The COVAX Smokescreen: Charity in The Service of Pandemic Profiteering

The rich get vaccines, and the poor get empty promises. The world thus remains divided between the greed of a handful of billionaires and the urgent health needs of the billions: all the while a self-obsessed ruling-class engorge themselves at the expense of our futures. Ordinary people in their billions, are thereby forced to endure poverty and degradation, while philanthropists like Bill Gates shout out from the rooftops about their humanity while propping up a failing economic system that thrives upon inequality.

In the midst of this deadly pandemic, pharmaceutical corporations happily join with Gates in celebrating his tech-savvy saintliness, but for the majority of the world’s poor Gates (the mortal) is seen in a less flattering light. He is correctly seen as the embodiment of everything that is wrong with the world. He is the gentler side of capitalism personified. Gates doesn’t just take… he gives back too; if only to ensure that the global capitalist machine that he worships can keep ploughing our bodies into the earth to yield profits for the few.

Over recent decades Bill Gates has moved frictionlessly from the world of computers to that of global public health, and in doing so has reinvented himself as the architect of health interventions that, most of all, benefit the powerful. This, of course, is not how Gates likes to present his almsgiving to the public. But he, more than any other individual, has succeeded in bringing the principles of privatisation into the heart of global health systems; working to synchronise the goals of multi-lateral organisation like the World Health Organization with the needs of Big Pharma.

Now it is common-sense that with effective vaccines in existence, these should be made available to the entire world, not just to those people residing in the richest countries. But this solution remains but a utopian dream. This distribution problem therefore represents a serious concern for ordinary people, and it is one that Bill Gates is fully aware of; in fact, it is an issue that Gates himself never stops warming the world about. For instance, on March 31, 2021, he blogged that:

The more the virus that causes COVID-19 is out there in the world, the more opportunities it has to evolve—and to develop new ways of fighting our defenses against it. If we don’t get the vaccine out to every corner of the planet, we’ll have to live with the possibility that a much worse strain of the virus will emerge.”

He then referred his readers to his own preferred COVAX initiative which he boasted had “recently announced that it’ll be able to deliver 300 million doses by mid-2021” – doses that will go to some of the poorest countries in the world. But this effort, as nice sounding as it is, represents far too little far too late; and even the philanthropic king himself admitted that “the world is going to need a lot more if we’re going to truly stamp out the threat of COVID-19.” Moreover, considering that his COVAX facility still represents the main means of getting vaccines out to every corner of the planet, it is more than a little concerning that COVAX is totally incapable to doing its stated job. We should also remember that COVAX’s existence would not even be necessary if it were not for Bill Gates’ own early and ongoing efforts to oppose the waiving of patent rights on vaccines: an inhumane action which helps ensure that vaccines remain largely inaccessible and unaffordable to the world’s poor.

The roots of COVAX

Launched in June 2020, COVAX is the vaccine pillar of the “Access to COVID-19 Tools Accelerator” (ACT-Accelerator) which had been set up in April by Gates and his lackeys as a means of counteracting popular demands that any forthcoming vaccine roll-out should prioritise global public health instead of protecting patents and corporate profits. The launching of this initiative therefore quickly marginalised the World Health Organization’s own COVID-19 Technology Access Pool (C-TAP), a project which took a more progressive approach to the pandemic by calling for “the global community to voluntarily share knowledge, intellectual property and data necessary for COVID-19.”

As the influence of Gates’ billionaire lobbying had been central to the emergence of COVAX it is unsurprising that its day-to-day operations are currently being led by GaVi, the Vaccine Alliance, a well-known pro-corporate health initiative that was established by the Gates Foundation in 2000. The prioritising of markets and corporate profits (through the use of public-private partnerships) has always been central to Gates’ personal modus operandi, although you would be forgiven for missing this aspect of his so-called humanitarian work if you have ever read any of the propaganda about his do-gooding that saturates the mainstream media. Nevertheless, although studiously side-lined by Gates’ many powerful corporate-backed sycophants, the philanthropist’s many critics have always made their numerous and well-informed concerns with Gates’ charitable work crystal clear to all who were willing to listen. Writing just over a decade ago two such public health authors observed:

At the first GaVi-partners meeting, the head of SmithKline Biologicals outlined the conditions for industry participation. These included ‘a guarantee for ‘reasonable prices’, support for a credible and sustainable market, respect for international property rights, a tiered pricing system including safeguards against re-export of products back from developing countries to high-priced markets, and a prohibition on compulsory licensing.’ Each of these conditions prioritizes profits over children’s lives. Moreover, industry representatives opposed technology transfer arrangements, claiming that vaccines were too complex for public research institutes and local production in developing countries.”

