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The Global South is Dying and There is Blood on Joe Biden’s Hands

Joe Biden has announced that he is in favor of waiving coronavirus vaccine patents, but this is not enough. Patents must be completely abolished to expand vaccine production and distribution to send critical supplies to the Global South.

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Cemetery workers in Rio de Janeiro, Brazil fill the grave of a Covid-19 victim. Over 3000 people died of Covid-19 in Brazil in April alone. (Image: Bruna Prado, AP)

While the United States is re-opening and coronavirus cases and deaths are plummeting, the Global South is being brutally ravaged by the pandemic. 

In India and Brazil, thousands are dying every day. Dozens of countries in the Global South are experiencing a coronavirus peak while countries in the imperial core flaunt their decreased case numbers and increased vaccination rates. The dynamics of colonialism and imperialism are on display, over and over again. Far from an aberration, this is how capitalism functions: by exploiting the global working class and hyper exploiting workers in semi-colonial countries. 

There is plenty of blame to go around — in India and Brazil in particular, the right-wing leaders are directly to blame for the spread of the pandemic. The pharmaceutical companies, which took billions in government funding to produce vaccines, are now making a killing in profits, and lobbying to make sure that vaccine patents aren’t waived, securing their monopolies.

Donald Trump’s America First policy led the way in vaccine imperialism, and the EU and other imperialist countries have followed the United States’s lead in opposing patent waivers. 

But Trump is no longer president. As head of state of the country that has unilaterally held up patents for the entire world for well over 100 days, hoarded vaccines, and left the Global South to die, Joe Biden has blood on his hands for those who have already died and, even more so, for those who will die as a result of these policies during a catastrophic pandemic.

While the pandemic creates a certain urgency around lifting patents for coronavirus-related medicine, it also highlights the broader problem of all patents, which create mass profits for pharmaceutical corporations instead of producing critical medicine for the public in and for the Global South. It highlights the fact that every day, bourgeois politicians who lead global institutions like the WTO uphold this system of patents, which ultimately guarantees the deaths of millions of people all over the world. It highlights the need for a global movement to lift all patents — not just now, but always — and the need for free quality public healthcare around the world.

The Crisis

According to the UN World Health Organization, 87 percent of the world’s vaccine supply has been administered to wealthy or upper middle-income countries, compared to only 0.2 percent of the supply reaching lower income countries, demonstrating the massive consequences of vaccine apartheid. There has been a calamitous increase in coronavirus cases in the Global South, notably in India and Brazil. But these countries are not alone.

Last week, cases in Nepal rose by 137 percent. Colombia is in the midst of a third coronavirus surge, with nearly 500 deaths a day on average over the past week, a higher per-capita death rate than India’s (according to official statistics), on top of police brutally cracking down on protesters. In the past two weeks, Uruguay had the highest number of per capita Covid-19 deaths outside of Europe. More contagious variants, which have risen due in large part to insufficient vaccination capacity, have been fueling many of these spikes. Without a global vaccination drive and ramping up of vaccine production, we will likely begin to see vaccine-resistant variants of coronavirus emerge, which will only further devastate the already ravaged Global South.

In addition to the catastrophic mass death, the economies of these countries will continue to struggle while imperialist countries reopen and return to “normal.” This may mean forcing these countries into more IMF loans that force privatizations and austerity on the working class of the Global South, plunging them further into economic crisis. These are clear consequences of imperialism at work. 

In the meantime, wealthy countries like the United States are engaged in mass vaccination campaigns and will have much of their populations vaccinated in just a few months, including low-risk populations. In fact, the U.S. may give coronavirus vaccines to teenagers with no underlying health conditions in the next month — that is, before essential workers in the Global South have a chance to get a vaccine. As of April 19, only 37 percent of Indian healthcare and frontline workers had been vaccinated. By September, children as young as 5 may be approved for the vaccine in the United States — again, before front-line workers in the Global South who are more exposed to the virus. This is not to say that children shouldn’t get vaccinated, but to highlight that without centralized vaccine production and distribution and a global focus on directing available vaccines to the most at-risk populations, the most vulnerable populations in the Global South will be left to languish. 

