it makes no sense from a public health perspective, even if you’re just a hard nationalist, right? Even if you don’t even care about the welfare of the Global South, it’s in everyone’s best interest to have as many avenues as possible to scale up vaccine distribution and the line ‘Oh, it’s well, it’s moot,’ I think it’s popular and I think it’s again — Howard Dean used it in his op-eds opposing this, several different IP lobbying groups, the Chamber of Commerce used it in their press release — is that it kind of allows you to cop out, it allows you to just dismiss the issue rather than have to look like your cartoon Bond villain, which I think most people would look at this and think you’d have to be to sort of put pharmaceutical company profits and the preservation of global IP regime over the lives of millions of people.

Screenshot from an op-ed by Howard Dean in Barron’s.

One of the things that people in your world are starting to come up against is these counter arguments that they’re sort of poo-pooing, dismissing it and I guess I want to ask from your perspective and we saw this a lot in the late ’90s and early 2000s with access to HIV drugs, there was a lot of what I would argue is sort of not subtle racist kind of statements about how ‘Oh, well, these people couldn’t really do it anyway, even if it was free,’ and we know that wasn’t really true. I want you to talk about how some of these kind of cultural biases, maybe racism is too harsh of a word, but some of these cultural biases are an assumption that somehow the only countries that can actually manufacture, because you’re right, waiver in and of itself is not going to be enough, there has to be assistance with copyright, manufacturing, production, a bunch of other stuff and we talked about that at beginning, that goes without saying, to what extent do you think some of these cultural assumptions of the Global North or the rich countries having the sort of know how kind of feeds into this counter narrative that the whole thing is a bit of a Pollyanna-ish left-wing cause celebre?

Peter Maybarduk: Yeah, so in the case of HIV/AIDS it was considered completely impossible to manufacture affordable AIDS drugs right until the moment that it was proven possible. The drugs were being priced at more than $10,000 per person per year until Indian firms and to some extent production out of Brazil as well, demonstrated that you could do it for $1 a day and from that we got an AIDS treatment revolution that has saved 20 million lives so far. So it’s certainly a mistake to just assume that we can’t do much better than we are doing so far and that we can’t achieve significant breakthroughs on speed, on efficiency on price, in the name of public health and the best way to get there is to unleash potential and making it possible for everyone to experiment with the manufacturer and to share the information that we have. So the waiver makes a significant contribution to that. That’s not to say that we know exactly what can be done how quickly. We have estimates and our hope would be that those estimates can be significantly improved upon if we get hold of government efforts and you stop having to spend time debating monopolies instead of just doing what needs to be done. I do think there are biases at work. I also think there’s an over reliance on industry. Perhaps it comes in part from this sort of belief that companies did this on their own, which is not the case, right? The US public invested $700 million in coronavirus research before COVID-19 because of other known coronaviruses and the foreseeability of a pandemic. That was the public not the private sector. The private sector ran relatively few clinical trials, other research related to this and the establishment of the new platform technologies was always a public/private collaboration and indeed the National Institutes of Health own key patents that are relied on by the major vaccine manufacturers against COVID-19 today. So these have always been shared projects patrimony of humanity and it’s a mistake to limit that to believe we can’t do better. It’s a mistake not to be ambitious about the response and that’s one of our real concerns right now that there are too many experts, too many of Washington’s serious people that are giving up on the possibility of making a difference in this pandemic, which by the way, hundreds of millions of people can’t expect a vaccine till 2024, perhaps more. It’s not clear that it’s the goal of public health intervention so far to vaccinate everyone. In fact, that’s probably not the case, the goal is more to vaccinate people in wealthy countries and manage the pandemic elsewhere, well, it becomes endemic, and we all need booster shots enough to deal with the variance. So obviously, we should be unleashing everything we can do. But I don’t want us to underestimate the challenges either. It’s not just this one decision, there are a lot of things we have to do together in order to come up with speedier solutions and we’re gonna have to fund it and we’re going to have to push companies to affirmatively share what they know as well. We’ve called for a $25 billion investment by the US government to retrofit factories with mRNA production lines and then provide the drug substance and manufacturing to bring 8 billion doses of mRNA vaccine online by next year and that’s enough for half the world’s population and it’s a big investment, but it’s pretty small compared to the trillions that the world will lose meanwhile if the pandemic goes unchecked. So that’s the scale we need to be thinking on, just much more ambitious about what can be done and simultaneously unleashing capacity all over the world, freeing it from these kind of monopoly restraints to experiment, not only with vaccines, but with diagnostics, with small molecule medicines or treatments, with personal protective equipment, even things like N95 masks and ventilators are heavily patented and I think one of the things that the waiver can really do is allow countries to just quickly reverse engineer many of those simpler technologies that can be brought to market pretty fast without some of the huge capital investments or complexities of the latest vaccines. That would make a difference in the pandemic too.

