MALAYSIAN Health Coalition notes Gilead Inc’s announcement on May 13 that they have signed non-exclusive voluntary licensing agreements (VLs) with five generic pharmaceutical manufacturers to expand the supply of Remdesivir to 127 countries. We also note Malaysia and other middle-income countries’ absence from that list, and that Remdesivir is not currently approved in any country for any indication.
We urge all global diagnostics, pharmaceutical and vaccine companies, including Gilead, to meet the following recommendations to ensure that all of humanity will have people’s vaccines, people’s medicines and people’s diagnostics.
Ensure Malaysia and all middle-income countries can import from VL generic manufacturers if necessary.
Malaysia has made significant progress towards universal health coverage, but gaps remain.
One, the financial and economic impact of the pandemic will further strain national resources and widen access gaps, especially when Malaysia is under-spending on health. Similar to many other countries, Malaysia has limited fiscal space for additional spending.
Two, reinforcing this argument is a World Bank projection that the poverty rate in Malaysia may increase by up to 16% as a direct result of the pandemic.
Three, based on Department of Statistics data, 3.1 million residents in Malaysia (9.5% of the total population) are non-citizens such as migrants, refugees and stateless persons with relatively lower healthcare access compared to citizens. The number of non-citizens is likely to be underestimated, and all residents need equal care. Therefore, any VL by any company for any diagnostics, pharmaceuticals and vaccines during the pandemic should include Malaysia.
Be transparent with decision-making criteria for all VLs and apply these criteria consistently.
We fear a fragmented future landscape of inconsistent decision-making criteria adopted by multiple companies deciding the levels of healthcare access for sovereign states in non-transparent, non-accountable and unfair ways.
Therefore, we urge industry associations like the International Federation of Pharmaceutical Manufacturers Associations, Pharmaceutical Research & Manufacturers of America or European Federation of Pharmaceutical Industry Associations to publish criteria for inclusion in these licences and ensure that decision-making takes into account real and meaningful country differences rather than operating purely on the basis of World Bank categorisations of country income status based on GNI per capita.
We also urge these industry associations to formally acknowledge, embrace, and incorporate thinking around Covid-19 technologies as global public goods, in line with the assertions contained in WHO’s Call to Action for Covid-19 and the European Commission’s Coronavirus Global Response.
There are crucial ethical, humanitarian, medical and public health reasons to make diagnostic technologies, pharmaceuticals and vaccines widely available during this worldwide pandemic.
International law under the World Trade Organisation’s Doha Declaration on intellectual property and public health allows for compulsory licensing for national emergencies or circumstances of extreme urgency.
While we recognise the relevance of the global intellectual property frameworks, we urge patent-holders to adopt global voluntary licensing arrangements to allow all of humanity to defeat this unprecedented pandemic.
Overcoming this pandemic requires a whole-of-humanity effort. The UN secretary-general has stated that human health, vaccines, therapeutics and diagnostics are global public goods.
There is an opportunity for global companies to take their place in history by ensuring widespread access to all potential Covid-19 vaccines, therapeutics and diagnostics. It is time to prioritise public interest and make decisions for global common good. History provides one timeless example: Sabin’s polio vaccine was never patented.
Malaysian Health Coalition
(MHC is an apolitical coalition of 46 Malaysian health professional societies, health professionals and citizens)