These are very much the same priorities that have been enshrined within COVAX’s operations. Indeed, one of the novel financing method utilised for securing COVAX’s ambitions is based upon the International Finance Facility for Immunisation (IFFIm), a facility that was founded in 2006 to better inoculate GaVi’s global health decision-making from democratic oversight. As described on their web site:

“IFFIm receives long term, legally binding pledges from donor countries and, with the World Bank acting as Treasury Manager, turns these pledges into bonds. The money raised via Vaccine Bonds provides immediate funding for Gavi, the Vaccine Alliance.”

Critics of Gavi’s “vaccine bonds” however have demonstrated how the use of such bonds means that the setting of public health care priorities can now effectively “bypass national governmental control in recipient countries while simultaneously providing an ethical cover for business as usual by pharmaceutical companies”. And it this model of financing – overseen by GaVi — that was meant to help undergird COVAX’s so-called Advance Market Commitment (AMC), which as of April 7 had raised the hardly awe-inspiring sum of US$6.3 billion. (Presently the UK government remains one of the few countries making heavy use of COVAX’s IFFIm option and has made a US$675 million commitment for the period covering 2021 to 2025 but has only offered a direct payment to COVAX of US$61 million. Other large direct payments have come from the Gates Foundation which has chipped in US$156 million, with the biggest contributor being the United States, who had made a direct payment worth US$2.5 billion.)

In addition to utilising IFFIm, the COVAX AMC – as their own report (dated April 15) notes – “builds on the experience of the US $1.5 billion Pneumococcal Conjugate Vaccine (PCV) AMC launched in 2009” by Gavi. This earlier “model” AMC is not however without its own significant problems and last June the campaigning group Doctors Without Borders criticised the PCV’s supposedly successful use of AMC funding. They pointed out that:

While the funding was intended to help encourage competition to reduce the overall price of PCV, in reality the bulk of the money essentially served as a subsidy for Pfizer and GlaxoSmithKline (GSK), which until December 2019 were the only two manufacturers of PCV. Of the $1.5 billion, $1.238 billion (82%) was disbursed to Pfizer and GSK.”

Their report concluded that while the vaccination effort had some successes, often partial,…

“…the AMC mechanism in effect increased profits of multinational pharmaceutical corporations at rates higher than necessary to incentivize their involvement to achieve vaccine access in developing countries, while doing nothing meaningful to stimulate competition from developing-country vaccine manufacturers.”

COVAX inequality

On April 15, 2021, COVAX optimistically boasted that “around 1.8 billion doses of COVID-19 vaccines have been reserved, but not yet locked in, through the COVAX AMC from a range of manufacturers.” But these doses are for potential use into 2022, which means that even if all these doses do arrive at their planned destinations, then COVAX is still absolutely failing in its efforts to vaccinate the world. But of course, COVAX’s aims were far more limited in the short-term, as they are only attempting to vaccinate 2.5% of people in the poorest 92 AMC-eligible countries by the end of May – countries which have a combined population of nearly 4 billion people.

Of course, COVAX does plan to provide more than 2.5% coverage in later months and years, and pledge to vaccinate 20% of any given country’s population, but these conservative ambitions are nowhere near good enough to prevent the global spread of the pandemic in the here and now! Afterall what is the point of a handful of rich countries being able to vaccinate most of their own populations while the pandemic continues to ravage human life in the rest of world while undergoing dangerous potentially vaccine-resistant mutations?

Making matters worse, many of the COVAX vaccines that were planned to be distributed all over the world over the past few months were to be produced and shipped from India, but owing to the devastating nature of the pandemic surge in India, their government — which is COVAX’s main supplier – has taken the decision to block most vaccine exports. This means that COVAX is now only able to potentially “deliver 145 million doses instead of about 240 million” by the end of May (enough to vaccinate less than 2% of the populations of the poorest 92 countries). Furthermore, contrast the woefully insufficient 1.8 billion doses that COVAX has so far managed to reserve (but has not locked in) with the more than 500 million doses that were ordered by the UK government alone. Or consider the fact that richer countries are still able to purchase vaccines directly from COVAX stocks: the most recent example being the Venezuelan government which purchased around 11 million doses from COVAX for an initial outlay of US$64 million (with another US$60 million to be paid later).

