Last week, countries once again returned to the World Health Organisation (WHO) to negotiate a Pathogen Access and Benefit Sharing (PABS) agreement that will be annexed to the Pandemic Accord. The accord was adopted at last year’s World Health Assembly but remains incomplete until work on the PABS Annex has been completed – which is supposed to be done by May this year.
Historically, countries have freely shared pathogens among each other for the purposes of developing tests, vaccines and medicines that can fight the health problems pathogens cause. The principle of fair and equitable benefit sharing, long recognised under the Convention on Biological Diversity, has often failed in practice when applied to global health.
South Africa knows this failure all too well. When it alerted the world that a new, more infectious Covid variant – Omicron – had emerged in 2021 it received no benefits, only blowback. This took the form of travel bans and, owing to vaccine apartheid, inadequate access to vaccines offering protection against Omicron.
Back in 2014, a Guinea patient with Ebola was responsible for the pathogen sequence information that enabled the development of the Ebola treatment Inmazeb. The drug generated substantial publicly funded revenues for the company Regeneron. Guinea itself never saw those benefits.
This is precisely what the PABS System is meant to correct. And benefit sharing could take many forms: discounted price, donations of products or a fixed percentage of the products’ revenues or profits. Benefit sharing could also mean not imposing intellectual property rights restrictions on medical products or manufacturing processes needed to fight the pathogen. In this way, countries that need access to these products could benefit from manufacturing them locally or regionally. This form of benefit sharing also encourages structural transformations. By sharing technical expertise and supporting new and emerging manufacturers, countries build production capabilities and employment opportunities.
All of these benefits are aligned with efforts by the Africa Centres for Disease Control to boost the continent’s medical manufacturing capabilities. This not only reduces its dependence (and expenditure) on imported medical products, but it also promotes greater health sovereignty on the continent.
The importance of this cannot be underestimated: recent funding cuts by USAid and Pepfar have exposed how reliant African health systems are on external aid to deliver essential health services – and the deadly and disruptive effects of this money being withdrawn.
We need to create a tightly managed system to share data where benefit sharing is secured through binding contracts, mechanisms to monitor the access and use of shared data, and the many possible forms of monetary and non-monetary benefit sharing. In the face of pressures from Global North countries to break the unity of the Africa Group, African countries must stand firm that these demands be included in the PABS Annex. Recognising the value of its data and insisting on fair returns is the foundation of equity, preparedness and true global solidarity. DM
Lauren Paremoer is an Associate Professor of Political Studies at the University of Cape Town and a member of the People’s Health Movement.