Philanthropy has an unprecedented opportunity to build a fair global health system – and to immunize the world
In my nearly two decades in public health, I have never seen a time richer in opportunities to fundamentally rebuild our global health system. The recent astonishing announcement that the Biden administration renounce the intellectual–property rights for the Covid-19 vaccine marked a radical change in the fight for a more equitable and just approach to global health.
It also marked a unique opportunity for philanthropy to participate in reshaping the global healthcare system into one that recognizes that none of us are safe and healthy until we are all safe. and in good health.
The need for such a change couldn’t be clearer. As Americans get vaccinated and the country begins to reopen, much of the world is experiencing one of the most devastating outbreaks still from the pandemic. Just last week 41,000 people have died in India and Brazil alone. For me, it’s personal. I have already lost several of my family in India to Covid-19, and more and more of my relatives in India are battling the virus right now.
Vaccines and other life-saving medical products do not reach the vast majority of people on the planet. This is the quite predictable consequence of a monopoly research and development system, in which companies use the intellectual property system to control the market, leaving the power to shape the response to the pandemic in the hands of a few private actors.
Ensuring equitable access to the vaccine should have been built into every step of the process from the start. Imagine how many lives could have been saved if government and philanthropic investments in vaccine development had been matched with investments to ensure accessibility of vaccines to all corners of the world.
Rather than continuing to support an elitist global health system based on a legacy of structural racism, philanthropy must focus its attention and investment on movements around the world that will ensure that the Biden administration’s waiver of intellectual property quickly translates into greater vaccine availability, while creating lifesaving structural changes. lives now and during future pandemics.
The organization that I co-founded, the Medicines, Access and Knowledge Initiative, has been fighting for years for global equity in access to medicines. We know that creating a global health system that works for all must redress the power imbalance between those who influence policy decisions and those most affected by them.
Our movement has the expertise, the leadership and the plan. What we lack is fuel.
To transform our global health care system, we need philanthropy to invest in advocacy, education and movement building in much greater ways than it has so far. For those funders engaged in the much-needed conversation about decolonizing philanthropy, I challenge you to put your money where your mouth is.
Invest in diverse leaders. The current system is literally killing the unprivileged, the vast majority of whom are people of color. In the United States, Native Americans and black Americans faced the highest death toll from Covid-19. The same is true around the world, where predominantly non-white populations suffer the most. For too long we have allowed philanthropists like Bill Gates to shape the response to global healthcare with the same monopoly model that built its corporate profits. This approach is lacking and must be rejected if we are to ever achieve true equity in global health.
Instead of leaving decisions about health and equity to wealthy business leaders, foundations should diversify their funding approach to include those with direct experience in the communities most affected. They can begin by providing general, multi-year operational support to organizations striving to replace the current monopoly system with one focused on providing global access to medicines and vaccines.
This includes groups such as student-led groups Allied universities for essential drugs, who successfully advocated for more than 30 medical research institutes to change their patent and licensing policies, leading to improved global access to medicines. Through his Covid-19 #free vaccine campaign, the organization is developing a pipeline of young black and brown public health leaders who are fighting for equitable access to vaccines. The organization’s alumni include a renowned activist Ady barkan and many others who have become leaders in public health.
Allied Universities for Essential Medicines are part of a larger movement that keeps pressure on the Biden administration and governments of other countries to quickly agree on the terms of the World Health Organization’s waiver of intellectual property for Covid-19 medical products and to accelerate sharing of knowledge and critical resources increase the supply and availability of vaccines. The movement is also pushing for policies that would fundamentally change the rules of the game – for example, ensuring that federally funded research and development, like the $ 2.5 billion in taxpayer dollars who funded the Moderna vaccine, are generally shared, no exception.
Let go of a nationalist approach to solving world problems. There will be no systemic change if American philanthropy, which holds the overwhelming mass of charitable assets globally, dictates to the rest of the world a top-down, primarily American view of public health – or hardly engages in international grantmaking.
The Covid-19 has shown us how artificial our borders are, especially when it comes to the spread of a deadly virus. Yet organizations based in the United States have received a 56 percent of the nearly $ 24 billion in global philanthropic grants to date, even though the United States is only 19% of Covid-19 cases and 17% of deaths. It is both unfair and short-sighted. Much of the world will not have access to vaccines until 2023. Waiting, the variants will continue to emerge and move towards America, posing a permanent threat even to countries whose populations are vaccinated.
American philanthropy can help by supporting nonprofits around the world that meet the immediate needs of hard-hit communities. For example, the Health justice initiative, which was founded during the pandemic by South African activist lawyer Fatima Hassan, has successfully used that country’s courts to create greater transparency and accountability for government and business in accessing the Covid-19 vaccine . Currently, the group is using legal and advocacy strategies to regulate the prices of coronavirus treatments.
Human rights lawyers like Hassan could turn the tide of the pandemic around the world by deploying legal tools to tackle human rights violations resulting from inequitable access to vaccines, while pushing for structural reforms that would improve the response to future pandemics.
Invest in radical change to democratize global health. To ensure fairness, we must repair an entire global system that allows private interests to make decisions about health.
We must democratize, localize and decentralize each step of the process – from drug development to distribution. My organization has built a participatory model to facilitate this structural change, starting this year with a focus on the patent and intellectual property system. We will bring together an interdisciplinary group, including members of affected communities, scientists, investors in pharmaceutical companies, policymakers, journalists, patent lawyers, movement leaders and patients. Through this process, we will develop a better understanding among people with different perspectives on the role of patents in society, ultimately creating a reform plan that has the perspective of affected communities at its center.
This is an unprecedented moment of opportunity in the global health movement, and philanthropy can play a vital role in making it happen. It is time for donors to reject the status quo that has failed for too long and help us replace it with a system that recognizes our obligation to provide every human being with the medical treatments and vaccines we all need and deserve.