Finally, it is important to contextualize the relatively small sums of money being ‘donated’ to COVAX and other critical global health initiatives by the most powerful countries in the world. For example, total annual funding for the World Health Organization runs at just over US$2 billion — representing “less than the budget of many major hospitals in the United States”. And while COVAX has received just over US$6 billion — with the largest chunk of funding coming from the US government (with another US$2 billion pledged) — it is informative to compare the scale of this funding to the recent increase in US military funding. Thus just before the pandemic broke President Trump announced a record-breaking annual request of US$740.5 billion for national security, which President Biden evidently deems insufficient as last month he requested a life-sapping US$753 billion (a 1.7% increase) to be spent on warmongering, and this is their military budget for just one year!

Releasing the patents

Socialists and critical public health experts have always opposed the use of market-based solutions to resolve pressing public health problems that are inflicted upon the world by the likes of Bill Gates and his friends in high places at the World Bank. But in mid-February even the president of the World Bank went on the record to express his concerns with COVAX’s severe limitations, stating the obvious fact that “manufacturers are reluctant to commit the doses to developing countries while they have the chance to sell it, or provide it, at a higher price to the advanced economies”. As if all this were not bad enough, around the same time Dr. Tedros Adhanom Ghebreyesus, the director general of the WHO, noted that their ACT-Accelerator (of which COVAX was just one part) was “still $19 billion short of the funds it needs to expand access not just to vaccines but also to diagnostics and treatments like oxygen.” Little wonder that the Lancet medical journal concluded that “COVAX is wholly unequipped to resolve many of the most pressing threats to its mission.” (Lancet editorial, March 13, 2021)

A rising tide of public anger at the major shortcomings of the global response to the pandemic, however, is now serving to push more critical arguments in the mainstream press. For example, last month Dr. Tedros finally felt pressurised to raise more far-reaching criticisms about COVAX in an opinion piece he wrote for the New York Times (April 22). First off, he pointed out the increasing disparity of health outcomes between rich and poorer nations highlighting how:

[O]f the more than 890 million vaccine doses that have been administered globally, more than 81 percent have been given in high- and upper-middle-income countries. Low-income countries have received just 0.3 percent.”

The WHO head had seemingly reached the end of his tether and he emphasized that COVAX had so far proved “totally insufficient” having only “distributed 43 million doses of vaccine to 119 countries — covering just 0.5 percent of their combined population of more than four billion.” Dr. Tedros went on to point out how “many of the world’s biggest economies” currently funding the COVAX initiative had simultaneously “undermined it” with “a handful of rich countries gobbling up the anticipated supply as manufacturers sell to the highest bidder”. Likewise, he added, “vaccine diplomacy has undermined Covax as countries with vaccines make bilateral donations for reasons that have more to do with geopolitical goals than public health.” It is for such reasons that Dr. Tedros asked medical companies if they could now step up and support the COVID-19 Technology Access Pool — the WHO’s more progressive alternative to Gates’ ACT-Accelerator. Yet perhaps the most significant solution proposed by Dr. Tedros to redress the ongoing problems caused by COVID-profiteering was “to waive intellectual property rights on Covid-19 products” – something that was argued for last October at the World Trade Organization (WTO) by the governments of South Africa and India amongst others.

Similar demands for opening access to vaccine patents have been repeatedly made by health experts throughout the pandemic. A recent article published by four influencial health commentators made the obvious point that for “low-income countries, COVAX is a vaccine lifeline when the prices of bilateral agreements become too high.” They then went on to highlight how the limited resources devoted to COVAX by high-income countries means that vaccine hoarding countries can falsely emphasize to the world how caring they are while still relying on COVAX supplies as “an insurance mechanism should their bilaterally-agreed supplies fall short.” Little wonder that the writers concluded that “COVAX is serving as a smokescreen to cover up vaccine nationalism.” They continued:

“The cost of medicines is seen as the root problem of access to vaccines and technology. Hence the campaign for a temporary suspension (waiver) of intellectual property rights protected under the Trade Related Intellectual Property Rights (TRIPs) agreement of the WTO for all medical products required to fight the pandemic.

