Latin America can lead the way on a new public health model | Coronavirus pandemic

The experience of the COVID-19 pandemic has demonstrated that countries in the Southern Hemisphere cannot rely on the international system or the rich nations of the Northern Hemisphere to help them get through the health crisis.

When Bolivia reach an agreement With Canadian manufacturer Biolyse Pharma to provide a COVID-19 vaccine to its people, the Canadian government failed to take the necessary measures to green-light exports.

When Uganda was trying to buy a dose of the AstraZeneca vaccine, it charge three times every dose that richer European countries paid.

As India and South Africa lead an alliance of most of the nations on Earth at the World Trade Organization change the organization’s rules and allow the production of a COVID-19 vaccine anywhere. it is possible that a small group of wealthy nations, led by the United States, the European Union and the United Kingdom, blocked them.

When the COVAX initiative was founded by wealthy nations and international organizations, it promised to buy and distribute a COVID-19 vaccine equitably globally, but it did not. . Some rich countries, like UKalready received a substantial supply of vaccine from COVAX, while poorer countries have had to wait or rely on vaccine funding, which are often near-expiring doses.

Today, the coronavirus pandemic may have subsided, but the real enemy of health still exists: a patent system that keeps drug formulas secret, a commercial system that allows corporations to price drugs outside The reach and global governance system holds the power to change any of this from poor countries.

If we want a better international health system, we will have to build it ourselves. With the victory of Luiz Inácio Lula da Silva in Brazil and the rise of new progressive governments in the region, Latin America is ready to begin this urgent work.

In my previous roles as Minister of Health of Ecuador and Director of the Institute of Health at the Union of South American Nations (UNASUR), I have seen possibilities take shape as countries work together. each other according to the principles of equality and social justice, bound by a common vision, and with the power to make that vision a reality.

To break the power of the current system and create a new one, we need to challenge it on four levels: transparency, knowledge, industry, and governance.

First, we need collective pricing and procurement. The main reason companies get away with arbitrary drug pricing is secrecy in commercial transactions.

We can turn the tide by creating a Drug Price Bank and starting to buy generic drugs. We established one such bank in 2016 when I was the medical director of UNASUR. It’s a simple database of drug prices, made up of an initial list of 34 kinds of medicine. The 12 participating countries shared the prices they were offered by pharmaceutical companies – to see the prices offered to other countries in turn.

Armed with comparative statistics, governments have successfully reduced prices at the negotiating table, increasing access to medicines for everyone in the region while challenging secrecy built in major pharmaceutical contracts. At the time, UNASUR estimated that if all 12 countries purchased the required quantities of the 34 drugs listed at the lowest prices in the region, the total savings would amount to approx. 1 billion dollars per year.

We can relaunch this price bank and take it further. Once we have information about the price, we can negotiate to buy together, continue to reduce the price when ordering in bulk. Through collective buying, we can reduce the inflated profit margins of major pharmaceutical companies and turn it into healthier lives for our people instead.

Second, we need shared capabilities. Prescribing new drugs and vaccines is not easy. The regulatory infrastructure takes years to set up, from training skilled technicians to building laboratories and establishing information sharing with regulatory agencies around the world. When a country has greater capacity to tailor vaccines and treatments, it can lend these capabilities to countries that do not – a simple system of solidarity that speeds up approach.

This happened in the area. During the pandemic, Mexico’s Medicines Regulatory Authority (COFEPRIS) assisted the Paraguayan health authority in assessing India’s Covaxin for emergency use approval, although Mexico has no plans to use it. We can build on this and establish a region-wide mechanism.

Third, we need to establish and expand national production. Within a few months of scientists developing a vaccine for COVID-19, wealthy nations have purchased almost all of the existing and future dosages, leaving very little for the rest. our back.

Cuba has been isolated from this failed system. It benefits from decades of investment in public healthcare and domestic pharmaceutical manufacturing, which means it can develop two vaccines in the country — with over 90% effectiveness rates. — and quickly began to vaccinate people. It has sent its vaccines to other embargoed countries such as Iran, Venezuela and Nicaragua, and has also signed agreements to co-produce vaccines with countries such as Vietnam and Argentina.

Domestic pharmaceutical production in Latin America is expanding. Argentina is important manufacturing capabilities with 190 factories and 40 public laboratories. Mexico plans to produce its own COVID-19 vaccine candidate, Patria in the national pharmaceutical company Birmex. Brazil has notable manufacturing capacity and Colombia is also looking to expand.

By nationalizing production and developing their own industries, countries in the Southern Hemisphere can coordinate production and distribution, ensuring health emergencies are addressed in the best interest of all. interests of the people, not corporations in the Northern Hemisphere.

Finally, we also need to act in concert on the international stage. From advancing international trade reform to co-financing solutions and filing complaints together – we can be more effective by coordinating our actions.

When I was leading the Health Institute at UNASUR, we created a space for new forms of collective action in the region, renegotiating the terms of existing health policies at the General Assembly. WHO World Health. Between 2010 and 2016, 35 joint interventions was carried out at the WHA on behalf of UNASUR countries, on issues such as access to medicine, health as a fundamental human right, WHO reform, the sustainable development goals and other issues. other.

Likewise, when the tobacco company Philip Morris tried to sue Uruguay for initiating anti-smoking laws, the Southern Common Market (MERCOSUR) managed to act as a block in front of the International Center for Settlement of Investment Disputes (ICSID) to demonstrate their regional support. The last ICSID ruling in favor of Uruguay.

Acting as a bloc can support other efforts to secure required licenses to manufacture COVID-19 vaccines and drugs in chile, Colombia, Bolivia and Dominican Republic. Such licenses, permitted under WTO rules, allow governments to begin manufacturing or importing alternative generic versions of a patented medical product without consent. prior to the license holder. This is what Bolivia needs from the Canadian government to be able to import 15 million doses of the vaccine produced by Biolyse.

A progressive medical bloc, with its collective purchasing power, management capacity, and drug production and distribution capabilities, could pressure to jointly achieve the right to manufacture life-saving drugs.

These ideas for building a new global health system from below can be taken quickly and begin to improve the lives of our people. Now is the time to rally progressive governments, in Latin America and beyond, to end big pharmaceutical monopolies, democratize pharmaceutical production, reduce drug prices, build health systems. to expand public health service delivery, strengthen governance capacity, and maintain the right to health care for all. We know what needs to be done, now we need to muster our collective strength to make it happen.

The views expressed in this article are those of the author and do not necessarily reflect the editorial views of Al Jazeera.

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