Adam: One of the things that people will say counter to that, because I think sometimes people hear this and you hear this argument and they go, okay, well, the Biden White House and Bill Gates and all the people opposing the IP waiver, they’re not evil, and then you say, well, it’s about ideology to a large extent — I think for Gates is also how he makes his money, he makes his money off patents, and strict global IP enforcement — it’s that on some deep level, I think if we’re being generous, that they really believe that this will be a slippery slope and if you read the internal documents of the IP enforcement lobby and the big pharma lobby, they repeatedly talk about how this would stifle innovation in the future. They say, ‘How would we attract outside income if they thought their profits could be undermined?’ The sort of same arguments people have been making for centuries about why we have to patent these life-saving drugs and I want to start off by sort of addressing that, I want to address like sort of this kind of hair-on-fire, slippery-slope argument that this will somehow be a gateway into kind of despotism and I even read some of those statements, quite frankly, as veiled threats about about a capital strike or capital slowdown, that if Biden actually goes through with this, because, you know, there’s a ton of pressure on him from Democrats in Congress, as you know, it’s it’s not nothing. I think they view it as a real possibility, that if he goes through with this, that the pharmaceutical industry, its profits will basically tank overnight, that there’s a fear of precedent here and I want to talk about how y’all and activists and others manage that apocalyptic vision of sort of socialists taking over the private pharmaceutical industry and do you think any of those fears are justified and what does it really mean that we’re even in a situation where ostensibly the most powerful person in the world has to beg these private companies to stem a global pandemic?

Peter Maybarduk: I do not think those fears are justified if we consider the technologies we’re talking about, again, they were very heavily publicly funded in the first place. People know about Operation Warp Speed and the billions of dollars that US taxpayers shelled out last year to accelerate the development and manufacturing of vaccines. They know less about the fact that they were publicly-funded technologies in the first place for the past 15 years, as I mentioned, with collaborations in coronavirus research, as well as the types of new vaccines, the platforms like mRNA that are being rolled out now, all of that public investment for the first place. So it’s not just a question of private investment, what happens private investment, we’re funding this stuff to the tune of, even in normal times, the National Institutes of Health are investing $40 billion a year in biomedical research and development. That’s all publicly funded. So we got to account for that. Secondly, here, the entire world is the market for these technologies. There’s not really, there’s not an incentives problem. The company’s vaccine makers in particular are doing very well now and they plan to raise prices a great deal and so they will be just fine even if at some point they have to deal with biosimilar competition like every other industry. And of course, the Warp Speed funding did de risk the investment for these companies. So the idea that we’re putting innovation incentives at risk seems pretty ridiculous to me. Also, it’s kind of like we have the opposite problem because something like the waiver, as far reaching as it is, what it does is it gets the WTO out of the way, you still got to fight pharma potentially country by country a little bit, there are still lobbies and rules in place in each member state and so we actually have a ways to go to clear each barrier so that far mine It’s thicket of rules are not a problem. I guess I’m trying to say that the problem really is that there are still far too many rules and incentives that protect the industry from competition, even when the public has completely de-risked the investment for pharma, the so-called Moderna vaccine, which is really the NIH-Moderna vaccine, taxpayers paid 100 percent of the development of that project so I don’t even really know what we’re talking about with this whole idea that, you know, we’re going to compromise.

Adam: The sky is falling. What are the IP lawyers going to do if they have to make $10 less a month?