100+ Days Without Lifting Restrictions 

On Wednesday May 5, the Biden administration announced that it supports waiving intellectual property protections for Covid-19 vaccines. U.S. Trade Representative Katherine Tai also announced, “As our vaccine supply for the American people is secured, the Administration will continue to ramp up its efforts – working with the private sector and all possible partners – to expand vaccine manufacturing and distribution. It will also work to increase the raw materials needed to produce those vaccines.” 

This makes it more likely that countries will be able to issue compulsory licenses, allowing third-party manufacturers to make and sell other companies’ patented products, and increasing transparency around some manufacturing processes. However, this is just the start of the conversation — it could be months until the patents are actually waived. Moreover, we don’t know for how long the patents will be waived, or what the specifics of the plan are. Further, Biden did not clearly support a waiver on therapeutics or diagnostics, which are also desperately needed. 

This is far too little, far too late.

The World Trade Organization (WTO) has an Agreement on Trade-Related Aspects of Intellectual Property (TRIPS) which is designed to “protect intellectual property rights,” thereby guaranteeing the pharmaceutical companies monopoly control of production. At a WTO convention in October 2020, representatives from India and South Africa argued that property rights such as patents, industrial designs, copyright, and protection of undisclosed information have been slowing down critical vaccine efforts. They proposed that aspects of the TRIPS waiver inhibiting information and technology sharing should be temporarily waived to expand production and distribution capacity, citing the devastation of the HIV/AIDS epidemic as evidence of the human toll of withholding treatment options from the Global South. WTO decisions require consensus, so all 164 countries must agree to the proposal for patent waivers to enact them. 

So, the United States is doing more than just blocking patent waivers. Under Trump and later Biden, the country was blocking over 100 countries from even discussing a waiver. The United States’ allies, countries such as those in the EU the United Kingdom, Switzerland, Canada, Australia, Norway, Japan, and Brazil that oppose the waiver are also standing in the way of WTO consensus.

The result is that pharmaceutical companies are not producing enough vaccines, and the devastation of the Global South is being construed as collateral damage. Manufacturers are on track to produce 6 billion doses this year, but according to experts, double that number is needed for global herd immunity. Much higher production of the vaccine is actually possible, were it not for the United States and other countries in the Global North blocking the patent waivers. 

Vaccine Hoarding

But the problem isn’t just that there aren’t enough vaccines. The problem is also that vaccines are being hoarded by the wealthiest countries in the world — first and foremost the United States. The contracts that the Trump administration signed with the vaccine manufacturers (and that Biden upheld) quite literally prohibit the U.S. from sharing surplus doses with the rest of the world. These clauses were designed to “retain liability protection,” because the PREP act gives vaccine and therapeutics manufacturers comprehensive protection from liability for products developed to address public health emergencies, a phenomenon quite specific to the UnitedStates, but that ultimately protects the interests of pharmaceutical corporations. And it took catastrophic death tolls, massive global pressure, and fear of declining U.S. influence abroad to finally push Biden to pursue the most basic measures.

The case of AstraZeneca is particularly horrendous. The U.S. government contracted with AstraZeneca for a total of 300 million doses — enough for a little less than half the U.S. population to get vaccinated, despite already having negotiated contracts with Moderna and Johnson & Johnson. As a result, even though the FDA hadn’t even approved the AstraZeneca vaccine for use in the United States, the country had 60 million doses in its possession. It took until the end of April to decide that India, with thousands of deaths a day, should have access to those unused vaccines collecting dust in storage facilities. 

