Summit for Vaccine Internationalism hails a “new international health order.”

The four-day Summit was an emergency response to vaccine apartheid. 85% of vaccines that have been administered worldwide have been in high- and upper-middle-income countries. Only 0.3 percent of doses have been administered in low-income countries. At this pace the pandemic will continue to rip through the Global South, leaving the whole world highly vulnerable, for another 57 years.

Commitments were made in five key areas vital for speeding up the production and distribution of medicine to end the pandemic:

1. Open collaboration over Covid-19 vaccine technologies
2. Solidarity prices for Covid-19 vaccines
3. Sharing of regulatory capacity to approve Covid-19 vaccines for domestic use
4. Pooling manufacturing capacity to ramp up vaccine and medical equipment production
5. Collective disobedience to challenge the Big Pharma monopoly enforced through the World Trade Organisation

Hailing the commitments, Summit coordinator and cabinet member for the Progressive International, Varsha Gandikota-Nellutla, said:

“A new international health order is in formation. It is desperately needed to overcome the vaccine apartheid which threatens our very survival, calls the South’s sovereignty into question and risks further murderous mutations of this virus.

“A concerted effort from states, institutions, companies and peoples is needed to move from nationalism to internationalism, from competition to cooperation, from charity to solidarity. Over the course of this Summit, we saw participants take these first bold steps, putting national resources to collective benefit, based on the principles of sovereignty, solidarity, and the universal right to life.”

The new international health order echoes proposals put forward in the 1970s through the UN by Global South states to end economic imperialism and dependency through a New International Economic Order.

The Progressive International will organise further meetings to assist in turning these commitments into a reality. The organisation will seek to provide a framework for the proposed integration of capacities and ongoing collaboration between participants and to expand this emerging alliance for vaccine internationalism to include other states, manufacturers and political actors.

Key commitments to advance vaccine internationalism made at the Summit:

1.Open collaboration over Covid-19 vaccine technologies

• Cuba and Mexico offered their nationally developed vaccines in clinical trials - Cuba’s Soberana 2, Abdala, and Mambisa and Mexico’s Patria - to new partners to openly collaborate on vaccine trials and licensing. The offer of open, rather than exclusive, licensing is hugely significant. The majority of Covid-19 vaccines operate as full monopolies, and have not been offered to any other manufacturers to make. The minority of vaccines that have been offered to others, have been licensed on a limited or exclusive basis, such as AstraZeneca’s agreement with India’s Serum Institute, which shuts out other Indian manufacturers from making it. It has been extensively reported and confirmed that the Jenner Institute at Oxford University, which developed the vaccine, had originally intended to offer it to the world on an open license basis, but instead entered into an exclusive arrangement with AstraZeneca on the urging of the Bill and Melinda Gates Foundation.
• Hugo López-Gatell Ramírez, Mexico’s Deputy Secretary of Prevention and Health Promotion, told the Summit, "We are interested in collaborating with other countries on the production and distribution of the Patria vaccine. We are exploring the possibility of open licensing, as was originally intended for the Oxford-AstraZeneca vaccine."
• Anyang’ Nyong’o, Governor of Kenya’s Kisumu County, invited Argentina, Cuba and Mexico “to come to Kenya to share technology and expand production of the vaccine candidates you are developing.”
• Factory owners around the globe, from India to Canada told the Summit they stand ready to retrofit facilities and move forward with vaccine production if given the chance — but they have been rejected. Hemanth Nandigala, Director at Virchow Laboratories in India explained, "We did reach out to a few [companies], both local as well as international. There was no revert at that point in time."
• Phase 3 interim results presented over the weekend for the Soberana 2 vaccine surpassed efficacy thresholds required for approval by regulators and health agencies worldwide, including the World Health Organization.
• Jorge Arreaza, Venezuela’s Foreign Minister, used the Summit to state that his country would take up Cuba’s offer of collaboration, saying “thanks to the solidarity of Cuba...with her vaccine candidates, we will produce two of the vaccines here in Venezuela."

2.Solidarity prices for Covid-19 vaccines

• Cuba committed to not only open collaboration but affordable prices with Dr. Regla Pardo, Cuba's Vice Minister for Health, telling the Summit: "Cuban vaccines will be affordable and will benefit those most in need."
• Hugo López-Gatell Ramírez, Mexico’s Deputy Secretary of Prevention and Health Promotion, told the Summit, "From the beginning of the Patria project, President Andrés Manuel Lopéz Obrador has had in mind that it would include a scheme for solidarity pricing for other countries."
• The emphasis on affordability is critically important in a market where Pharmaceutical companies have made huge profits and engaged in price gouging, with countries paying wildly different prices — South Africa was reported to be paying more than double EU price for the Oxford-AstraZeneca vaccine at the start of the vaccine rollout this year.

