Germany’s Health Minister Jens Spahn pushed back hard Thursday against voices calling for a waiver on the intellectual property of COVID-19 treatments and vaccines in a high-profile visit to Geneva. His trip coincided with German Chancellor Angela Merkel’s farewell visit to the United States, including a summit with US President Joe Biden, where protestors chanted “free the vaccines” along Merkel’s route.

In Geneva, Spahn’s day of meetings included public appearances at a WHO press briefing, followed by a panel discussion at the Geneva Graduate Institute’s Global Health Centre, Spahn said that the three companies that had developed the first COVID mRNA vaccine technologies “are startups” and should not be compelled to give up their IP.  Encouraging them to voluntarily share their know-how with developing countries would also yield more vaccines, faster, he stressed – with that being the ultimate goal.  

“This is always better to be done on a voluntary basis, as long as the companies are willing to cooperate and we are building up the capacity…” said Spahn, speaking at the Graduate Institute event, co-moderated by GHC founder Ilona Kickbusch and co-director Suerie Moon. 

Two German firms, CureVac and BioNTech, have been the frontrunners, along with Moderna, in the development of COVID mRNA vaccines. But only BioNTech has brought its COVID vaccine to market – in a collaboration with Pfizer. CureVac’s vaccine, meanwhile, showed disappointing results in its latest clinical trial – which yielded only a 47% efficacy.  

COVID mRNA Vaccine Was First Product Marketed by Startups

“For Moderna, CureVac and BioNTech it is the first product in their inventory, and the first time that they actually make a profit,” Spahn observed, speaking at the WHO briefing.

He added that removing their IP rights at this stage would not be effective – since the main barrier is to expanding capacity is the know-how required for complex and sensitive vaccine manufacturing – rather than patents per se. 

“I am sure that next year, we will have a surplus of production,” he added. “So if we can reach this goal without interfering with intellectual property rights, let’s do it this way, it’s even quicker.”

He stressed, however, that German government support for BioNTech and CureVac vaccine R&D process came with the understanding that the firms would voluntarily collaborate in rapidy scale up –  “with the expectation that these companies would cooperate with companies in Asia and Africa, and there are talks going on….”

However, he stopped short of saying whether either company might actually join initiatives such as he recently-announced WHO mRNA vaccine technology transfer hub – which WHO said it was creating in partnership with the South African government. 

German Position Challenged By WHO and UNAIDs, Demonstrators in DC  

Over the course of Thursday, however, Germany’s approach was being sharply challenged on various fronts.

In Baltimore protestors chanted “free the vaccine” as Merkel arrived to receive an honorary degree at Johns Hopkins University, which boasts one of the most prestigious schools of public health in the world. Later, in Washington, D.C., demonstrators were set to protest outside of the White House as Merkel and Biden met. They were calling upon the German Chancellor to stop blocking the COVID IP waiver initiative, which is currently deadlocked in talks at the World Trade Organization.  

Body bags lined up outside the White House prior to today's Merkel-Biden summit. The world is calling on #Germany to end its deadly opposition the the #TRIPSwaiver for COVID vaccines & treatments. pic.twitter.com/n2Ll2GNPF7

— CTC (@citizenstrade) July 15, 2021

In Geneva, meanwhile, Spahn was also being challenged for his country’s continued opposition to the IP waiver – first by WHO Director-General Dr Tedros Adhanom Ghebreyesus and later by UNAIDS Director Winnie Byanyima. 

Tedros, appearing with Spahn at the WHO briefing where a new German vaccine donation of 30 million doses also was announced, said that donations were no longer enough to stem the pandemic tide in poor countries.  He declared that the continuing unequal distribution of vaccines between rich and poor countries, pointed to a “market failure” which meant that a “limited” waiver on vaccine IP was needed.  

Referring to the talks at Geneva’s WTO, currently deadlocked between countries seeking a blanket patent waiver and high-income countries, including Germany, Japan and the United Kingdom, that are opposed, Tedros said, “When we say waiver, it is not to snatch the property of the private sector….  I think there could be a balance…. if there is an agreement in IP waiver. It could be for a limited period or instance…. It could be for a year or two, and it could be for a specific product like, like the vaccine.”

The Indian and South African sponsors of the waiver initiative had hoped to have final draft proposal ready for review by WTO’s General Council meeting at the end of the month. However, prospects for that appear uncertain. 

UNAIDS’ Byanyima Lays Down Gauntlet

In the late afternoon session at the Global Health Centre, Byanyima harkened to the history of the AIDS pandemic, when millions of Africans died before life-saving anti-retroviral treatments became accessible. 

She warned that history is now being repeated with COVID – with Africa now seeing it’s biggest COVID wave so far  – accompanied by far higher mortality rates than that seen in developed nations.   

“There was an increase of 15% in the number of new cases in Africa last week, globally it is 3 %,” said Byanyima.  “Deaths have increased by 23% in the African region, while globally it’s coming down by 7%.

“So here is my challenge, my dilemma,” she told Spahn, “People are 40 years struggling with HIV/AIDs. When antiretrovirals were first found in the west, in Europe and America, people in the south continued to die.  It was only when a global movement came to demand, it took six more years before the prices came down.

“Nine million people died, who could be alive today…. Now their survivors are now at risk of severe disease and deaths from COVID. How many years will they have to fight to have a vaccine that would protect them?

“It seems to me that the approach you’re proposing, which is that the companies who own this technology choose when and whom to share with, at the time they want to, could mean that more millions of people could die,” Byanyima continued.

And while donations, such as the one million doses committed recently at a meeting of G7 nations, “are welcome” they are not enough.

“The world needs 13 billion..every corner of the world needs this… and this means  maximizing the supply,” she asserted asking, “how can this happen without sharing the technology, and how can governments wait for profit-seekers?”

Spahn Sticks to Support for Tech Transfer, not IP Waiver

Responded Spahn: “I agree, it’s about sharing technology.  But the question here is how it’s shared.  And it always brings me back to this one argument, which still is valid:  just having the patent, does not make you a vaccine producer the next week. It’s far too complex.

“And when we see how long it takes to build up to set up the production side, even for experienced companies, then I would say if you really want to share it needs, cooperation, sharing tech transfer, transferring expertise.

“I do absolutely agree with you, we really need to scale-up, But we are, and they are, on the way to scale-up.  It has taken some time to produce the first 50 million doses, but we will see, I don’t know how many billion doses produced already this year, and especially next year.

“And as I said, I might be wrong, but from today’s point of view, and what I see going on worldwide, I actually see that there is an overcapacity developing for mRNA technology… which as I said is OK.  But it actually shows how different it is this time, to the experience you so rightly described of the HIV experience.”

Image Credits: Health Policy Watch.