Nima: The US Chamber of Commerce is very, very concerned.

Peter Maybarduk: Yeah, that’s a good point. It’s really, it’s my law school classmates, man, or they’re gonna get put out of jobs and I don’t feel too bad for them.

Nima: And what do we have to show for it? People surviving?

Adam: I know, millions of people in the Global South being healthy?

Nima: To your point about certain barriers and then other opportunities, can you tell us a little bit about how COVAX fits into all of this and lay out for our listeners what COVAX is, but then certainly how they play into the additional crucial rollout of this vaccine beyond the hospitals and clinics in wealthier nations.

(Source: Pan American Health Organization)

Peter Maybarduk: So COVAX is the global initiative to provide vaccines to countries that are not able to provide for all of their people themselves, and to be clear, we support it, because it’s the vehicle and people are working hard over there to get vaccines to everyone that needs them. But COVAX doesn’t have all the tools it needs to get this done. The COVAX target, optimistic, everything works target, maybe one in four people in low and middle income countries by the end of this year would have been vaccinated and it may well not go nearly that well. So that’s obviously not good enough, you know, millions more people could die and COVAX is not really able to sit across the table with the pharmaceutical companies, the way that, you know, say like a motivated US president could do and say ‘You’re going to play ball, you’re going to share your technology, here’s what’s going to happen.’ To your point it is also, it’s heavily influenced by Gates, it’s an alliance that involves Gates funded organizations, CCEPI and Gavi, as well as the World Health Organization and so it definitely has a stake, an ideological stake and sort of political limits that are kind of rooted in the IP system. I mean, like you said, Bill Gates made his money off copyright, we’re not going to get an alliance like that to do some of what is needed to share technology with the world. It’s just not what it’s built or set up to do, but it is there to take advantage of the manufacturing capacity that is made available and ensure a solid rollout of vaccines and equitable allocation to countries that need them. So that’s all good and what we should be doing is putting COVAX in a radically different position by changing politics at the highest level, we can, to tell the pharmaceutical companies, ‘Here’s what you’re going to do, you are going to share your technology and here’s how we’re going to vaccinate the world.’ And so we really need those commitments in our own countries. I’ll sort of give an example of what that could look like or why some of this stuff is so outrageous in addition to the fact that billions of people aren’t going to get vaccinated for a long time. The Moderna and Pfizer vaccines are very similar, right? They’re both mRNA vaccines, but one of them needs to be stored at 80 below and the other does not and why is that? It’s because Moderna is not sharing its technology with Pfizer and vice versa and so instead of just having the best possible vaccines to roll out worldwide, the entire world, including COVAX has to figure out how to provide end to end, cold chain, ultra freezer storage and get vaccines like that to remote locations that don’t have that sort of equipment. Companies could, Moderna could just tell Pfizer how to do it. Instead, the entire world has to wrestle an impossible logistical challenge and deal with rolling out an inferior vaccine compared to what we could have because of commercial secrecy and a lot of people will die because of that.

Adam: Yeah, we covered the vaccine apartheid. Many of the similar issues back in January, we had Heidi Chow on from Global Justice Now and one of the things that she said is that every country she spoke to, every activist in the Global South or even political leader in the Global South she talked to, they didn’t want charity, they wanted justice. They didn’t want a handout, they wanted the opportunity to have the ability to manufacture their own products if they needed it and I think one of the things that COVAX does, and I think by design, is it still maintains this power dynamic relationship between the rich countries and the Global South, it doesn’t really undermine that by giving them the capacity to do it themselves, and again, I understand that some countries won’t be able to do it themselves regardless, but it’s more multipolar. There’s more places you can go to try to get the drugs and I think that asking some of these leaders, which again, is why it’s uniformly opposed I think in the wealthy countries, let’s be quite honest majority white countries — Australia, Europe, North America, Canada, US — is that they don’t want to give up the power really, I think. I think that giving up this power dynamic where you have to come to them and sort of beg and then we have this sort of pernicious concept of vaccine diplomacy where you even have explicit concessions made in exchange for some of these drugs and I know that COVAX is different than some of that, but it seems like that, you know, this idea that we can give up that power is something I think that those in Washington, because I do think it even has national security implications as well. They’re not necessarily willing to give up too easily. I want to talk a bit about that power and how people in Congress who are attempting to lobby the president and even the activists within the countries we mentioned in Europe are attempting to lobby their leaders, how are they sort of framing this? Because it seems like from a basic health perspective this is a no fucking brainer, right? There’s a five alarm fire and there’s four fire hydrants and we’re only using one fire hydrant right now. Doesn’t make any sense.

