Policy and Advocacy

A shot at recovery

Measuring corporate commitments towards a free, fair, and accessible COVID-19 vaccine

Publication date: 22nd April

Covid-19 anywhere is Covid-19 everywhere. That’s why we need a People’s Vaccine: patent-free, mass produced, distributed fairly, and made available free of charge, to every individual, rich and poor alike, around the world. To protect everyone, everywhere, corporations must commit to openly sharing their vaccine technology to enable billions of doses to be made as soon as possible at the lowest possible price.

Amidst troubling opacity, especially on purchasing agreements and vaccine prices, we found that the commitments made by the five leading US-funded vaccine developers highlighted in this brief, from our colleagues in Oxfam America, are far from what is needed. To address this unprecedented global crisis, we need corporations and governments to do everything in their power to deliver a free, fair and accessible Covid-19 vaccine – a People’s Vaccine.

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5 ways the World Bank can promote a fairer and faster global vaccine roll-out

29 March 2021
By Katie Malouf Bous, Oxfam International’s Senior Policy Advisor for Public Services and International Financial Institutions & Anna Marriott, Oxfam International’s Health Policy Manager.

While wealthy nations have been vaccinating their citizens at a rate of one person per second over the last month, the majority of developing countries have been unable to administer even a single dose of a COVID-19 vaccine. Only three percent of people in these countries can hope to be vaccinated by mid-year, and only one fifth at best by the end of 2021.

Global efforts to improve access to vaccines through the World Health Organisation’s (WHO) COVAX facility have been welcome but far from enough. Developing countries remain at the back of the vaccine queue and pharmaceutical monopolies mean they are being shut out of the technology that would allow them to expand local manufacturing and produce more doses to scale up vaccination campaigns. This is the reality despite over $100 billion of taxpayers’ money being spent on vaccine research and development (R&D). 

This vaccine inequality is a moral stain. It is also a global public health risk — the longer it takes to vaccinate everyone, the more likely it is that vaccine-resistant variants will emerge and delay the world’s efforts to end this pandemic. And the economic impact of vaccine inequality is huge: the International Chamber of Commerce has put the global cost at $9 trillion, with half of this being absorbed by developing countries. The IMF has warned that income losses will be highest in developing nations because of unequal vaccine access.

In this context, the World Bank announced in October an envelope of $12 billion for developing countries to finance the purchase and distribution of COVID-19 vaccines, aiming to support the vaccination of up to a billion people. This support is crucial. However, without addressing global vaccine supply constraints and high prices, weak healthcare systems, and pre-existing health inequalities, this will be an uphill battle. As the Bank’s vaccine projects move forward, we offer five recommendations for how it can support a fairer and quicker global vaccine roll-out including through its own program:

1. Countries should not be pushed further into debt to buy vaccines.
The Bank’s $12 billion program is urgently needed but follows its normal financing terms based on country income. Only the poorest countries at high risk of debt distress qualify for purely grants — otherwise low-income countries will get concessional loans or a mix of grants and loans, and middle-income countries will get market-rate loans. In order to pay for life-saving vaccines, countries are going further into debt at a time when they can least afford it. Stopping COVID-19 is a global public good that poor countries should not have to borrow for. Even before the pandemic 64 countries were spending more on debt repayments than on healthcare. Taking on more debt for vaccines could constrain countries’ ability to invest in their longer-term public healthcare systems to prevent and control future pandemics, and ensure health for all.

The Bank and its donors must urgently find ways to offer more debt-free financing to countries for the vaccine and for health care services. The accelerated IDA20 Replenishment process should be one important and timely vehicle to make commitments that address this pressing problem.

2. The Bank should push for structural solutions to low and unequal vaccine supply.
Our dependence on just a few pharmaceutical corporations who cannot make enough doses for everyone means that, even with the Bank’s financial support, countries are being charged far more than they can afford for far fewer doses than they need. At the price Uganda paid for the AstraZeneca vaccine ($7), it would cost more than double the country’s entire healthcare budget to vaccinate everyone. In this context the Bank’s $12 billion will be quickly used up on insufficient numbers of vaccines and with no spare change for roll-out. Moreover, unless supply constraints are tackled, people in developing countries will be waiting years without access.

