How to end pandemics

We already have a guide on responding to pandemics and just as viruses know no borders, our response to them must be borderless too

As fear of monkeypox grips the world, as exhaustion sets in over Covid-19 and as concerns mount about pandemics to come, leaders can sometimes feel they are being challenged by unprecedented crises for which there is no guide. Luckily, there is a guide to responding to pandemics: the AIDS movement’s collected knowledge of what we have learned responding to HIV.

Our biggest takeaway is this: just as viruses know no borders, our response to them must know no borders.

The G20 is uniquely positioned to provide crucial support in a global response to pandemics, bringing together, as it does, countries that host the world’s major pharmaceutical producers. The G20 has come together before to make bold political choices to address systemic common challenges, as it did in 2008 in the wake of the global economic crash. Faced with the ‘pandemic crash’, people across the world look to the G20 to play its part through courageous cooperation.

The cooperation required

Key to the cooperation needed is the sharing of intellectual property rights and technology transfer, the quickest tools to ensure the world can produce the health technologies needed to control pandemics, save lives, limit disruption and protect the global economy. G20 governments, which fund, regulate and procure at huge scale the outcomes of biomedical research and development, are in a unique position to make sure that licensing and technology transfer enable global access.

This is the most effective way to ensure that people in the Global South as well as in the Global North receive the vaccines, diagnostics and therapeutics needed to defeat pandemics. Left to the market to fix, pandemics will persist, the damage wrought to all economies will well exceed any individual company’s profits, and the longevity of the harm will go beyond any medicine’s expiry date.

The AIDS crisis would be over today if every person with HIV had gained access to antiretrovirals as soon as they were developed in the 1990s. But medicines were kept at unaffordable prices, at $10,000 per person per year. It took nearly a decade for governments of the Global South to be able to access medicines at prices they could afford, a decade in which 12 million lives were lost and economies suffered irreparable damage.

History repeating

The same story is unfolding with SARS-CoV-2 today. Essential vaccines and therapeutics have remained accessible primarily to people in wealthy countries, which has enabled the virus to mutate into ever-elusive variants, delaying the return to pre-pandemic norms of social and economic life.

There are those who argue that the only way to incentivise and reward R&D for new health technologies is for pharmaceutical companies to hold onto fully exclusive intellectual property rights for extended periods. This argument does not recognise the billions of dollars of public money that fund R&D, and the responsibility of governments to protect public health. Nor does it recognise that companies will continue to profit in the same way from the markets they already serve. With production taking place in the Global South as well as the Global North, everybody wins.

A way forward

This past July, the UK-based pharmaceutical company ViiV Healthcare helped to light a way forward when it pledged to voluntarily transfer the technology for a revolutionary new HIV prevention tool to 90 countries. Broadening access further to include every country that needs it would speed up access worldwide, helping to bring down new HIV infections. Bavarian Nordic, the Danish producer of the monkeypox vaccine, has recently recognised that it alone cannot meet global demand for vaccines.

Enabling worldwide production of and access to affordable lifesaving health technologies will keep us all safe and protect every country’s economy. This approach is key for an effective pandemic response. If we fail now, we will fail to respond appropriately to future pandemics.

The economic damage wrought by pandemics is not inevitable. Lessons learned from the AIDS pandemic provide a guide for leaders to emerge triumphant, together. In this time of crisis, the only realistic strategy is to be bold.