I think the patent waiver could be useful. I have an article that just came out in Foreign Affairs this morning that basically says that the patent waivers are a good development but are insufficient to solve the problem because the problem with vaccines is that they are more complicated than small-molecule drugs. For instance, if you have the structure of an antiretroviral drug for HIV/AIDS, the likelihood is that you can bring together organic chemists and formulation experts and produce that drug; the only thing standing in the way is the patent. Vaccines are far more complicated. It takes years to know how to create and build vaccines and do it under a quality umbrella for quality control and quality assurance, having the regulatory authority in place. Just waiving patents will not be sufficient to solve this problem.
What we need is the help from the U.S. government to actually make a lot of vaccine for the world. Look at the scale that we're talking about. There are 1.1 billion people in sub-Saharan Africa, 650 million people in Latin America and about 500 million people in the smaller, low-income countries of Asia. When you add up those numbers times two doses, we're talking about five to six billion doses of vaccine. Where's that going to come from?
The mRNA technology is still new. It's a great technology—I got the Pfizer-BioNTech vaccine, and I'm grateful for it—but can we scale that up, and what will a patent waiver do for that? It's the same with the adenovirus vector vaccines, and we have our vaccine. For instance, with regard to our vaccine, we have Biological E. making a billion doses. Who's going to make the other four to five billion doses? I think there seems to be.... There's not an adequate foreign policy for producing vaccine at the scale that we need and in the time frame that we need. We really need it now.
We have the added problem, of course, that the whole game plan for the global vaccinations relied heavily on India to be the big producer between the Serum Institute and Biological E. Now those vaccines are not being exported because they're being kept within India, so it's like a domino effect and the whole thing is kind of falling apart.
I worry that there's not an adequate structure. The COVAX sharing facility was well-thought-out, but the vaccines simply aren't there right now. The key message, I think, for the Biden administration is this: “Thanks for the patent waiver. It's a good first step, but now what are you doing to do?”