To vaccinate the developing world against Covid-19, consider the lessons of AIDS. In 2004 that disease was burning across Africa. Treatments were available but expensive, and everyone wanted to expand Africa’s access to them. Drug-industry critics on Capitol Hill pressed President Bush to solve the problem by breaking Western manufacturers’ patents. He said no and came up with a better plan.
At the time, I worked at the Food and Drug Administration. Generic-drug makers, mostly in India, promised cheap versions of AIDS drugs, but there was reason to worry about their quality. My colleagues and I thought that patients in Africa deserved the same first-rate treatments Americans got.
The drug industry worked with government to develop their AIDS medicines into cheaper combination pills. The FDA put these products through a process for “tentative” FDA approval without the expense of full-blown clinical trials. The U.S. government purchased these pills in bulk and distributed them widely in Africa. This process became known as the President’s Emergency Plan for AIDS Relief, or Pepfar. This program slowed the spread of AIDS and helped save millions of lives.
Many of the AIDS drugs that foreign drug makers wanted to produce by ignoring U.S. intellectual property were later found to be subpotent and adulterated. Had the Bush administration used American funds to support the production and distribution of these counterfeit pills, it could have been a public-health disaster, leaving millions of people partially treated with inferior medicine.
President Biden now faces a similar moment of peril and opportunity. America needs to help combat Covid-19 in low- and middle-income countries. The White House is under pressure to suspend patent protections for vaccines so foreign firms can start producing them.
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