Feature story |

MSF’s recommendations to control the ongoing COVID-19 pandemic

5 min

As countries convene to discuss the pandemic response at the United Nations General Assembly this week, Médecins Sans Frontières/Doctors Without Borders (MSF) calls on governments to urgently resolve the glaring inequity in access to lifesaving COVID-19 medical tools for people in low- and middle-income countries (LMICs). 

Throughout this year, MSF has addressed critical needs and experienced struggles in providing care for people facing COVID-19, in countries ranging from India, Lebanon and Yemen, to Brazil, Mexico, and Peru. To date, more than 4.5 million people have died of COVID-19 – the pandemic is still a daily life-or-death emergency for millions of people around the world.

MSF urges all countries act in solidarity and support following measures to ensure that each country has sufficient tools to save as many lives as possible in this pandemic: 

1) Vaccine dose redistribution: Today global vaccine inequity is severe, and people are dying. We have witnessed the massive stockpiling of vaccine doses by some high-income countries as the rest of the world goes without. The world now faces a situation in which healthcare workers and high-risk populations in LMICs may not receive their first doses until after the majority of high-income countries are fully vaccinated. 

The fastest way to save lives right now is for high-income countries – including the US, UK, Canada, and Germany – to immediately redistribute their excess vaccine doses to LMICs, via the COVAX Facility and other regional mechanisms. This must be done well before these doses expire. MSF urges countries that have already vaccinated their vulnerable populations to stop purchasing additional doses and redistribute excess doses to support World Health Organization (WHO) targets of vaccinating at least 40% of all people globally by the end of 2021, and 70% by mid-2022.

2) Reaching vulnerable populations: Based on our experience in resource-limited settings, governments must prioritise funding not just for delivery but also for strong health promotion and dialogue with communities to counter disinformation and fear resulting in vaccine hesitancy. We also urgently need to reach people ‘outside’ the system – refugees, internally displaced persons (IDPs), migrants, and those living in non-government-controlled areas. 

3) Sharing vaccine technology: As the pandemic remains out of control and with the emergence of new and more transmissible variants, the need to dramatically increase the global production and supply of vaccines is obvious. Vaccine manufacturing capacity must be boosted in LMICs by utilising all policy and legal measures, including through full transfer of mRNA vaccine technology and know-how by the pharmaceutical corporations Pfizer (US), BioNTech (Germany), and Moderna (US). To dramatically boost vaccine supply in LMICs, and attain independent sustainability, full transfer of such technology needs to happen transparently and be open to all competent alternative manufacturers. High-income countries, particularly Germany and the US, which host BioNTech, Pfizer and Moderna, should demand these companies share their mRNA vaccine technology and know-how with the WHO COVID-19 mRNA Vaccine Technology Transfer Hub based in South Africa. High-income countries should also provide financial and technical support to the Hub.

4) Access to new treatments and tests: In addition to vaccines, the world urgently needs access to newer therapeutics and diagnostics to reduce the number of hospitalisations and deaths in this pandemic. The slower and lower rate of vaccination in LMICs increases the risk of transmission and variant spread, locally and globally. In the face of ongoing and new waves of the virus around the world, health systems are being pushed to their limits, highlighting the urgent need for diagnosis and treatment of people with COVID-19. Yet, new WHO-recommended COVID-19 therapeutics, such as tocilizumab (produced by Roche, based in Switzerland) and sarilumab (Regeneron, US), remain out of reach for people in LMICs due to high prices, limited supply, intellectual property (IP) barriers, and absence of transparent access plans. 

MSF calls on all governments to take actions to overcome the market monopolies held by the pharmaceutical companies, and support biosimilar production to lower prices and ensure sustainable access to these important new therapeutics.

5) Stop blocking the Waiver on COVID-19 monopolies: Further, countries must support the ‘TRIPS Waiver’ proposal at the World Trade Organization (WTO), which if adopted would provide all countries with an expeditious way to remove key Intellectual Property (IP) barriers and legal risks around production and supply of COVID-19 medical tools, including vaccines, treatments and diagnostics, during the pandemic. Nearly a year after the Waiver was first proposed by India and South Africa; it is now supported by over 100 nations, while a small group of high-income countries continues to oppose it. These countries – particularly the European Union (EU), UK, Switzerland, and Norway – must stop blocking this lifesaving pandemic initiative supported by a majority of the world.

Countries should collectively acknowledge the limitations of relying on the pharmaceutical industry’s ‘good will’ to stem a global pandemic, and instead support the will of LMICs demanding self-reliance through the TRIPS Waiver