On a sunny April morning in Philadelphia, Tifrah Akhtar was racing the clock to pick up a rushed-printed sign. Her sign read, in bold letters: “President Biden, Do What You Promised and #FREETHEVACCINE.”

Less than 72 hours before, Akhtar had heard President Biden was coming to Philadelphia to speak at an Amtrak station. She’d seen an opportunity, and with help from her six organizer roommates and community organizations like Reclaim Philadelphia, Vietlead, and others, word spread. Approximately 70 people rallied that day to ask President Biden why he was not upholding his campaign promise to relax or cancel coronavirus vaccine patents for global distribution.

“We knew we had to act really fast,” said Akhtar. Akhtar, whose family is from Pakistan, has relatives both abroad and locally who are or have been sick with COVID-19. But while the vaccine is now readily available in Philadelphia, she says her cousins in Pakistan have no dream of getting the vaccine at present.

“I’m afraid every day, glued to the family group chat and wondering what is next,” she said. “Here in Philly I just read that 400 vaccines were thrown out. This is a huge injustice.”

Akhtar is part of a movement worldwide calling for a “People’s Vaccine” — an emergency waiver by the World Trade Organization (WTO) that would open up the patents for COVID-19 vaccines so more countries could manufacture them. The movement saw a major victory on May 5 when, after months of stonewalling, the Biden administration announced support of the waiver of intellectual property rights.

It took direct action, open letters, engagement with local, state, and federal civil servants and an incredible cross-pollination of community organizers from public health, international solidarity, and trade justice campaigns to generate the roar of public pressure that the administration could not ignore. And yet, the fight is far from over.

“Could You Patent the Sun?”

Major advances in public health have often been brought about by public and private collaboration and funding, including with philanthropic support.

In 1955, the medical breakthrough of the vaccine for polio, which used to paralyze or kill thousands of children annually, brought a global sigh of relief. The research that led to the discovery of the vaccine by American virologist Jonas Salk was collectively funded by 80 million individuals.

When asked in an interview who owned the patent to the vaccine, Salk replied, “the people.”

“There is no patent,” Salk stated. “Could you patent the sun?” The vaccine was deemed to have been funded by the people and therefore part of the medical commons, he was saying.

But by the mid-90s, with the dawn of the World Trade Organization and a fully entrenched neoliberal economic framework, views on intellectual proprietary ownership of vaccines had become more rigid.

“This is a fight that has happened before over the decades,” said Arthur Stamoulis, executive director of Citizens Trade Campaign.

After years of activism and research, for example, functional medication for HIV/AIDS offered hope of an end to that crisis. But those drugs were only accessible to individuals — and countries — who could pay for them. For nearly a decade, entire countries couldn’t access the drugs because of intellectual property controls enforced by the WTO.

Citizens Trade Campaign, a national coalition of environmental, labor, consumer, family farm, religious, and other civil society groups that work on trade justice campaigns, were part of the fight to make HIV/AIDS medication accessible to the world.

“There was a lot of activism directed at Clinton, Gore, and George W. Bush, and there was an agreement within the WTO that said in emergency situations countries do have the right to waive intellectual property rights,” said Stamoulis. “It didn’t happen overnight, but it happened eventually.”

The Fight for a People’s COVID Vaccine

In October 2020, India and South Africa proposed a temporary TRIPS (Trade-Related Aspects of Intellectual Property) waiver of the patent rights for COVID-19 vaccines. This waiver, if passed in a consensus vote by all 164 WTO member countries, would allow for countries to manufacture a generic version of the vaccine at scale, without fear of legal repercussions.

More than 100 nations, most of them poorer, have supported the waiver, but several rich governmental bodies, including the EU, the United Kingdom, New Zealand, Australia — and until May 5, the United States — blocked it.

“COVID vaccines were developed with broad public support, and everyone worldwide deserves access to them,” said Arthur Stamoulis, executive director of Citizens Trade Campaign. Massive infusions of taxpayer money — the whopping $18 billion Operation Warp Speed — lowered the risk to pharmaceutical companies to enter the vaccine race in 2020, ultimately bringing several successful vaccines to market.

And while this breakthrough is one of overwhelming relief, worldwide vaccinations to date are cut starkly along lines of nationality and wealth. One in four citizens of rich nations have received a vaccine, but only one in 500 people in poorer countries can say the same, World Health Organization Director-General Tedros Adhanom Ghebreyesus said in a recent meeting of the United Nations’ Economic and Social Council.

