By Riccardo Petrella, Roberto Morea and Roberto Musacchio(*)
A mixture of hypocrisy, cynicism and indecency
We did not
expect innovative proposals, but we did expect a little more breath of change.
Well…. there was no breath. Worse still, in its place there were strong ugly
Declaration never, not even once, refers to the ‘universal right to health’. It
does not mention it, confirming what the dominant groups have been doing for
years: erasing it from the world political agenda and with it the principle
that guaranteeing health universally, i.e. for all, is an institutional
obligation for the public authorities, the states, and not a political option
of magnanimity or compassion towards ‘the poor’ on the part of world leaders. Conversely,
the Declaration speaks several times of “equitable and affordable
access” to the tools for combating Covid-19 pandemic (vaccines, medical
treatments, diagnostics and individual protection tools). In other words, a typically
mercantile principle and objective, of monetised exchange (sale and purchase)
according to market rules that have nothing to do with the right to health in
equality and justice. In the market there are no rights, except for private
property, no social justice. Forgetting the universal right to health is an act
of political indecency.
surprisingly – another key aspect – the Declaration insists that the necessary
steps that will be taken in the coming months to promote access to vaccines for
all, must be defined and taken in the framework of the WTO Treaties (World
Trade Organization, an independent body from the UN) and, in particular, of the
WTO-TRIPs (Trade-Related Intellectual Property Rights) treaties. And not within
the general framework of the UN and specifically the World Health Organisation
(WHO, a UN agency). The Declaration of Rome remains entrenched in the primacy
given, also in the field of health, to the “world” regulation fixed
in the logic of inter-national trade (dominated by the merchants and financiers
of the most powerful countries in the world). The Rome Declaration remains on
the position of refusing to attribute this primacy to the UN in general, and to
the WHO in particular, as requested, especially in recent years, by 100 or more
states, hundreds of Nobel Prize winners, scientists, personalities from the
world of culture and thousands of associations and organisations, including
trade unions. The acceptance of the primacy of the UN and the WHO implies that
the rules on this matter will be established in compliance with the Universal
Declaration of Human Rights of 1948 and the international treaties on civil,
social and political rights of the 1970s.
The signatories of the Rome Declaration are well aware that since 1994,
the year of its creation, the WTO has been the scene of continuous hard
struggles by the vast majority of member states against the most powerful
states to defend their rights to life and their economic and social
sovereignty, which have been systematically dismissed in the WTO treaties.
Therefore, claiming that the objective of the global fight against the pandemic
pursued by the most powerful states of the G20 remains that of “leaving no one
aside” is an act of hypocrisy. The reality Shows that the strategy to combat
the pandemic, which was adopted a year and a half ago in the name of fair and affordable access to
vaccines and in compliance with the WTO/TRIPs treaties, has helped to sideline
hundreds of millions of people who, as of 21 May 202, are excluded from
vaccines (only 1% of the African population has been vaccinated) and
, above all, from health care in general. According to the WHO, more than half
of the world’s population is still without basic health coverage in 2020, and
the pandemic has made the situation worse.
Declaration confirms that, today, the key solution chosen by those in power is
to increase the production of vaccines and to distribute and administer them as
widely as possible, as quickly as possible and on an equitable, safe and
efficient basis, for the benefit of the populations of the poorest low-income
countries (92 countries in the world) and middle-income countries (more than
30). This apparently reasonable choice is a mystifying and unacceptable choice because
it postulates the acceptance and the maintenance of the gulf and the inequalities
between the rich and ‘developed’ countries of the North, particularly the
‘West’, and the poor, underdeveloped or less developed countries. Prioritising
on production and distribution of vaccines substantially means to maintain the
structural supremacy and power of the rich countries in the financial,
technoscientific, productive and commercial fields. It means that private
companies from the developed world remain the absolute owners of knowledge
about life, the owners of patents, the producers of vaccines, the leaders of
international trade, the providers of medical and health services, the
controllers of health markets, the masters of the digitalisation of health
systems… So, In the spirit of the Rome
Declaration the best practical solution is that the rich countries (continue
to) “help” the poor countries. In this context, the life of billions of people
and their future is obligatorily depending, and will depend, on aid, “charity”
and benevolence from the rich and the powerful.
indecent and cynical conception! Let’ give one good example. At the last
meeting of the general council of WTO-TRIPs the representative of the USA said
that Biden Administration is open “now that the full access to vaccines has
been ensured for the American citizens” to consider means and ways to lifting
WTO rules on intellectual property right with the aim to foster affordable
access to vaccines to all peoples in need. To sum upon on this point, all that
remains for the poor countries is waiting for receiving vaccines and access to the other
medical tools offered by the rich countries. To this end, however, they must be
recognised by COVAX as eligible for assistance from the rich. COVAX is the mechanism
set up by the countries of the “North” , run by two public-private organisations,
CEPI and GAVI, whose aim is to encourage the sharing of research and
development and the purchase/distribution of vaccines for the benefit of poor
countries. Bought vaccines are
transferred as free aid to the populations of low-income countries, and as
reduced-price aid to those of middle-income countries.
