Moving forward with lessons from the past

What was your motivation for initiating the COVID-19 Technology Access Pool to harness the power of science for all?

At the beginning of the pandemic, we were overcome with fear and uncertainty, not knowing the virus, its causes, how long it was going to last, how it would behave, or if we were going to be able to find a cure or treatment. But we did have experience from dealing with previous epidemics that shed light on the challenges we would probably face. We knew we needed to understand the virus, building upon experiences with other COVID-19 viruses; to be able to research and develop together – as fast as possible – possible treatments, therapeutics and vaccines; and to be ready to make all those available in an affordable, fast and equitable way. Ensuring equitable access was already a significant concern from the early stages of the health emergency; we knew what was coming, bearing in mind experiences such as responding to HIV/AIDS, where availability and affordability were the greatest barriers that kept millions of people from developing countries at risk, despite full access to anti-retrovirals in the developed world – barriers that were overcome thanks to public health initiatives that increased competition, such as voluntary licensing, and resulted in enormous reductions of prices for antiretroviral therapy. We need to learn from those lessons and be better prepared!

As a global community we are committed to the 2030 Agenda for Sustainable Development and we knew that the pandemic was putting at risk achieving the third Sustainable Development Goal. So many people were at risk of being left behind unless action was taken.

What is your vision of social solidarity?

Solidarity should be at the core of public policy and especially in issues related to health. In my country, Costa Rica, we set up a social security system in 1949 that is based on solidarity, and ensures universal health coverage and access to quality health services. Our strong social security system is perhaps the key to the levels of social development and equality we have achieved. So, solidarity is at the core of Costa Rica’s public policy responses – it’s in our DNA. Access to health is a fundamental right and we have worked hard to guarantee it to all people.
How is that expressed through C-TAP?

The principles of the Solidarity Call to Action are precisely all about solidarity: establishing that health is a global public good and that multilateral action requires that knowledge, data and innovation be shared to tackle global crises. Recognising the substantial public investments in medical research, and the need to prompt innovation, C-TAP aims to find a balance and invites the voluntary sharing of licences, which should be done in transparent and non-exclusive ways to scale up production and ensure equitable access. This unprecedented moment needs to be tackled using extraordinary measures that make sure everyone around the world has access to life-saving treatment.

My hope is that as a global community we can translate C-TAP principles in practice, which will enable us to be better prepared to respond to any health crisis. Unfortunately, COVID-19 has shown us an ugly picture and dramatic situations. Despite the rapid development and approval of vaccines, we have not delivered on our promise of equitable access. We have failed to protect those at higher risk first, everywhere. That needs to change. New tools such as a World Health Organization Pandemic Treaty will create better frameworks for regulating and coordinating our responses in all parts of the world.

Also, the current climate crisis, biodiversity loss and environmental degradation all strongly link to the spillover of zoonotic diseases. We will face more health emergencies unless we take drastic measures now to reverse the environmental challenges.

What hurdles must C-TAP overcome?

C-TAP is a platform that could be very beneficial not only for addressing the current pandemic but also for addressing the ones to come. We will continue to face this sort of challenge more frequently. We must be prepared. We should not pass by this opportunity to strengthen the mechanisms we already have in place. We must take stock, reassess and, if necessary, change gears. C-TAP can help in scaling up production and ensuring equitable access around the world. The most difficult hurdle that remains is resistance from industry. It should be seen as a win–win possibility, a very beneficial middle ground for everyone. ▪