The Bank should use its global voice and echo calls made by the WHO for urgently needed structural fixes including the waiving of intellectual property rules for COVID-19 vaccines, tests and treatments and the sharing of vaccine technology and know-how via the WHO’s COVID-19 Technology Access Pool (CTAP). Both are needed to unlock existing manufacturing capacity in developing countries and scale up production. The Bank can also play a major role in providing needed finance for more local R&D and manufacturing of vaccines and other medicines in the Global South to meet immediate and future pandemic and everyday essential health needs.

3. Vaccines should be free of charge and prioritised based on need.
At the national level, it is crucial that vaccine allocation plans are transparently published and demonstrate government commitment to ensuring vaccines go first to those who need them most, and not those with the deepest pockets or best connections. And, without exception, vaccines should be provided to people free of charge. These should be two non-negotiable requirements before Bank funding is signed off.

Oxfam’s research on the World Bank’s initial COVID-19 response found that ensuring free access to healthcare during the pandemic has been a major blind spot. We found that very few of the COVID emergency projects were addressing financial barriers to accessing healthcare, such as removing user fees for healthcare services. User fees lead to avoidable deaths, impoverishment and increased disease transmission. Even if it is the Bank’s intention for vaccines to be free, it should clearly and publicly state its expectation that vaccines should be free of charge, including in every project.

4. World Bank funds should be available for any safe and effective vaccine.
The Bank should also urgently get in step with the vaccine regulatory approval requirements used by the WHO and COVAX. As things stand, it has set the bar inexplicably high for which vaccines can be purchased with World Bank money, requiring approval from both the WHO and at least one stringent regulatory authority — all of which are based in rich countries. Developing countries that want — or indeed need — non-Western vaccines that are approved by WHO but are of little interest to rich country regulatory authorities, could be prevented from using Bank funds to buy them.

5. The vaccine roll-out must build up public healthcare systems for the future.
The COVID-19 crisis cannot be considered a short-term emergency. The support low- and middle-income countries receive from the Bank and other donors must go beyond short-term stop-gap measures, and address the underlying causes of weak, underfunded and inequitable healthcare systems, particularly overwhelmed workforces.

Oxfam’s research on the Bank’s initial COVID-19 response also found weaknesses in this area: two-thirds of projects lacked plans to increase the number of healthcare workers, despite huge shortages. In 70 percent of countries supported, the number of nurses per 10,000 people is below the WHO’s minimum recommended level, with 34 countries, like Malawi, not even halfway to meeting it. These healthcare workers will be crucial in a successful vaccine roll-out.

In its new assessment of country readiness for COVID-19 vaccines, the Bank has recognised this challenge, raising a red flag that “few countries are using the opportunity provided by the deployment of vaccines to strengthen healthcare systems and find long-lasting solutions for similar future challenges.” This assessment offers the Bank a clear directive to step up to the challenge and do all it can to support countries to build up their healthcare workforces and create more resilient and fair public health systems.

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NGO coalition pens open letter to Taoiseach calling for urgent waiver to allow Covid-19 technology-sharing

Martin Luther King Jr once said, “The time is always right to do what is right.” For our politicians, that time is right now.

24 February 2021

The pandemic is still raging across the world – and without strong moral leadership, people in developing countries will suffer the most.

Given the limited global supply, many people in low- and middle-income countries won’t have access to vaccines until at least next year, while it’s been reported that if current trends continue, the world’s poorest countries could have to wait until 2024 for mass immunisation.

Not only is this level of inequity a catastrophic moral failure that will lead to needless suffering and loss of life, ongoing outbreaks could lead to new vaccine-resistant variants developing. Without urgent united action to achieve herd immunity in developing nations, the health crisis and resulting economic crisis here and worldwide will continue.

That’s why today, a coalition of Irish organisations, networks and unions, wrote an open letter to Taoiseach Micheál Martin urgently requesting Ireland’s support for proposals to allow Covid-19 vaccine technology to be shared openly through an emergency waiver at the World Trade Organisation (WTO).

This emergency waiver would allow more vaccines and treatments to be produced on a global scale.

The WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires WTO members to provide long-term monopoly protections for medicines, tests and the technologies used to produce them.

But after a global campaign by public health and development groups, in 2001 the WTO issued a binding declaration about better balancing TRIPS intellectual property protections and public health needs.