Further, waiving patents is just the first step. Biden has not taken the next necessary steps — committing to exporting all unused vaccine doses and more raw materials for vaccine production, forcing pharmaceutical companies in the U.S. to share their vaccine formulas, and retooling existing manufacturing plants to be more capable of producing mRNA vaccines. Johnson & Johnson and Moderna, in particular, had their research and development processes entirely publicly funded. Biden could easily require them to share the technology behind their vaccines, but hasn’t indicated he would do so yet. 

Big Pharma’s Big Bucks 

Large Western drug-manufacturing corporations including Moderna, Johnson & Johnson, AstraZeneca, and Pfizer/BioNTech oppose patent waivers, claiming that vaccine development is unpredictable and costly and that strong IP protection incentivized rapid vaccine development. However, public funding covered 97.1-99.0 percent of the research and development costs for the AstraZeneca vaccine, primarily from a variety of international governmental institutions. Moderna clearly states that 100 percent of its research costs were covered by a $1 billion investment from the government.

By some estimates, Pfizer, Johnson & Johnson, and AstraZeneca have paid out $26 billion in dividends and stock buybacks to their shareholders in the past 12 months, which is enough money to vaccinate at least 1.3 billion people. These companies have taken public funds to conduct research operations, sold the vaccines to generate huge profits, and are withholding the information required to produce the vaccines in order to protect these profits. 

Big Pharma also alleges that vaccine manufacturing is too difficult to be taken up by entities that are not large corporations, and therefore patent waivers alone will not immediately yield more vaccine doses. However, generic manufacturers have been making high-quality vaccines and medical products for years, and allowing them to produce coronavirus vaccines will likely not decrease quality in and of itself. While it’s true that vaccine production and distribution is a multilayered process that requires trained staff and proper facilities, and that waiving patents will not immediately generate the almost 12 billion needed doses overnight, imperialism and colonialism have left many countries without the technology for this kind of production. Further, capitalist irrationality has kept those with the resources to produce badly needed vaccines from doing so. 

Lifting all patents is a step towards the conditions that will allow more manufacturers to produce this critical resource. But this is not enough: it must also be accompanied by sharing trade secrets, technical know-how, and physical supplies to build new manufacturing plants and appropriately train staff. 

Biden Loves Big Pharma

Of course, Biden’s priority is to protect producers’ profits, especially given the affiliations of his staff. White House adviser Anita Dunn is co-founder of the consulting firm SKDK, a public affairs and political consulting firm that works for Democratic Party politicians and closely with Pfizer. Biden’s domestic policy adviser, Susan Rice, holds up to $5 million in Johnson & Johnson shares. Science adviser to the White House, Eric Lander, holds up to $1 million in BioNTech shares.

Even at the discounted rate that U.S. consumers are receiving the vaccine at, it may generate revenues of approximately $15 billion a year for Pfizer. The vaccine is one of the highest-grossing pharmaceutical products of all time, which is why drug companies are relying on politicians to push back against efforts to create a generic vaccine.

Imperialist Aid 

After weeks of nothing, Biden has finally agreed to send “aid” to the most hard-hit areas of the world. But we should never trust U.S. “aid.”

The United States has been facing a decline in its imperialist hegemony prior to Donald Trump, but Trump was a precipitous decline. Global competition with China is at the center of nearly all of Biden’s policies, especially as China emerged from the pandemic significantly quicker and with less catastrophic human and economic wounds. And the current G7 conference is part of a U.S. imperialist project to lead the world against China. A Reuters article claims “G7 mulls a message to China: the West ain’t over just yet.” The Guardian  likewise writes that the “UK and US urge G7 to ally against threats from Russia and China.” In other words, this conference was about the West, specifically the United States maintaining global imperialist supremacy.  This patent waiver must be seen in this context.

In this respect, U.S. aid is not about being humanitarian; rather, it’s about maintaining the United States’ position as a global hegemon. The Democrats essentially said as much: a letter addressed to Joe Biden asking that he waive patents said, “Your Administration has an incredible opportunity to reverse the damage done by the Trump Administration to our nation’s global reputation and restore America’s public health leadership on the world stage.”