“South Africa and India put forward a proposal for a vaccine waiver supported by developing countries and civil society campaigns. However this was blocked by the EU, US, UK, and Switzerland among other high-income states.”

This deadly blockage on the production of the necessary vaccines — which can help alleviate the spread of the pandemic — serves to endanger us all, but particularly those in the world’s poorest countries. This is why it is necessary for trade unions and community groups in high-income states to demand that their governments place the need of humanity before protecting the needs of corporate profiteers. An example of such effective organising can be seen though the recent activism of Socialist Alternative councilmember Kshama Sawant. By working alongside various trade unionists and civic groups Sawant managed to force Seattle City Council to pass a resolution (on April 26) calling on President Biden to end his government’s opposition to the international campaign for an Intellectual Property Rights waiver from the WTO for COVID-19 vaccines. On the day this resolution was passed, Councilmember Sawant said:

I congratulate our movement on winning today’s City Council resolution, urging the Biden administration to put human lives before billionaire profit, and remove the WTO patent restrictions to allow all billions of people to have access to the life-saving vaccine. This resolution demonstrates our movement’s rejection of the status quo of profit-driven vaccine apartheid and vaccine nationalism, and our fight for vaccine internationalism, for a People’s Vaccine!…

“Billionaires are lying when they claim that these profits are necessary to develop future vaccines and treatments, because clinical innovations have been possible only thanks to overwhelming amounts of public funding, and the hard work of many publicly-funded salaried researchers, not by billionaires.”

But passing resolutions is not enough to force the hands of the billionaire-class, which is why Sawant continues to organise on the streets to build the type of socialist mass movement that can wrest a People’s Vaccine from the capitalist class. On May Day this saw Sawant and her supporters take their protest to the offices of the Bill and Melinda Gates Foundation in Seattle where they demanded that Biden and Gates immediately act to remove patent restrictions to allow the production of generic versions of all lifesaving COVID-19 devices.

Bill Gates and the question of public funding

The focus on Bill Gates’ unique role in blocking solutions to the COVID nightmare enveloping the planet is worth reflecting upon here for two reasons: firstly because of his widely publicised defence of the indefensible, that is the protection of patents for COVID vaccines; but also because of his role in ensuring that one of the first vaccines that made it to market remained accessible only to those with the requisite buying power. The vaccine in question is now widely referred to as the Oxford-AstraZeneca vaccine, but we should recall that when it first successfully developed by researchers at Oxford University in April 2020, the researchers involved in its discovery had promised that the rights for producing their vaccine would be made freely available to all drug manufacturers. This after all was a vaccine that was developed, like most vaccines, as a direct result of public sector funding – with less than 2% of the identified funding for the development of the Oxford vaccine derived from private industry. But Gates knew better than to allow a vaccine to be used to help the world, and with a little persuading a “few weeks later, Oxford—urged on by the Bill & Melinda Gates Foundation—reversed course. It signed an exclusive vaccine deal with AstraZeneca that gave the pharmaceutical giant sole rights and no guarantee of low prices”.

AstraZeneca subsequently arrived at a rare compromise with the rest of the world when they promised that, in the short-term, the corporation would not turn a profit from its COVID-19 vaccine. But it turns out that there remains an important clause in this agreement, which determined that as soon as the corporation believes the pandemic is over, then their profiteering can begin. Other problems similarly reside in the small print, as prices paid for the Oxford- AstraZeneca vaccine vary considerably. Such discriminatory variations, as one might expect, caused some controversy in South Africa – one of the countries where the Oxford-AstraZeneca was trialled on humans – who found out that they were sold the vaccine at nearly 2.5 times the cost it was sold to the European Union (with the EU paying less for the vaccine that the UK government – costs per dose were US$2.15 for the EU, US$3 for the UK, and US$5.25 for South Africa).

Global solidarity?

As this pandemic has starkly illustrated, we are struck in the tragic position where the most powerful countries in the world are refusing to take the necessary actions to help prevent the spread of the pandemic. It seems that the only time that such capitalist powerbrokers ever act with any urgency is when they feel they can turn a profit, either for their country or for their billionaire friends.

