Chane Nel
The COVID-19 pandemic revealed that wealthy states act primarily out of a narrow sense of national interest or humanitarian instincts rather than of any legal or ethical necessity. Indeed, this tendency predates the pandemic and is synonymous with the known patterns of global coloniality. States are ignorant of the power that lies in the principle of international solidarity to eradicate or at least mitigate vaccine inequities. A trend that fosters the issue is the international community's perception of vaccines as a market commodity rather than a public good.
International solidarity, according to a Draft UN Declaration of Human Rights and International Solidarity, is 'a spirit of unity among individuals, people, States and international organisations, encompassing the union of interests, purposes and actions and the recognition of different needs and rights to achieve common goals', and names its constituent parts as preventative solidarity, reactive solidarity and international cooperation. International solidarity has a long history, even though it is not often termed in this manner. Solidarity has been increasingly understood as a requirement of justice, and pandemic cooperation has been assimilated into a jus cogens rule. The African perspective of solidarity and how it is implemented should be specifically highlighted. If it were to be followed, states would be obligated to cooperate since they make it a non-voluntary choice emphasising a strong moral imperative. A common tendency seen in international law is that African states do not receive recognition for their contributions to solving major problems. It has often been found that these states' implement innovations with long-term solutions, such as the African Union's COVID-19 Vaccination Development and Access Strategy (AU Vaccine Strategy), and achievements to speak for it. The African Vaccine Acquisition Trust secured 400 million vaccine doses by October 2021 compared to COVAX, only providing 30 million doses to forty-four countries. Often overlooked is the notion of ubuntu which has proven effective for centuries and should be included when discussing international solidarity. When individuals and groups interact harmoniously rather than discordantly; generously rather than greedily; and symbiotically rather than predatorily, ubuntu's ethical code is enacted.
Obiora Okafor, one of the leading advocates of international solidarity, has urged the international community to contribute to the redistribution of vaccines from the Global North to aid nations by joining forces with them. He argues that vaccination efforts had already demonstrated global elitism and privileged access even in infancy. In 2022, he presented to the UN General Assembly his report on Global vaccine solidarity and human rights in the context of the COVID-19 pandemic, in which it was argued that regarding the element of mutual aid as a prerogative of international law, solidarity would appear to imply a form of cooperation between states that goes far beyond the mutual obligations between the subjects of that order. Therefore, ensuring states act in solidarity during pandemics would be a daunting task. However, given that this may be our best bet for combatting vaccine inequity, more research should be dedicated to this principle. Equally important, vaccine inequities exist for everyday diseases which often go unnoticed and implementing solidarity could aid this problem specifically, as more states would pay attention to it. The equitable distribution of vaccines would be achieved when vaccines are distributed equally among all states based on need and regardless of their economic status. As recent as June 2023, Okafor presented a report to the UN Human Rights Council that makes a case for the approval and support of a UN Declaration on the Right to International Solidarity, one that would ensure that international solidarity is recognised as a human right, making it incontestable for states to comply with.
The peak of the COVID-19 pandemic prompted new counteracting innovations such as the COVID-19 Vaccines Global Access (COVAX) which is the Access to COVID-19 Tools' vaccination pillar. COVAX is a collaborative initiative led by CEPI, Gavi and the World Health Organisation (WHO), besides key delivery partner UNICEF, to accelerate the production of COVID-19 vaccines and ensure equitable access for all states. Criticism of COVAX has not been spared as it served the interests of developed states while portraying to assist developing states, with expired vaccines being donated as one example. Through the AU Vaccine Strategy developed by the African Centres for Disease Control and Prevention, African states were urged to collaborate urgently on developing, accessing, and deploying a vaccine, thereby engendering their participation in the vaccine development and research process. Despite the AU Vaccine Strategy furthering international solidarity, it has been undermined by COVAX as donors questioned its necessity since COVAX was the primary method of vaccine distribution. Thus, the only solidaristic initiative is the AU's Vaccine Strategy since COVAX allowed the global North to profit from vaccine candidates that they could produce. In contrast, the global South was forced to wait, which indirectly increased competition, a relationship that was not symbiotic in nature.
Coupled with these innovations is also the issue of the ongoing vaccine development and research process being patented, which has caused many developing states to battle diseases for longer than necessary due to the inability to afford vaccines. South Africa and India proposed a temporary intellectual property waiver during the pandemic due to the intellectual property issues surrounding the vaccines. However, it was only approved in 2022 as opposing states argued that compulsory licenses, controlled by the World Trade Organisation (WTO), could solve vaccine inequities. As this was a crucial proposal for pandemic times, it is believed that the international community should explore this further to implement a permanent solution to vaccine patenting that would be beneficial to all states. Caution must, however, be taken when dealing with the WTO as it is often criticised for blocking trade rather than developing it. The WTO kept quiet when COVAX diverted attention away from a historic opportunity to establish a vaccine distribution system that limited wealthy purchasers' power and curtailed pharmaceutical profits. An example illustrating vaccine inequity and nations' failure to assist one another can be seen in the epidemic of HIV and AIDS in Africa. It took nearly a decade for the first antiretroviral drugs to reach the African continent, despite being the hardest-hit region, and antiretroviral drugs reducing mortality by ninety per cent.
Another recent development that should also be closely examined is the proposal of the WHO pandemic treaty. International Health Regulations will also be revised as part of this process. The WHO is coordinating a multi-disease, multi-tool, end-to-end platform to coordinate the rapid development and equitable access to medical countermeasures in the event of a future pandemic. From the outset, it can be seen that this treaty will implement solidarity amongst states and organisations, even if not explicitly stated as such. Nevertheless, this treaty would have to be approached with circumspection as it has often been revealed that international organisations such as the WHO, built on Western ideals, still favour their creators. WHO member states received the zero draft of the treaty on 1 February 2023, and the treaty is expected to be launched in September 2023 as part of the UN General Assembly's high-level meeting on pandemic prevention, preparedness, and response. We must, however, reserve our praise of the treaty for now since it would only assist in vaccine inequity during pandemics, leaving a gap in vaccine accessibility for other diseases during normal times. It is recommended that this treaty include measures to combat common diseases and mechanisms for monitoring and enforcing states' commitment to solidarity.
As we await the adoption of Okafor's latest report and the WHO pandemic treaty by the UN Human Rights Council and WHO member states, the simplest solution would be to abrogate patents of vaccines for all diseases. In our modern age, it is remarkable to witness colonising powers still playing such an influential role in international health, which may be easily curbed if states act in solidarity. Whether a stance will be taken against these powers, along with reformulating international laws, is yet to be seen.
Jecker NS and Atuire CA, 'What's Yours Is Ours: Waiving Intellectual Property Protections For COVID-19 Vaccines' (2021) Journal of Medical Ethics.
Jecker NS, Atuire CA and Kenworthy N, 'Realizing Ubuntu in Global Health: An African Approach to Global Health Justice' (2022) Public Health Ethics.
Soule F, 'Addressing Vaccine Inequity: African Agency and Access To COVID-19 Vaccines' (2022) China International Strategy Review.
Twitter 'Obiora C Okafor' <https://twitter.com/obioraokaforc/status/1674134014414802958> accessed 14 July 2023.
World Health Organisation 'COVAX' (2020) <https://www.who.int/initiatives/act-accelerator/covax> accessed 14 July 2023.