With the EU currently blocking the waiver, the letter – coordinated by Oxfam Ireland and signed by Access to Medicine Ireland, ActionAid, Amnesty International Ireland, Comhlámh, Concern, Dóchas, Goal, the Irish Global Health Network, INMO, MSF, Oxfam Ireland and Trócaire – details how the EU’s current position threatens the prospects of ending the pandemic, despite the waiver being supported by more than 100 nations at the WTO.

The Coalition writes:

Ireland has a well-deserved reputation of supporting the human rights of the world’s poorest people. We are respected for our constructive engagement, acknowledging the importance of collective efforts amongst states for the problems that pay no heed to borders, such as the coronavirus pandemic. With so many of the world’s poorer nations supporting this emergency waiver already, you can help maintain Ireland’s moral and public health leadership in the world by siding with the majority to prioritise saving lives. Indeed, not doing so is self-defeating, as it is clear that the sooner the world’s population is vaccinated, the sooner EU citizens are safe.

While the signatories acknowledge that the waiver will not completely solve the problem, it will allow for a temporary space within the WTO rules to empower governments to move quicker when accessing intellectual property-protected technologies needed to protect public health.

Thus, we respectfully request that you break with the unconscionable policies the EU has supported before the next WTO General Council meeting of March 1-2 and announce that Ireland will no longer support opposition to the temporary, emergency Covid-19 WTO waiver of certain TRIPS provisions.

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Historic climate win in French court as law rules in favour of Oxfam and partners

The people have had their say – and in this case, it was the people of France.

In December 2018, four NGOs – including Oxfam France – launched a legal action against the French government for failing to cut the country’s emissions fast enough to meet its climate commitments.

The four organisations were backed by a record 2.3 million people, all of whom had signed a petition supporting the action.

Now a French court has found in favour of the plaintiffs, agreeing that the country’s political leaders have failed to take adequate action to tackle the climate crisis.

This marks the first time that the French state has been taken to court over its climate responsibilities – and the decision leaves the government open to lawsuits from French citizens who have suffered climate-related damage.

It could also force the French government to take further steps to cut its emissions.

Other countries, including Ireland, have already brought similar cases to court. In June 2020, Friends of the Irish Environment took the Irish government to the Supreme Court for failing to take adequate action on climate change – and won.
Climate Case Ireland was the first case of its kind in Ireland and only the second case in the world in which the highest national court of law required a government to revise its national climate policy in light of its legal obligations.

Michael McCarthy Flynn, Head of Policy and Advocacy at Oxfam Ireland, said:
“As our own Supreme Court has already put the Irish government on notice for failing to take adequate action on climate change, in a similar case, it is essential that the new Climate Change Bill currently going through the Oireachtas is robust enough."

- Michael McCarthy Flynn, Head of Policy and Advocacy at Oxfam Ireland
Ireland’s win followed that of the Urgenda Climate Case in the Netherlands in December 2019, when the country’s Supreme Court upheld previous decisions that the Dutch government had a duty to urgently and significantly reduce emissions in line with its human rights obligations. Climate change litigation is increasingly seen as a way to influence policy, according to a 2019 report by the Grantham Research Institute on Climate Change and the Environment. The report, co-published by the London School of Economics and Political Science, revealed that more than 1,300 climate cases have been filed in at least 28 countries, with governments cited as the main defendant in over 80 percent of cases.
Back in France, the government’s proposed climate law is, by its own admission, not enough to achieve its target of cutting emissions by 40 percent by the end of this decade. Even this target is not enough to put the country on track to tackle the climate crisis, Oxfam France said.
“For the first time, a French court has ruled that the State can be held responsible for its climate commitments. This sets an important legal precedent and can be used by people affected by the climate crisis to defend their rights.

“This is a source of hope for the millions of French people who demanded legal action, and for all of those who continue to fight for climate justice around the world. It is also a timely reminder to all governments that actions speak louder than words.”

- Oxfam France
The French government now has two months to appeal the court’s decision. While the four NGOs have asked the court to order the state to take extra measures to fulfil its climate commitments, the court has reserved its decision until later in the spring, allowing for further discussions between the two parties.
Oxfam launched the legal action because the climate crisis is fuelling poverty, hunger and inequality around the world. Often it is the poorest countries that have contributed least to the crisis that pay the highest price. In September 2020, Oxfam revealed that the richest one percent of people produce more than double the emissions of the poorest half of the world population combined.