So, with good knowledge of the funding problems that laid ahead, in March 2020 the World Health Organization created the first means by which members of the global public could contribute towards their COVID-19 Solidarity Response Fund. Yet as is so often the case, in reality it seems that the main target donors for this so-called solidarity fund were members of the billionaire-class seeking to garner some cheap publicity. I say this because by the end of last year the WHO had observed that “more than 650,000 leading companies, organizations and individuals [had] committed over US$239.2 million” to the Fund – which works out to be an average rate of funding of US$370 per donor… hardly much of a sacrifice for the world’s leading companies. Individual donors are not listed on the Fund’s web site, but corporate donors who are prominently advertised include the likes of Facebook, Google, GlaxoSmithKline, Johnson & Johnson, Morgan Stanley, and Walmart. However, as if this poor show of international solidarity were not bad enough it seems that the rate of support for this Fund had slowed considerably, and a further 19,000 donations had only garnered another U$8 million from the global ruling-class. Compare this paltry sum to the trillions of dollars that the super-rich have amassed in savings during this pandemic. Or contrast this lacklustre display of corporate aid with the generosity of ordinary members of the public: where, in the UK alone, the public donated £5.4 billion to charitable causes between January and June 2020 (equivalent to just short of US$7.5 billion).

Perhaps partly born out of frustration with the dangerously slow pace of global vaccinations, in February 2021 the “co-creator of the Oxford University/AstraZeneca jab” Professor Sarah Gilbert lent her name to support a new funding initiative called “Arm in arm” which sought to collect donations from the public to help pay for the costs of vaccinating the rest of the world. Although the money generated through this program is again being channelled to the WHO’s COVID-19 Solidarity Response Fund, the difference between this initiative and the official WHO fundraising project is that the Arm in arm project has used their social media channel to raise important criticisms of the pro-corporate narrative being pushed by the likes of Bill Gates. Thus one of Arm in arm’s first tweets highlighted the results of a public survey that highlighted how the majority of British people believed “the UK government should press pharmaceutical companies to share their Covid vaccine formula to allow doses to be rolled out faster.” More recently still, on May 1, Arm in arm tweeted an article that outlined the devastating impact that Tory cuts to foreign aid budgets would have for an ongoing academic study being undertaken in collaboration with the University of Oxford that was concerned with developing “vital coronavirus research, including a project tracking variants in India”. On the same day the fund-raising initiative also retweeted a post calling for Big Pharma to waive vaccine patents – providing a link to an article that lambasted Bill Gates for promoting the lie that it would be impossible to scale up vaccine production if patents on vaccines were ever relaxed.

In contrast to adopting such a critical position on the issue of drug patents, the same questioning attitude is never likely to be vocalised by the WHO Foundation, a new philanthropic body that was formed in May 2020. The creation of this foundation is not a good omen, and in many ways only serves to reflect the increasing influence that the Gates Foundation has exerted over the recent evolution of the WHO and the corporatisation of global health care provision. In explaining why this new philanthropy was established the WHO Foundation pointed out that its formation owed much to the fact that the WHO itself “is not set up to approach individual or corporate donors.” As they went on to note:

“For example, High Net Worth Individuals (HNWIs) look for a personalized process in which they can invest and engage, and the WHO Foundation can provide that. Furthermore, the WHO Foundation, as an independent entity, can offer tax incentives to donors.”

In December the WHO Foundation subsequently announced that their inaugural CEO would be Anil Soni, an elite powerbroker who was recruited directly from the ranks of Big Pharma – with Soni having the added ‘benefit’ of being a former senior advisor to the Gates Foundation. And while High Net Worth Individuals seem to remain the WHO Foundation’s primary target audience, last week (on April 28) the WHO Foundation launched a new project called “Go Give One” to fund the work of COVAX. In many ways this new initiative duplicates the work being undertaken by Arm in arm, however, the primary difference between the two fund-raising initiatives is that the WHO Foundation’s messaging is unlikely to stray from neoliberal narratives that promote only personalised cross-class solutions to the deep-rooted problems that are caused by capitalist greed.