The IMF’s proposal to allocate Special Drawing Rights — reserve assets that countries can use to supplement their foreign exchange assets, such as gold and U.S. dollars — aimed to “free up resources” for coronavirus relief programs such as vaccination campaigns. The poorest and most heavily debt-burdened countries will receive the largest increases in gross international reserves that are non-conditional and non-debt creating, but this doesn’t solve the problem of unsustainable debt burdens. A couple of weeks ago, Pakistan signed a massive austerity budget which included cuts to social and development spending in exchange for a $6 billion loan, and debt will surpass 50 percent of GDP in Uganda by June 2021. Canceling the debt is the only way to put resources towards public health and social safety measures instead of in the hands of bourgeois financial institutions.

U.S. aid, and the aid of institutions that protect its interests like the IMF, has always been a tool of imperialism. This “aid” is in the form of loans to impose privatization later on, to buy off leaders, or to support coups like the “aid” to coup leader Juan Guaido in Venezuela. 

This “aid” isn’t a favor or a humanitarian gesture — it’s about competition with China and maintaining U.S. global hegemony. And further, the rhetoric of “aid” from colonizers and imperialists is a fallacy. Europe and the United States have under-developed, hyper-exploited, and extracted labor and resources from the Global South. Anything the U.S. or Europe sends their way isn’t “aid” — it’s crumbs from the table of wealth created by colonialism and later imperialism. 

A Necessary Program 

Joe Biden’s statement in favor of lifting patents is too little, too late. The crisis is well underway, due in part to months of U.S. government inaction under Biden. Countries in the Global South should not have to wait until the latter half of this decade to fully vaccinate their populations. Patent abolition, sharing of formulas and technical know-how, and public control of all pharmaceutical companies and laboratories are imperative to expanding vaccine access to all as quickly as possible. The sooner that vaccine access and uptake is universal, the fewer vaccine-resistant variants will emerge, which will truly end the pandemic.

The coronavirus crisis has just highlighted the cruel capitalist system of patents which systematically makes life saving drugs inaccessible to the Global South and creates mass profits for Big Pharma. All patents are cruel and inhumane. That’s why all patents have to go, starting with coronavirus vaccine patents, until resources are produced as public goods instead of for private profits. 

But even that is not enough. The pharmaceutical system only cares about profits, not about lives. That’s why we must demand immediate state and health care worker control of all pharmaceutical companies and laboratories to equitably distribute vaccines the world over. 

Online petitions, formal statements to the WHO, and pleading with the (neo)reformist parties who join national governments will ultimately go nowhere. The only way to implement the measures we need is to develop the common struggle of the working class internationally. We must fight against the union bureaucracies that have supported reactionary “national unity” throughout the pandemic, refusing to fight for the necessary measures to protect workers or compensate them appropriately.

We call on all working-class organizations to campaign for urgent means of struggle, starting with the demand for the abolition of patents, vaccines for all, and the medicine, equipment, and funds necessary to combat the pandemic. There is no time to lose — our lives are worth more than their profits.

The pandemic highlights all the other cruel and irrational aspects of the brutal capitalist system, such as borders in a globalized world where diseases spread freely and the IMF recommending getting rid of subsidies and cutting wages during a period of mass unemployment and financial insecurity. Capitalism is irrational, inhumane, and genocidal, and will not act to stop any resurgences of the pandemic by allowing all production to be put towards stamping out new coronavirus variants. 

Joe Biden isn’t going to stop the genocidal march of the pandemic. Instead, he’s shown that he will protect capitalist profits and drag his feet towards even the smallest changes that will take months to implement. The coronavirus highlights that we need vast, deep change — the kind that only an international movement of the working class and the fight for socialism can bring. 

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Tatiana Cozzarelli

Tatiana is a former middle school teacher and current Urban Education PhD student at CUNY.

K.S. Mehta

K.S. Mehta is a research assistant in New York City.

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