Nima: We have to pay someone for the use of their fire hydrant.

Peter Maybarduk: Yes.

Adam: Right and we’re foreclosing on all these other avenues, and what really should be a dynamic multitasking, but I again, I do think that there’s a real entrenched interest in not giving up that power dynamic that we have over the poor countries and I want you to comment on that and whether or not you think that’s maybe one thing motivating the hesitancy because again, the Biden ministration has reportedly been quote-unquote “considering” it for over two weeks now.

Peter Maybarduk: Yeah, absolutely. I mean, it’s absolutely the case that COVAX is designed not to change the balance of power and that is its philosophy for getting countries to donate doses from a limited supply and our call from the beginning of the pandemic has been, it’s critically important that we share vaccine recipes and do everything we can to expand supply all around the world. And it’s true that it is, in a sense, at least more about charity than justice and that is also what fuels the movement for the TRIPS waiver because if you are not sitting on a factory and tremendous manufacturing capacity yourself and you’re trying to protect your people, what do you do? Do you go to Bill Gates for a handout? Maybe sometimes in times of disaster there’s not a ton of choice, you know, maybe you do, but also, and what we really want, is to fight for the right to defend our people and fight for the right to self determination and sovereignty and all of these things and it’s an obscenity and it’s cruel that there is an international legal regime that blocks countries from doing that. I’ve seen it in action, by the way, I mean, you know, I was hired initially to help health agencies and civil society groups in developing countries, overcome patent barriers where possible, and I was working with governments, I mean, I’ll just one vignette, you know, working with a government that had had a plan and had lined up a suite of what we call licenses, a sort of a policy package to introduce generic competition for a series of needed medicines, and they have the legalities lined up, they had their procurement plan lined up, and at the last moment they were blocked by their own finance ministry because those people were sitting down with Europe to negotiate a trade deal and the European negotiators had expressed some displeasure with this plan, because it would put the interests of European pharmaceutical companies, you know, at stake. And that was it, you know, the health interests were arrested, the plan was stopped pending these negotiations and I saw that pattern sort of repeat many times. So it’s pretty terrible that countries have to make that sort of choice, and we should fight like hell to change it.

Nima: You spoke earlier about planning for the next pandemic, the inevitable next crisis, what are you currently working on? What do you foresee Public Citizen working on in the future that folks should learn about now and help out with now and get involved with now?

Peter Maybarduk: Yeah, so the TRIPS waiver is part of that, right? Because I mean, as you extend the timeframe the possibility to manufacture and reverse engineer more and more technologies, it just becomes greater and greater and in general, what we want for the world is an open knowledge economy where scientists and manufacturers everywhere can build on the state of the art, can expand manufacturing capacity, can improve global pandemic resilience with just more manufacturing, more innovation and so on. So, the waiver, we’re also calling, as I mentioned, on the Biden administration to launch a manufacturing program of global ambition to meet global vaccine needs and to fund it fully, with the goal of ending the pandemic to be clear. There’s going to be a next stage to all of that, there are discussions in various offices of the World Health Organization and with Gates and with Gates-supported organizations like CEPI, the Coalition for Epidemic Preparedness, that are working on plans to establish regional manufacturing hubs that would be plants that could manufacture vaccines, among other things, around the world and when the next pandemic breaks out, for example, there’s a Gate sponsored goal to develop the next vaccine for the pandemic within 100 days, all of which is really laudable, and there’s still the possibility that it won’t happen at all. But what is not at all clear in that is sort of what will the governance of those facilities be? Who will be involved? Who will decide? Will they be accountable to local populations? You know, will, Africa have much of a role in deciding what manufacturing facilities there look like? Will the technologies be affordable to everyone involved? Will the technologies be open for continued innovation and improvements? So the political economy of pandemic preparedness for the future is certainly up for debate. In other words, the world is taking a lesson from COVID, about pandemic preparedness and there will be some sort of investment and development to be more prepared for emerging diseases in the future, including with regard to manufacturing capacity and rapid vaccine development. But who will own it? Who will benefit? And to what extent will there be equitable distribution of the fruits? I think, you know, are open questions.

