WTO Director-General Ngozi Okonjo-Iweala calls for more ‘political will’ on Covid, future pandemics

In the meantime, she said, the world needs to find ways to bolster vaccine tech transfer — to ensure that even if an intellectual property waiver does materialize, countries have what they need to manufacture the shot.

In an interview with POLITICO, Okonjo-Iweala talked about the TRIPS waiver, how to prepare for the next pandemic, and what the world is still getting wrong in its fight against Covid-19.

Read the interview below, which has been edited for clarity.

Q: What are we still getting wrong in the fight against Covid-19 and are there realistic ways to improve before another more transmissible and potentially more deadly variant emerges?

A: It hasn’t sunk in. This “no one is safe till everyone is safe” has become a trite comment. What we’re getting wrong is that we’re not realizing this is actually true and that nobody in the developed countries — where you have vaccination rates of more than 60 percent — can really sleep easy whilst vast numbers of people are unvaccinated elsewhere. The developed countries should be full-time trying to work with those countries whose vaccination rates are low to solve whatever problem is there on the ground so that they can be vaccinated.

But people kind of feel, well, we’ve given them money here, we’ve done this here, we’ve given donations and we’ve done our bit. I don’t think that that is sufficient. If these countries have very weak capacity on the ground to administer [shots], then you have to either be massively empowering multilateral organizations … to go in there and try and help solve the problem [or] you have to be willing to finance health systems strengthening in those countries. We’re still in danger because there are masses of people in the world not vaccinated.

The second thing we’re getting wrong is we think this thing is coming to an end. There is now this feeling that it’s over … let’s just let everything go. And that may be a little bit too complacent. We really need to be careful.

The third thing we’re getting wrong is that we are not preparing for the next pandemic. There’s not enough surveillance of what is happening with diseases. And we need to finance that.

Over five years, the world should spend $75 billion, $15 billion a year of which $10 billion goes into a financial intermediary fund that could be managed by the World Bank to prepare for the next pandemic. And the point is that there’s reluctance to come up with this money. We’ve spent $26 trillion in fighting the pandemic. But we are not ready to spend $75 billion for starting prevention now. That is wrong. That is plain, absolutely wrong.

Q: Where do the conversations on the TRIPS waiver stand, specifically with the smaller group of representatives from the U.S., the EU, India and South Africa?

A: It’s been quite difficult. You know, if it were easy, it would have been done. They were discussing this a year before I got here. That’s why we started doing this small group process, and it’s a tough one. But I think, let’s say we see some movements in the right direction, towards the framework, that’s as much as I can say, I don’t want to say more. We don’t have it yet. We still have gaps to bridge.

Q: Are you optimistic?

A: Ahhhhh. I’m not … I’m not pessimistic. I’m an optimist by nature, so I always see the glass half full. But, seriously, we need to keep working at it because we think there is a landing zone. That can be hard. But we have to be very careful to work it until all sides are comfortable with where we are.

Q: Is an agreement for an IP waiver on diagnostic materials and therapeutics achievable?

A: It would be jumping too fast. People need to wait and see what we come up with respect to vaccines before we move on to therapeutics. They’re a little bit different from vaccines. It’s not as easy to manufacture vaccines. Therapeutics and diagnostics are a bit different. There’s not as much worry when you’re doing generics for therapeutics as there is for when you’re doing vaccines.

Q: What are the biggest obstacles at this point in the pandemic to complete global vaccinations on Covid?

A: I spoke to the president of Botswana a few days ago. In this country and many others, people were trained to get the jabs and there was no supply. And after waiting for a long time, they didn’t get their shots. Now there are shots. But by then people have said, “Well, these things are not coming, and I’m going to go about my business.” So there’s a bit of apathy. There’s some hesitancy. You would really need to mount campaigns to get people to take these jabs. Why? Because the world is still at risk.

Q: What else do you expect to see in a broader trade and health package to respond to the pandemic? Do you expect members will pledge not to impose export restrictions during future pandemics?

A: There’s divergent views on that package. There are many who are prepared to do what you said and say, “Look, in a pandemic, we will not do that.” But there are other members who feel that this will tamper with their rights and obligations under the WTO, which says you can impose those things, but you have to be transparent, it has to be proportionate, transparent and temporary. So they still want to retain that ability within the WTO. They don’t want their rights and responsibilities tampered with.

Again, it sounds difficult, but already I can see how that would be a landing zone for those diverging views that would help with this.

Many things can be done to move products. We’ve been working a lot on supply chain. Working with manufacturers of vaccines, for instance, on helping monitor their supply chains, shortage of raw materials. And in doing that, we’ve encouraged them to decentralize production.

The last part is cooperation with other international organizations that we also want to see in the package. During this pandemic, WTO, WHO and WIPO have come together and we are preparing a platform so that whatever agreement we come with on intellectual property, we will actually have technical assistance to help countries implement or take advantage of that agreement.

Q: You mentioned tech transfer. What conversations are you and WTO having about tech transfer as it relates to vaccine production now and in a future pandemic?

A: WTO has been meeting with CEOs of vaccine manufacturers alone and having these conversations before we brought the other organizations in because we can jointly solve problems. These conversations are to encourage the manufacturers to indeed voluntarily transfer the technology because even if you get an IP waiver, or some compromise, it’s not sufficient if they do not actually walk you through the process of manufacturing [the vaccine]. They’ve shown greater willingness to do this.

Q: In thinking about the next pandemic, where is the global health community going to get the money to adequately prepare?

A: In my last speech to the G-20, a few days ago, I said to them, “This is not about developmental aid. It’s not about incrementalism. This is a massive political effort in which the political will to spend this money, which is peanuts, compared to what we spent already, that decision has to be taken politically.” I’m a former finance minister, I know budgets are stretched and it’s very difficult. But the leaders have to come together and say, “Listen, $75 billion, let’s compare [that] to what has been spent. This is really nothing.” You can even use innovative financing instruments … where you can leverage some money from the capital markets. There’s no lack of instruments and approaches. But where’s the political will?