‘Vaccine apartheid’ awaits Ngozi Okonjo-Iweala's first day at WTO

The World Trade Organisation (WTO) is meeting in the coming days to conclude the appointment of its new Director-General, signalling an end to the push-and-pull between the US and other members.

But the imminent appointment of Nigeria’s Ngozi Okonjo-Iweala, after the US finally backed her, could mean her first challenge is something she has worked on before: vaccine politics.

Ngozi, a former Finance Minister of Nigeria, has been sitting on the board of GAVI, the global vaccine alliance that often works with pharmaceutical companies and donors to ensure adequate delivery of inoculation services to the world.

Hogging vaccine

As the Director-General of the world’s biggest trade arbiter Ngozi, who will replace Brazilian Roberto Azevêdo, may now face up the Big Pharma accused of hogging vaccine technology in the combat of the Covid-19 pandemic.

“I look forward to finalising the process of WTO DG. Grateful for the expression of support from the US today for DG WTO,” Ngozi wrote on her Twitter page on February 5.

This week, Washington abandoned its hardline stance against Ngozi, just after South Korean Trade Minister Yoo Myung-he dropped from the race.

Dr Okonjo-Iweala had been endorsed by all other members of the WTO except the US and South Korea. And, according to the tradition at the WTO, decisions must be reached by consensus, which means that any member disagreeing curtails the decision.

With the departure of Donald Trump, however, the US administration under Joe Biden has loosened its stance, endorsing Ngozi as an adequate official for the world’s biggest trade arbiter. 

“Dr Okonjo-Iweala brings a wealth of knowledge in economics and international diplomacy from her 25 years with the World Bank and two terms as Nigerian Finance Minister,” said the US Trade Representative in a statement on Monday.

“She is widely respected for her effective leadership and has proven experience managing a large international organisation with a diverse membership.”

First female leader at WTO

Leading the 164-member organisation Ngozi, who will be the first female and African to head the WTO, may now go back to her notes about vaccine politics. In pitching for the job last year, Ngozi had told audiences across the world of the need to equalise vaccine distribution, including allowing poor countries to manufacture local vaccines using technology from the developed world.

“This has not triggered. It’s not really being talked about,” she told a talk-show hosted by the Brookings Institute in September, referring to the WTO rules that allow certain asymmetries in the utilisation of intellectual property rights.

“But when the issue of vaccines and potential therapeutics that could come on the market and diagnostics are looked at, this could be a very good way to make them more accessible and affordable for developing countries.”

That was before the first Covid-19 vaccine hit the market. When it did, the richer countries and their Big Pharma have been accused of running ''me-first'' policies, stocking up and vaccinating their people first. Last month, South African President Cyril Ramaphosa accused richer countries of ''vaccine apartheid'' after it became clear the developing world may wait for at least a year longer on the queue to get sufficient supplies. Speaking at a virtual event, World Economic Forum, Ramaphosa, who was also Chairman of the African Union, said the rich were hoarding the vaccine by stockpiling amounts they may not need.

“This is being done to the exclusion of other countries in the world that most need this,” he told the panel of the WEF.

Waive restrictions

Under the WTO, the agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) is supposed to address this inequality by allowing poor and developing nations to use technology created in rich countries to manufacture cheaper generic drugs and vaccines as long as they will be sold within their locality. This is one way India has become the biggest supplier of medical drugs to Africa by making generic drugs within technology from the West.

India and South Africa had pushed for a waiver of restrictions on intellectual property rights on Covid-19 vaccines, citing the provision in TRIPS where such could be lifted in case of emergency.

“On one hand, these countries are buying up as much of the limited supply as they can, leaving no vaccines in the pie for developing and least-developed countries.

“On the other hand, and very strangely, these are the same countries who are arguing against the need for the waiver that can help increase the global manufacturing and supply to achieve not just equitable, but also timely and affordable access to such vaccines for all countries,” India argued in a statement to the TRIPS Council last year.

All countries have accepted that Covid-19 is an emergency, but richer countries have cracked under Big Pharma pressure to impose further non-tariff barriers making it difficult for the poor to import. A vaccine importation strategy publicised by Kenya on Thursday revised the dates to 2023, when at least 16 million people may have been vaccinated. An initial target was to meet this by the end of this year.

“We are appalled by the inequitable distribution of Covid-19 vaccines across the world,” says Christine Jamet, director of operations at medical charity group,  Médecins Sans Frontières (MSF), addressing vaccine shortage in southern Africa last week.

“While many wealthy countries started vaccinating their health workers and other groups nearly two months ago, countries such as Eswatini, Malawi and Mozambique, which are struggling to respond to this pandemic, have not received a single dose of vaccine to protect the most at-risk people, including frontline health staff.”

Covid deaths

MSF has been campaigning to manufacturers to help distribute both the test kits and vaccines equitably by prioritising frontline health workers and people with underlying health conditions and thought to be at most risk of Covid-19 deaths.

Dana Gill, US Policy Adviser for MSF Access Campaign, argued on February 1 that richer countries had ignored calls to distribute doses of the vaccines to the poor, even as they ramped up millions of doses for themselves.

But vaccines, like trade in most new technologies, have been a sensitive issue at the WTO. Ngozi’s first task may be to restart negotiations meant to reduce tariffs and make trading between countries easy. Known as the Doha Development Round, the negotiations that began in 2001 were supposed to progressively lower trading barriers, including access to technology.

Ngozi now awaits endorsement, if no other country vetoes her candidature. And it will also mean she inherits other challenges, including the trade tiff between the US and China, pecuniary situation of the organisation, as well as problems of developing countries.