Demonstrators protest vaccine patents. (Source: Medecins Sans Frontieres)

Adam: I think the key is no matter what it is you have to make sure you kiss the ring of a billionaire from the United States.

Peter Maybarduk: Well, you know, that’s one of the things though, that is unsettled. I agree, that’s the challenge, right? I mean, but there could be a real difference, for example, if there’s, one idea is a pandemic treaty that has been proposed, another is just making sure that the World Health Organization has more say than the Gates funded private organizations, that there is a governance structure that’s accountable to states, to countries and their people.

Adam: And one of the basic problems we’ve talked about is just the power dynamics at play are so tremendous. I mean, I’m sure you don’t need to hear it all over again but the Gates Foundation alone their annual budget is greater than the GDP of I think something like 20 African countries combined. So the amount of power that that wields is so tremendous and of course, it ends up becoming a race to the bottom a number of ways, much like it did for education, but enough of my editorializing. Thank you so much. That was really clarifying. We really appreciate you coming on. Thanks so much for all the work y’all are doing. I really do wish, I know I come off extremely cynical but I promise I’m not that way just to be cool.

Nima: You?

Adam: I try. Well, I try to be realistic. But we’ll see and I hope I’m wrong. I hope Biden comes to Jesus on this one and it does the right thing.

Peter Maybarduk: There’s reason to be cynical. There’s also reason to be hopeful and fight like hell for change. I think that for the future Gates and Gates connected organizations can spend billions and just start and say, here’s what it’s going to look like, but it is hard for their legitimacy to do that without widespread support or without, you know, some like what, you know, we can sort of go along with that or we can say no and we do have an opportunity now, a window, to say that global health infrastructure has to be accountable to the people and that’s what we’ll be working on.

Nima: Well, I think that’s a great place to leave it. On that note of, again, optimism. We’ve been speaking with Peter Maybarduk, human rights lawyer and Director of the Global Access to Medicines Program at Public Citizen. Peter, thank you so much for taking the time and talking to us tonight on Citations Needed.

Peter Maybarduk: It’s great to be with you. Thank you.


Adam: We oftentimes, people message us and say ‘Your show depresses me.’ I don’t think we try to be depressing for the sake of being depressing.

Nima: I wonder why that’s the case. (Laughing.)

Adam: Well, I think we try to be realistic about the world, part of what makes people listen to the show, I think, or listen to us is that if we tell them something we really believe it to be true. We’re not going to bullshit you. We’re not going to be a doomer, you know, we’re not going to say, ‘All parties are the same, like whatever,’ you know, I’m not doing that shit. I think we try to be incredibly sober about reality and I love that he thinks that Biden could potentially move on this, that would be earth shattering, that would be an atomic bomb if he did. It’s definitely, from my perspective, one of those things where I feel like if they were gonna do it, they’d have done it already, but you know, we’ll see. This is definitely a scenario where you and I would be very happy to be wrong, obviously.

