Unfortunately, for all the noise in the last few months, this is exactly what we do not have. Countries are not working together; problems of the immediate present, like access to test kits, Personal Protective Equipment and drugs, are being prolonged even as immediate solutions exist; vaccines for the coronavirus are being abandoned to corporations and institutions who do not have our best interests at heart; and the system that produced the colossal catastrophe that is the global response to the pandemic is being left untouched, as if it is somehow the solution, rather than the problem. It’s time to take the fight from genteel seminar rooms and court chambers into the streets to bend the will of the world to give us what we deserve: the drugs and vaccines we need to live.

Access to treatments for Covid-19: While the world waits for vaccines, several existing drugs, from steroids to antivirals, have shown different degrees of utility in containing the harm done by the novel coronavirus. There are three problems with access to these drugs. One: the framework by which drugs are selected for evaluation is opaque and industry-led, which sometimes results in more expensive therapies being tested in favour of older, cheaper therapies. Two: for newer therapies, intellectual property monopolies dramatically constrain access to the drug both in terms of price and availability, as the situation with remdesivir, currently playing out, shows. Three: government funds used in clinical trials, such as in the case with remdesivir, are not accounted for in terms of either government or public access, while the data produced in the trials is kept secret, unnecessarily constraining the ability of the public to understand the evaluation.

Dismantling the Vaccine Intellectual Property System: Who will get coronavirus vaccines as they enter the market over the next few years? This is an immediate concern, both within countries (will the rich will have an advantage over the poor, regardless of need) and between countries (whether rich countries will corner the market, leaving less for poor countries, again, regardless of demonstrated national need). Enabling fair, just and widespread access to vaccines will require a few things to happen immediately, all of which entail dismantling intellectual property monopolies, mandating a close level of sharing of cooperation of technology and biological material, and agreeing to be bound by an epidemiological-driven global vaccine allocation model. One: having rich governments account for the vast sums of money being thrown at vaccine efforts, for example, the fact that the US government has entirely funded Moderna’s vaccine effort, by Moderna’s own admission. Two: having influential global organisations like CEPI (Coalition for Epidemic Preparedness Innovations), Gavi (the Vaccine Alliance), and the WHO actually exercise their influence and power, by not only having patent monopolies suspended but also enforcing cooperation so that new vaccine manufacturers can enter the fray and increase supply. Three: having the WHO act decisively, both in terms of enforcing a global vaccine allocation model, as well as by making C-TAP, the Covid-19 Technology Access Pool, actually function.

A new system for the production of pharmaceuticals: A priority that is harder to see in the eye of the coronavirus storm is that the current system of production of drugs and vaccines is inefficient, unjust and unsustainable. We have viable alternatives, for example, the WHO’s flu network production of the existing coronavirus vaccines that billions of us take annually. These vaccines are produced by an intergovernmental, inter-institutional, global cooperative approach that involves 140 national laboratories across 110 countries – and results in effective, inexpensive, vaccines that can be produced at scale for the entire planet at an affordable cost. To forge a new system, we must recognise that we already, in effect, have this system among us, and to reconsider what medicines and especially vaccines represent – a global public good that is part of the essential duty of states to provide, rather than be consigned to the brutal logic of neoliberal market systems.