Irish corporate tax policy to be assessed by the UN as a human rights issue

As reported in the Irish Times the UN Committee on the Rights of the Child has taken the decision to examine the impact of Ireland’s international tax policy on the ability of countries of the Global South to raise revenue and fulfil their human rights obligations, in particular those that relate to children. As a signatory to the UN Convention on the Rights of the Child (UNCRC) Ireland is obliged to avoid policies that undermine the human rights of children at home or abroad. This is the first time that the external impact of Irish tax policy will be assessed under an international human rights instrument, and comes in response to a detailed submission  from a coalition of Irish, Ghanaian and international civil society organisations, including Oxfam Ireland.

Tax policy is critical for the realisation of human rights. It shapes states’ capacity to raise revenue, fund essential public services, and consequently to fulfil their human rights obligations. Academics, UN experts and civil society organisations have all emphasised this link, particularly in relation to economic, social and cultural rights – without fair and functioning taxation systems, efforts to deliver adequate housing, healthcare and education and to tackle poverty and inequality are badly undermined.

Crucially, this impact is not limited neatly within national boundaries. In a globalised economy, multinational corporations can exploit divergent domestic laws and a climate of competition, rather than cooperation, between states to dramatically reduce their tax bills. Through complex corporate structures, profits are shifted across borders into low or no tax jurisdictions, sheltering billions of euro every year, eroding tax bases and public budgets. These practices are particularly harmful for developing countries, which are more reliant on corporate income tax than higher income countries. Vital revenue is siphoned away, prolonging a country’s reliance on aid, exacerbating inequality and keeping people trapped in poverty.

Too often Irish corporate tax policy is considered only from the narrow perspective of the benefits it can bring to Ireland – insufficient attention however is given to its negative impacts beyond our borders. Other countries’ ability to raise badly needed revenue is undermined by tax avoidance, and in countries of the Global South, this can mean the difference between life and death.

Ireland’s role in the international tax avoidance landscape is well-documented, recognised by EU institutions, UN Commissions, bodies within the US Congress, and academics. A recent working paper by the National Bureau of Economic Research (NBER) found that ‘more than $616 billion in profits were shifted to tax havens in 2015, close to 40% of multinational profits’, and identified Ireland as ‘the number one shifting destination, accounting for more than $100 billion alone.’ Ireland also continues to negotiate tax treaties with countries of the Global South in a manner that facilitates avoidance, and undermines other countries’ capacity to raise revenue. In pursuing a recent tax treaty with Ghana, Ireland went against the advice of the Department of Foreign Affairs, who advised that the effect of such tax treaties between ‘developed and developing countries is that capital flows from developing to developed nations’.

Growing public demand for tax justice has brought increased scrutiny on these practices, including by UN human rights monitoring bodies. In 2016, the UN Committee on the Elimination of Discrimination against Women (CEDAW) expressed concern regarding Switzerland’s financial secrecy and tax policies and how they impact other states’ capacity to raise revenue and fulfil women’s rights. Successive UN Special Rapporteurs on extreme poverty and human rights have called on governments to stop facilitating avoidance, and to recognise the impact this has on some of the world’s poorest communities.

In October 2020, the UN Committee on the Rights of the Child announced that, for the first time ever, the negative consequences of Irish tax policy will be examined under the framework of another key international human rights treaty: the UN Convention on the Rights of the Child (CRC). As a party to this Convention, Ireland is obliged to avoid policies that foreseeably undermine the realisation of children’s rights, at home or abroad, and its progress is reviewed at UN level every five years. But as the evidence presented to the Committee demonstrates, it is currently failing to meet these obligations due to its facilitation of harmful tax avoidance.

The Irish government must now formally address the impact of its tax policy on the realisation of children’s rights in other countries, in a detailed submission due by the end of 2021. It will then be formally reviewed by the Committee at hearings in Geneva in May 2022 for compliance with its international law obligations under the Convention. The coordinating civil society organisations, including Oxfam Ireland, will also build on their initial submission and provide further evidence to the committee as part of this process.

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