3. Sharing of regulatory capacity to approve Covid-19 vaccines

• Argentina has lent the advanced regulatory capacities of ANMAT, Argentina's state regulatory entity, to collect data on new vaccines and share this with countries throughout the region, including Mexico, Bolivia, Ecuador, Paraguay, to speed up the process of approval of Sputnik and other vaccines. At the Summit, Dr. Carla Vizzotti, Argentina’s Health Minister, committed to extending this facility to any country in need. She said, "We have worked with Summit participants like Cuba and Mexico to synchronise our regulatory systems in order to facilitate stronger cooperation and enhance access of the entire population to vaccines, medicines and new technologies from a regulatory standpoint. Without a doubt, we extend this cooperation to all countries of the world – above all, those in the region of Africa. It’s a pleasure to be able to offer our regulatory capacity to the world.”
• Citing the case of Paraguay, Hugo López-Gatell Ramírez, Mexico’s Deputy Secretary of Prevention and Health Promotion, said, "At the instruction of President Andrés Manuel Lopéz Obrador, COFEPRIS [Mexico’s health regulator] reviewed India's Covaxin, despite Mexico having no plans to use the COVAXIN vaccine. We did this to support the Paraguayan health agency to have the data it needed to evaluate whether to authorise the vaccine for emergency use." At the Summit, Mexico committed to performing such checks for any country in the world and proposed that the participating governments consider a collective strategy to organize and share such results. Hugo López-Gatell Ramírez proposed “creating joint sessions for the scientific committees within our regulatory agencies so that they can share perspectives and generate a joint regulatory healthcare model that could be harmonised across multiple countries."

4. Pooling manufacturing capacity to ramp up vaccine and medical equipment production

• Countries with considerable production capabilities — Argentina, Mexico, Venezuela — pledged to ramp up manufacturing in order to produce enough doses to export to other countries.
• Venezuela, in an official government paper tabled at the Summit, offered to lend its manufacturing industry to "ensure the distribution of supplies to the areas of greatest need at any given moment." It cited the case of the city of Manaus, in the north of Brazil, which suffered from a “lack of oxygen, which Venezuela was able to remedy thanks to our production capacities in the south of the country on the border with Brazil.” Venezuela, represented at the Summit by Foreign Minister Jorge Arreaza, proposed participating countries “draw up a map of the productive and health care potential ... — and with this, to know where the necessary supplies are produced (vaccines, personal protective equipment, oxygen, etc.) and draw routes to ensure there are no supply failures."
• Jorge Arreaza, Venezuela’s Foreign Minister, also proposed a new technology sharing platform for the participating states “that will permit us to get practical information about cases, infections, and the concrete reality of the pandemic in all regions.”
• Dr. Carla Vizzotti, Argentina’s Health Minister, pledged, “Once Argentine needs are met, we plan to begin exporting vaccines immediately."
• Hugo López-Gatell Ramírez, Mexico’s Deputy Secretary of Prevention and Health Promotion, told the Summit that Mexico plans to “revive” its state-run pharmaceutical production companies such as BIRMEX. He said, “this year, we hope to empower BIRMEX to produce the Sputnik V vaccine and also play a leading role in the production of our own vaccine candidate."
• Pinarayi Vijayan, Chief Minister of India’s Kerala state, committed his state to the expansion of vaccine production by setting up a research unit at the Institute of Advanced Virology and mandating public sector enterprises like the Kerala State Drugs and Manufacturers to “produce and export medicines."

5. Collective disobedience to challenge the Big Pharma monopoly enforced through the World Trade Organisation

• The Summit heard from Xolelwa Mlumbi-Peter, South Africa’s Ambassador to the World Trade Organisation, who is leading efforts there to secure a timely and comprehensive TRIPS waiver to release Covid-19 vaccines from their intellectual property restrictions. She said, “Access to lifesaving drugs should not be dictated by where one lives.”
• Bolivia’s Foreign Minister, Rogelio Mayta Mayta, called for “collective disobedience” to introduce “a credible threat to the monopoly pharmaceutical model currently at play.”
• Giorgio Jackson, a Chilean congressman, told the Summit how he drafted a blanket intellectual property waiver law in the Chilean Congress as a way around Global North intransigence at the WTO and saw it passed by deputies 127-0 only to be blocked by President Pinera.
• Bolivia has entered an agreement with Biolyse, a Canadian vaccine manufacturer and Summit participant, to produce 15 million doses, at $3-4 dollar per dose, enough to vaccinate the entire adult population of Bolivia. But Biolyse can only legally produce the vaccines if the Canadian government grants them a compulsory license. Canadian prime minister Justin Trudeau’s refusal to do so was denounced at the Summit by Canadian opposition MP Niki Ashton, who called it “shameful” and pledged to work with the Bolivians to pressure her government.
• Benjamin Blanco, Bolivia’s Vice Minister for External Trade, invited participating governments to join them in invoking compulsory licenses and expose Global North governments' compliance with Big Pharma demands. He said, “we invite any country that is interested to collaborate with local manufacturers and join us — to announce their intent to invoke a compulsory license order. If we act together, governments could be compelled to approve these initiatives."
• Pinarayi Vijayan, Chief Minister of India’s Kerala state, told the Summit that “Options like compulsory licensing should be explored and public sector pharmaceutical companies which are capable of producing vaccines should be immediately mobilized into action.”