As of May 7, 30% of adults are reported to be fully vaccinated in the United States. In India, only about 3% have been. The CEO of the world’s largest vaccine producer, the Serum Institute of India, in September asserted that at the current production rate, some people might not receive vaccines until 2024.

Citizens Trade Campaign is still in the fight. In February 2021, the organization published an open letter to President Biden in support of the TRIPS Waiver, signed by 400+ organizations.

“Defending monopoly protection is the antithesis to the current call for COVID-19 medicines and vaccines to be treated as global public goods,” said Yuanqiong Hu, policy co-coordinator for Doctors Without Borders’ Access Campaign, in a statement on the signing. “In these unprecedented times, governments should act together in the interest of all people everywhere.”

But even with more than 400 groups representing tens of millions of members, the Citizens Trade Campaign letter was little more than a blip in the national news. The patent waiver faced strong opposition by pharmaceutical companies such as Pfizer and Moderna, as well as from the Bill & Melinda Gates Foundation. Bill Gates had previously been against the waiver, saying that the profit incentive from licensing the vaccine is what has driven the innovation to create the vaccine. But on May 6, the Gates Foundation reversed course and announced support for a limited waiver.

As COVID cases in India began to quickly mount in April, new allies for the TRIPS waiver emerged. An open letter from 175 former heads of state and Nobel laureates added to the movement’s momentum. They were joined by 10 U.S. senators and more than 100 representatives.

On April 22, protesters outside the Pfizer shareholder meeting in New York City held up a 7-foot-long needle. That action, says Ben Levenson, an organizer with Justice is Global, was driven by longtime HIV/AIDS advocates. A parallel protest happened outside the Moderna shareholder meeting on April 28.

Over the next two weeks, on-the-ground protests, rallies, postcard campaigns, and digital organizing have targeted the Biden administration, Congress members, Big Pharma companies, and the Gates Foundation.

“It’s a really beautiful moment for international solidarity,” said Hillary Haden, executive director of the Washington Fair Trade Coalition. Haden is part of a large informal coalition including groups like Citizens Trade Campaign, Peoples Health Movement, Global Trade Watch, Fair World Project, Justice is Global, and others that began working on the patent issue in December.

One speaker at an April 30 rally in Seattle was Hassan Khan, a tech worker, human rights advocate, and volunteer with the Coalition for Seattle Indian Americans, who recently lost a 38-year old cousin in India to COVID-19. There, the virus has inundated the country’s health care system in a matter of weeks. Booming case loads, spurred on by a new, fast-spreading variant, have overwhelmed hospitals and communities, with no end in sight.

“When humanity is at stake, we must lower the barriers that are erected to protect the margin of rich pharma companies,” Khan told a crowd at the “Rally to Demand Biden and the Billionaires End Vaccine Apartheid!” which was held outside the offices of the Bill & Melinda Gates Foundation.

Pfizer alone generated $3.5 billion in revenue in the first three months of 2021, with the overwhelming majority of their vaccines having gone to wealthy countries so far, The New York Times reported.

“Money is not everything,” said Khan. “People’s lives are what matters.”

Beyond moral arguments of addressing medical apartheid, vaccinating the world is ultimately what is required to end the pandemic, proponents of the TRIPS waiver say. The longer the pandemic, the more opportunity there is for dangerous new variants to emerge, like the B.1.617 “double mutant” variant which could be more resistant to vaccines.

New alliances forged through the shared vision for vaccine access have given this movement some momentum. The trade coalition co-organized the rally with the Coalition of Seattle Indian Americans and other groups, and also worked with Seattle City Councilmember Kshama Sawant on a resolution in support of the waiver — the first of its kind in the country.

Stamoulis at the Citizens Trade Campaign was surprised at how quickly the movement gained steam. “It’s a testament to the power of cross-sector, cross-border organizing.”

Biden’s support of the TRIPS waiver is a clear victory for the movement, because of the prominent role the United States has in driving WTO agendas. Still, the next phase will require continued pressure, as the exact parameters of the waiver are negotiated — a process which could take months.

“Our hope is that other opponents of the waiver quickly lift their blocks against it,” Stamoulis said. “Our movements need to continue pressing for a speedy and robust waiver deal, as well as follow through by the administration on financing, info sharing and other production support.”

In Seattle, in front of the doors to the Gates Foundation, a woman came up to the mic with her parai drum, a traditional instrument in India, often associated with grief and resistance.

“‘Parai’ means ‘say,’” she told the crowd, before beginning to play. “Say it out loud. Say it until you are heard.”

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