Nima: Well, yeah, exactly. I mean, I think if you were to ask me the odds a few weeks ago, a few months ago, as to whether Biden would support this waiver or at least stop the calls to block the, is a lot of like, it’s a lot of do this to stop the this that does this that stops the thing, and that’s like, US Chamber of Commerce and Gates and the IP lobbyists are lined up against like, ‘No, there can’t be a waiver because this is, this is the bread and butter. This is the thing this, is this is how capitalism works. This is how the world should work. This is competition and innovation,’ right? And so I would have said I don’t think Biden’s going to do this, but I don’t work in this day in and day out. I’m seeing what the media is trying to spin in some cases. I’m also seeing, as we discussed earlier, that there are breaks from this kind of tried and true line of, you know, protect IP at all costs, and I think that if anything — and this is me being weirdly optimistic, possibly just because I trust other people who deal with this, people like Peter who know this in and out — that COVID-19 may have been a real turning point and also because Trump was such like a cartoon villain, such a ghoul, that Biden in so doing, trying to be the anti-Trump — and I don’t think he’s doing enough to be the anti-Trump, you can look across domestic and foreign policy and be like, you’re not doing enough to be the anti Trump — but just like Trump came into office explicitly with being the anti-Obama, if we’re seeing something similar on the back end there this could be one thing where all of a sudden, it’s like, well you don’t think he’s going to do this, history tells you he’s not going to do this and then all of a sudden, in the next couple of days, it’s going to be like — you know what? — there was this crazy statement that Biden said, no one would have necessarily bet on it, but that’s amazing that that actually happened in this changed.

Adam: I think that argument is not even really about pharmaceutical companies’ profits, although I do think the precedent with respect to IP, I mean, again, these mRNA vaccines, they’re applicable to other things, cancer drugs, I mean, it’s a huge sector, it’s trillions of dollars of profits for pharmaceutical companies, that if they feel like the toothpaste gets out of the bottle it can ever be put back again.

Nima: Sure.

Adam: I think that right there means it’s not gonna happen but the thing that I really think, the real reason it’s not going to happen, it’s because of the tremendous national security implications that the US and its parallel partners like the Gates Foundation infrastructure, and the broader European kind of American capitalist order, they love that these countries have to come begging. They love it, they love it, it’s always been the way it is. It’s been that way for 250 years.

Nima: Well, and then they get to also do victim blaming shifts, right? Where it’s like “we” quote-unquote “we” shipped X number of vaccines, you know, millions of vaccines to West African nations, and what are we seeing? ‘They don’t have the ability, they don’t have the infrastructure, they don’t have the capacity to distribute them and so they’re all, you know, going to expire. See, we told you that that shouldn’t be the case and we should just be able to use things like COVAX to do the thing that we want it to do anyway, while maintaining our stranglehold over the market.’

Adam: Because profits come and go, colonial power dynamics, they last a long time and they want them to last a long time.

Nima: Yes. I mean, those are the systems that I think we talk about all the time, right? It’s that kind of, what’s the new Jim Crow, right? It’s like the system is the same and you just have to call it something else. So you have to turn it into something else, but it’s actually maintaining the same kind of system.

Adam: Well, I think if there’s one take home lesson from this shit show it’s that the WTO protesters in the ’90s were 100 percent correct.

Nima: Yeah, I think that’s kind of a through-line of a lot of Citations Needed episodes (laughing) we trace it back and we’re like — you know what? You know who was right? — They were right. We were right.

Adam: Boy, were they vindicated and indeed, many of their worst prophecies were actually underselling how bad it would be. But yes.

Nima: Well it’s like global regimes and police brutality, right? Against dissent.

Adam: Yeah.

Nima: Yep. Well, that will do it for this Citations Needed News Brief. Thank you, everyone, for listening. Of course you can follow the show on Twitter @CitationsPod, Facebook Citations Needed, become a supporter of our work through with Nima Shirazi and Adam Johnson, all your support through Patreon is so incredibly appreciated. We are 100 percent listener funded, so if you’re considering it, and haven’t yet done it, please do. It really helps us out. It keeps the show going. We will be back very soon with another full length episode of Citations Needed so stay tuned for that and if you have not already, please do rate and subscribe to us on Apple Podcast or wherever you happen to get your podcasts from. I am Nima Shirazi.

Adam: I’m Adam Johnson.

Nima: Citations Needed is produced by Florence Barrau-Adams. Associate producer is Julianne Tveten. Production assistant is Trendel Lightburn. Newsletter by Marco Cartolano. The transcriptions are by Morgan McAslan. The music is by Grandaddy. Thanks again, everyone. We’ll catch you next time.


This Citations Needed News Brief was released on Saturday, April 10, 2021.

Transcription by Morgan McAslan.