**This article first appeared in the PSARA Education Fund’s Retiree Advocate, March 2021 edition**

Despite all the frustrations of the vaccine distribution system, most  of us will likely get vaccinated some  time this year. Not true for folks in poor countries. Some experts are saying  many will not get their shots until 2024.  Three years from now! 

 Rich countries have contracted with Big Pharma companies for existing and upcoming supplies. The US, Canada,  and EU countries have reserved enough doses for two to four times their entire populations. So far 130 countries have not gotten a single dose of vaccine. Why? Pharmaceutical corporations have gotten a web of patents on vaccines, production methods, testing  data, etc., to be able to throttle sup ply and maintain extremely profitable prices. 

 This is a moral and ethical issue: What  is it about my life that is more important than an African villager’s? It is a public good issue – no one is safe until we all are. And it is a racial justice issue; the countries left out are mainly Black and Brown. 

Debt and Trade Agreements 

 There is economic colonialism  involved here. Over the last 40 years,  indebted low- and middle-income  countries (LMIC’s) have paid billions to  rich-country banks and “investors.” To  make these payments, debtor nations  have cut back on their health systems,  even though health care is fundamental to life and to development. 

 Now COVID economic crises have  slammed poor countries. Wealthy  countries have recently offered paltry  amounts of debt relief without forcing  private-sector lenders to do the same.  Poor country childhood vaccination  rates (not for COVID, but for measles,  etc.) have dropped precipitously; 600  million more folks have dropped below  World Bank poverty lines.  

 So-called trade agreements since  NAFTA in 1994, have been negotiated mainly for the benefit of large  corporations (negotiated by Clinton,  never forget), mainly to allow for the  outsourcing of good jobs to low-wage,  low-regulation countries. 

 In addition, corporations, especially  in pharmaceuticals and tech, have  loaded these agreements with intel lectual property protections, extending  and enforcing their patents. (These are  the TRIPS agreements, in international  trade jargon.) This has become a key  corporate strategy – enshrine provi sions into trade language. It is a back door way to constrain national policies.  This means medicine and vaccine  patents give Pharma hugely profitable  monopoly rights. During the AIDS  crisis in the 80’s, popular protest in the  Global South forced some concessions,  allowing patent waivers and some local  production of retroviral AIDS drugs. But  it took struggle and lost time and lives. 

Gates, Always Gates 

 The Gates Foundation, along with  the World Health Organization, has  worked with many countries to set up  COVAX, which would buy and distribute a very limited supply of vaccines to  LMIC countries. The previous administration refused to help; at least Biden is going to join. But the needed funds  are not coming in, and even if they do  it would mean only about 10 percent of  all poor country populations would get  the vaccine, undoubtedly bypassing  the very poor in those countries.  So, then, would workers in Bangladeshi fast-fashion industries not be  vaccinated while rich-country consumers flock back into stores? How about  workers in the lithium mines supplying  batteries for our electric cars? Mexican  agricultural workers growing tomatoes  and avocados for us?

We do not need charity; we need justice. India and South Africa have proposed at the WTO to suspend pharmaceutical monopolies – a TRIPS waiver  — during the pandemic (the US under  Trump blocked it). Doctors Without  Borders demanded that all vaccine  deals between companies and countries, including cost and trials data, be  made public. 

 Fine, but justice demands more. Big  Pharma and rich countries must be  forced to share the know-how and the  intellectual property other countries  need. There must be technical assistance for countries to build their own  manufacturing facilities. Trade rules  must be rewritten. 

 Governments put billions into  research and demand nothing from  hugely profitable companies. These  corporations want to be seen as our  saviors during this pandemic. But they  make billions and keep the patents,  which allow them to decide who gets  the vaccine and at what price – who  lives and who dies. The balance between the power they have and the  public good is way off. That has to  change! 

 Lives matter more than profit.  Michael Righi is a retired economics  professor and a member of PSARA.