The COVAX mechanism
has proved unsuitable for two main reasons. Firstly, because rich countries and
private philanthropic bodies such as the Gates foundation have not fed COVAX
finances as expected. To do well, COVAX would need more than $40 billion. They
have received only $12 billion. Secondly, COVAX is based on the maintenance of
the patent system that makes vaccines and medical devices absolute private
property for 20 years, thus giving -as we have seen – political decision-making
and operational power over life and health to private multinational companies.
COVAX has no political power, no autonomous power of negotiation and decision.
It depends on the good will of pharmaceutical oligopolies and of the strongest
brings us to the controversial point concerning the provisional suspension of
patents. This was the most anticipated point of the G20 Global Health Summit.
The G20 formally opted not to decide and to postpone the debate to the 7-9 June
meeting of the WTO General Council. In fact, the postponement was necessary not
because of disagreement between some states (such as South Africa, India,
Russia, Indonesia and China…) on the one hand, and the EU, the UK, the US, Japan,
on the other. But to give the EU and the US time to agree on a common position
based, as proposed by the EU, on a third way solution between rejecting and
approving the suspension. The European Union is overwhelmingly opposed to
suspending the patent regime and even more so to abolishing it. It therefore
seeks to overcome the difficulties by shifting the debate to the definition of
a new global treaty on common global monitoring and response system to current
and future pandemics. Present system has admittedly demonstrated its weakeness
and inefficiency. In the mind of the European Union leaders, the new treaty
could adopt a model of common monitoring and responses system closer the intra-European
coordination system set up in the context of the recent creation of the
European Health Union.
also the position Mario Draghi seems to be taking. During his initial Summit
speech he expressed his support for a suspension of patents “on condition
that it is targeted and limited in time”. The same applies to the US
position, as expressed in Rome by the US Vice-President Kamala Harris (who was a little disappointing). Among the
members of the G20, only South Africa has a clear position on ensuring the
health of its citizens and other African countries. India is rather ambiguous.
In Modi’s ultra-nationalist and competitive strategy, the suspension rather
serves the objective of reinforcing India’s growing role as the world’s leading
producer of low-cost vaccines through the private enterprise Serum Institute of
India. This strategy has the support by Oxford University and Astra Zeneca,
which last year signed a deal for more than 1.2 billion doses of its vaccine to
be produced by the Serum Institute of India. India has a strategy of economic
expansion in the sector to compete with China. For its part, Indonesia, another
member of the G20, has made clear its desire, thanks to the reduction of patent
constraints, to become the main hub of South East Asia, in competition with
China and India.
not all that glitters is gold outside the North/Western countries when it comes
to economic strategy in the global pharmaceutical industry.
state of art above described will
perpetuate until the public authorities of the most powerful countries in the
world have dissociated and liberated themselves and their public health policy
from the state of subservience to their big multinational pharmaceutical and
chemical companies and financial groups, following the massive privatisation of
national health systems and the legalisation of private patenting for profit.
The Rome Declaration did not write a single line about the subservience of the
public powers. And pour cause. As everyone knows, the public authorities have
practically financed in toto (the case of the Astra Zeneca vaccine,) and in
large part (the case of Pfizer, Moderna, Johnson & Johnson vaccines) the
design, development, production and marketing of vaccines. If there are
vaccines, this is not thanks to the companies mentioned but to the large sums
of public money injected by the States in the sector (we are talking about tens
and tens of billions of dollars), through many ways, including the decisive one
of the “Advanced Market Commitments”, i.e. the guaranteed commitments
of public purchase of billions of doses produced by companies.
here is that the companies have pocketed everything and, without any major
investment, have already made billions in profits to distribute to their
shareholders, without the states, the citizens whose public money has been
poured into the coffers of the multinational companies, having obtained any
direct financial benefit in return. The states have spent and continue to spend
and the companies continue to make profits.
context, the sovereignty of the people, of the citizens, is reduced to zero.
Hypocrisy, cynicism and indecency prevail.
conclusion, again after the G20 Global Health Summit, it is clear that the
future of the realisation of the universal right to health and the future of
the earth life is not yet on track in the interests of all
the earth’s inhabitants and in harmony with respect for the rights of nature.
(*) Respectively president of Agora of the
Earth’s Inhabitants, president of Transform.Italia, former MEP and member of