How Joe Biden could vaccinate the world

President Biden surprised the world when his administration came out in favor of an intellectual property waiver for coronavirus vaccines. The U.S. is now backing an effort from India and South Africa to get a Trade-Related Aspects of Intellectual Property (TRIPS) waiver at the World Trade Organization (WTO), with the intent of expanding global vaccine production.

But it isn't going to be that easy. Germany's Angela Merkel has already come out against a waiver (one of the key vaccine firms, BioNTech, is based there), which could doom the effort because the WTO requires consensus. Luckily, there are other steps that Biden could take to accelerate vaccine production and distribution, which as we see in the ongoing viral conflagration happening in India, is absolutely vital. If the international community can't get behind vaccinating the world, Biden should go it alone.

Despite the protestations of various Big Pharma lackeys, a TRIPS waiver will certainly help at least a little. There are reportedly factories in Bangladesh and Canada that are ready to go, if they can simply get permission. Pharma companies are scenting gigantic profits from future use of mRNA treatments, and they will for sure try to keep total control of the technology, no matter how many people get killed as a result.

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Now, that doesn't mean Pfizer, BioNTech, Moderna, Johnson & Johnson, and so on shouldn't make any money. They did after all put a lot of work and money into this vaccine research, and should be amply rewarded for it. But rather than letting them lock up a potentially revolutionary treatment paradigm for decades, it would be wiser to just buy out their patents for a handsome price, and put them into the public domain. As Joel Dodge writes at People's Policy Project, federal law stipulates that the "government has the power to use or manufacture any patented product, and must provide only 'reasonable' compensation to the patent holder." Innovation also happens faster when scientists around the world can collaborate with each other without fussing over who owns what.

However, there are other obstacles to massively ramping up vaccine production that are probably more important than patents. As James Krellenstein and Christian Urrutia write in a report for PrEP4All (a nonprofit that advocates for HIV treatment access), reaching full vaccine production potential will require technology transfers so that other companies and countries can get the knowledge and machinery they need to boost production, and more importantly, a large direct government investment.

As they argue, there is a general incentive problem with relying entirely on private sector vaccine capacity. Before the pandemic, vaccines were a relatively modest part of the pharmaceutical sector, largely because most of them are only taken once or twice — just 3.5 billion doses were produced per year of all vaccines combined. That problem was made worse by the just-in-time production model that has become standard across all business over the years, which meant companies have kept spare capacity as low as possible. Now that we need on the order of 15 billion doses as soon as possible, private companies are scrambling to meet the need. (Indeed, one reason Canada has been struggling with vaccination is that its government privatized its state-owned vaccine factory in the 1970s.)

There is every reason for the U.S. government to simply build and own a permanent, large vaccine factory — both for jacking up production immediately, and to keep on hand for the future. In the context of the staggering damage the pandemic has inflicted on the global economy, the cost would be microscopic, only about $4 billion. As Krellenstein and Urrutia explain, the Moderna vaccine is the best candidate for mass production, because it is easier to scale up, more temperature-stable, easier to adapt to variants, and the American government already owns some of the intellectual property rights. (Moderna could also be hired to operate the facility.) As they write, "For less than the U.S. government spends on the COVID-19 response daily, it can build a facility to produce enough mRNA vaccine manufacturing capacity to vaccinate the entire world in one year, with each dose costing only $2."

Building a huge vaccine factory would also be handy in that it could be started immediately. The WTO is a sluggish organization, and while the Biden administration may be able to pressure the Germans into agreeing to a TRIPS waiver, it could take months, and then months more for other countries to start ramping up afterwards. That is time the world does not have. The Indian health care system is buckling under the explosion of coronavirus variant cases, and other countries could be next.

As I have previously argued, this is a dire threat not only to humanity around the world, but to Americans as well. A new variant could emerge that gets around all the vaccines, and the U.S. would be back at square one with a new pandemic.

Now, it would take a while to build a new vaccine facility, but a crash wartime mobilization-scale effort could probably get one going in six months or so. After all, private production of mRNA vaccines went from nothing to about 3 billion doses in less than a year. Currently even optimistic forecasts have poorer countries being vaccinated by 2023 at the earliest. That is unacceptable. What's more, because existing vaccines do not work as well against the variants, booster shots have already been developed — Moderna has one that should work against the variants from Brazil and South Africa. That's great, but it will require yet more doses on top of the 15 billion figure mentioned above.

The coronavirus pandemic has been one of the greatest disasters in modern history. For the foreseeable future, it will be a vital priority to build and maintain a vast capacity for vaccine production — not just for humanitarian reasons, but to protect the health and safety of the American people.