Real solutions

In February 2021, the South African delegation to the World Trade Organisation reaffirmed what most ordinary people of the world already know, that the pandemic represented a huge threat to us all and that COVAX was not a solution that was able to remedy this global problem. The South African representative observed that “the model of donation and philanthropic expediency cannot solve the fundamental disconnect between the monopolistic model it underwrites and the very real desire of developing and least developed countries to produce for themselves.” Simply put, they said, the “problem with philanthropy is that it cannot buy equality.” That is right, but to get to the real root of the issue we really need to see the underlying problem as capitalism itself. Philanthropy is after all just one tool among many that the billionaire-class relies upon to prop up a political and economic system that is premised upon inequality. This is why nice-sounding platitudes about Bill Gates (and other capitalists) wanting to help the poor need to be perpetually rammed down our throats by the mainstream media. But in peering beneath all the billionaire-classes harmonious mantras, philanthropic investments are continuing to play a critical role in sustaining a crumbling status quo that is premised upon exploitation. In this way we can see how…

COVAX presents a high-stakes demonstration of Gates’s deepest ideological commitments, not just to intellectual property rights but also to the conflation of these rights with an imaginary free market in pharmaceuticals—an industry dominated by companies whose power derives from politically constructed and politically imposed monopolies. Gates has been tacitly and explicitly defending the legitimacy of knowledge monopolies since his first Gerald Ford–era missives against open-source software hobbyists. He was on the side of these monopolies during the miserable depths of the 1990s African AIDS crisis. He’s still there today, defending the status quo and running effective interference for those profiting by the billions from their control of Covid-19 vaccines.”

Owing to Gates’ ongoing ability to reap immense profits from the current system – with his personal wealth actually increasing during the pandemic – his ability to interfere in global politics knows few boundaries and is certainly not limited to facilitating private profiteering from public health. Thus, Gates is also at the forefront of pushing false solutions to the ongoing climate disaster facing our planet, and earlier this year he even found the time to publish a book titled How to Avoid a Climate Disaster: The Solutions We Have and the Breakthroughs We Need. Herein Gates makes a number of “depressingly familiar” proposals for how to prevent the unfolding climate disaster, none of which include the urgent need to transition away from capitalism towards a socialist alternative. His rhetoric, even if it is not intended to, does however give some indications of the direction of travel that is necessary to embark upon if we are to generate real solutions to both the climate and COVID crises.

Gates is right that “Every country will need to change its ways.” And it is true, as he asserts in his book, that “It would be immoral and impractical to try to stop people who are lower down on the economic ladder from climbing up.” This is precisely why socialists continue to campaign for the ending of a global economic system that prioritizes profit before human life – a system that deliberately divides the world between the haves and the have-nots, and between two classes, the ruling-class and the working-classes. And in terms of the serious environmental problems facing our planet, Gates is correct in stating:

“[T]his isn’t primarily a technological problem. It’s a political and economic problem. People cut down trees not because people are evil; they do it when the incentives to cut down trees are stronger than the incentives to leave them alone.”

Such incentives are of course driven by capitalisms life-degrading priorities. And, yes, there is a very urgent need for ordinary people to deal with the very real political and economic problem that enables the ruling-class to direct and profit from the daily grind and impoverishment of the rest of us.

Finally, Gates is right that the primary answer to the ongoing oppression of our class and the destruction of our planet revolves around ordinary people taking “concerted political action”. As he puts it:

“It’s easy to feel powerless in the face of a problem as big as climate change. But you’re not powerless. And you don’t have to be a politician or a philanthropist to make a difference. You have influence…”

But while Gates emphasizes the role of individuals as political actors who content themselves with working strictly within the strict limits of a capitalist system, increasing numbers of people are coming to the important realisation that the working-class will always feel powerless so long as capitalism exists.

So, if we are serious about creating the type of democratic and socialist society that works to benefit the many not just the few, billions of people will need to take “concerted political action” — whether this be through protests on the streets or by linking up to organize powerful general strikes. Only then, when we take such powerful militant actions, will we be able to begin the process of transforming society so that human priorities are able to inform our politics and economics. As ultimately it will be through this process of struggle, a fight that needs to be waged worldwide in a climate of genuine solidarity, that the working-class will be able to prevent the impending climate catastrophe and safeguard our collective futures against this pandemic and any other future health disasters.

Michael Barker is the author of the 2017 book Under the Mask of Philanthropy.

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