"Whoever Finds the Vaccine Must Share It": Strengthening Human Rights and Transparency Around Covid-19 Vaccines

"Governments should continue to fund Covid-19 vaccines, especially to ensure access for low- and middle-income countries. While doing so, they should take all possible measures, including directing and conditioning funds in ways that are aligned with their human rights obligations to share the benefits of scientific knowledge and its applications widely, and ensure participation, transparency, and accountability in vaccine research, development, and manufacturing."

The race to develop COVID-19 vaccines has made headlines nearly every day since the World Health Organization (WHO) first described COVID-19 as a pandemic in March 2020. The protection of any one country's population from COVID-19 is highly dependent on and interconnected to the protection of populations in other countries. To that end, world leaders and experts have been clamoring for global cooperation and sharing of health technologies since the early days of the pandemic; advocates have increasingly called for a "people's vaccine". Based on research conducted by Human Rights Watch, this report examines key elements of a human-rights-based approach to COVID-19 vaccines funding rooted in principles of transparency and accountability. It assesses how a variety of core rights - including but not limited to the rights to life, health, and an adequate standard of living - are being taken into account in vaccine distribution and advocates for transparent reporting by governments on their funding agreements, terms, and conditions.

Between April 23 and October 13 2020, Human Rights Watch had discussions with more than 15 experts on access to medicines, intellectual property (IP), and human rights; analysed international human rights law and relevant national legal good practices; and reviewed publicly available documents and secondary sources. Human Rights Watch also drew on more than 6 months of reporting on the pandemic's impacts on different populations, including health workers.

The resulting report examines key global developments concerning vaccine access, such as the COVID-19 Technology Access Pool (C-TAP), "ACT Accelerator" and the COVAX Pillar, and the World Health Organization (WHO) Equitable Allocation Framework. It also looks at the role of multi-stakeholder initiatives, such as Gavi's "COVAX Facility", which plans to procure one billion doses for low- and middle-income countries (LMICs) by the end of 2021. Human Rights Watch makes the argument that "Global cooperation and transparency advance governments' human rights obligations to take individual and collective steps, while 'vaccine nationalism' - with governments racing to sign deals with developers reserving as many future doses of vaccines as possible for their exclusive use - does not."

As is explained here, vaccine manufacturing is specialised; know-how is one of the key barriers to expanding production. The United Nations (UN) Committee on Economic, Social and Cultural Rights (CESCR) has termed IP "a social product" and has called on states to "make every effort, in their national regulations and in international agreements on IP, to guarantee the social dimensions of IP, in accordance with the international human rights obligations they have undertaken". According to Human Rights Watch, "So far, however, governments have not shown leadership and commitment to global cooperation."

Furthermore: "To date, governments have made very little information publicly available around their funding agreements. Governments should commit to transparency by publishing contracts and reporting in detail on terms, conditions, and other aspects of funding for Covid-19 vaccines."

The report also looks at considerations around pricing, noting that, in many contexts, vaccines will only be accessible and affordable for communities if they are free at point of care. Human Rights Watch stresses that "Governments have a human rights obligation to take measures, individually and collectively, to ensure companies, universities, and other entities receiving public money use it in ways that maximize vaccine affordability for the benefit of people globally." People also have a right to know how how governments spend public money so they can ensure that it is used for public benefit; this is why transparency is so pivotal.

In light of the analysis, Human Rights Watch offers recommendations including, for example:

To all governments:

• Endorse and implement C-TAP, which is a common shared pool of rights to technologies, data, and know-how that everyone around the world could use to manufacture any medical products needed to tackle COVID-19, including vaccines.
• Collectively map out the global capacity to manufacture the needed supply of COVID-19 vaccines, and cooperate to develop a strategy to fund and support the creation of additional manufacturing capacity.
• Pledge not to sign bilateral deals with vaccine developers to pre-book future vaccine doses in ways that undermine equitable global allocation.
• Support India and South Africa's October 2020 proposal at the World Trade Organization to waive some provisions of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) and use TRIPS flexibily at the country level.

To governments funding COVID-19 vaccines:

• Create a public database of all contracts for funding related to COVID-19 vaccine research, development, manufacturing, or distribution.
• Ensure agreements to fund COVID-19 vaccines, at a minimum, require recipients to provide open, non-exclusive, and royalty-free licensing for preexisting IP owned and any future owned IP modeled on the "Open COVID Pledge".
• Ensure agreements to fund COVID-19 vaccines, at a minimum, require that compliance with vaccine price commitments is verified through an independent third-party financial audit and the audit report be published.

To governments participating in the COVAX Facility: Call on Gavi and the Coalition for Epidemic Preparedness Innovations (CEPI) to: endorse and design the COVAX Facility in a way that is aligned with the C-TAP; publish all agreements with vaccine developers and manufacturers; and attach conditions to their funding related to technology transfers, open and non-exclusive licensing, and transparent and affordable pricing.

To UN organisations: Create opportunities and mechanisms for meaningful, sustained civil society participation in all global vaccine access initiatives -publishing reports from civil society consultations and meetings.

In conclusion: "The time to move beyond rhetoric around global cooperation is now."