A. Kayum Ahmed, Achal Prabhala, Julia Greenberg, Ames Dhai, and Usuf Chikte
Johnson & Johnson’s (J&J) decision to export COVID-19 vaccines manufactured in South Africa and India to Europe, ahead of supplying both countries or their respective continents, contradicts the company’s publicly declared commitment to widening access to health care and to human rights. Given that less than 2% of Africans and about 15% of Indians are fully vaccinated, compared to 63% of Europeans, J&J’s commitment to human rights is disingenuous.
The company’s website proclaims, “At Johnson & Johnson, we believe one of the most significant opportunities we have is to improve access to healthcare”. But its decision to prioritize the delivery of vaccines to a highly vaccinated continent over expanding access in India and on the African continent has little to do with increasing access to healthcare, and is a stark reminder of how short-term profiteering thwarts access to life-saving vaccines.
In 2021, J&J forecast $2.5 billion in COVID-19 vaccine sales. J&J is not alone in bolstering its bottom-line amidst millions of deaths and hundreds of millions of infections. Research by the People’s Vaccine Alliance shows that nine new pharma billionaires emerged as a result of vaccine sales with a combined wealth of $19.3 billion—enough money to fully vaccinate all people in low-income countries 1.3 times.
The desperate need for COVID-19 vaccines has bestowed big pharma with immense power, demonstrated in the vaccine manufacturing contract between J&J and South Africa. J&J prohibited the government of South Africa from imposing any export controls on vaccines manufactured in the country, threatening to restrict local supplies if the government did not comply. Following significant pressure from the South African government and civil society groups like the Health Justice Initiative, J&J backtracked, and now plans to return vaccine doses that were shipped to Europe but remain in warehouses.
J&J’s position on human rights draw on the Universal Declaration of Human Rights as well as the two International Covenants on civil and political, and socio-economic rights. But J&J’s avowed commitment to human rights, responsibility to communities, and desire to be “good citizens” as outlined in its “credo”, cannot easily be squared with its avaricious actions in South Africa and India. After scandals related to opioids and arsenic in talc powder, J&J needs to look deeply into its balancing of its responsibility to shareholders and communities and reexamine its credo.
What is remarkable about J&J’s behavior in response to COVID-19 is that its actions could be construed as prioritizing the right to health for Europeans over that of Africans or Indians. The only way to make sense of this disparity, is to conclude that J&J adopts a peculiar understanding of the “human” in human rights that privilege Europeans. By ignoring the need for access to vaccines by Africans and Indians until forced to acknowledge them, J&J is deliberately engineering vaccine apartheid while simultaneously laying the ground for the emergence of new coronavirus variants.
J&J’s actions in the pandemic are consistent with allegations made in a recent lawsuit claiming that the pharma company “specifically marketed its talcum-based baby powder to Black women, despite links to ovarian cancer.” J&J was found guilty and forced to pay $2.1 billion in damages because asbestos in its baby power caused women to develop cancer. In response to lawsuits related to the opioid epidemic, J&J, which was accused of downplaying the products’ addictive properties to doctors as well as patients, was a part of a $26 billion settlement to those harmed by the company’s actions.
What is needed is a “public option” model that has already been demonstrated to various degrees in countries like Sweden, Brazil, and Cuba, where state-owned pharmaceutical manufacturers are motivated by public health needs rather than CEO bonuses and shareholder profits. While the public options on offer are still evolving and require long-term investment, they offer a pathway to realizing the human right to health.
In the meantime, pharmaceutical companies must be compelled to give up their intellectual property (IP) over vaccine formulas and share their technologies so that manufacturers across the world can produce enough vaccine doses for everyone. The Trade-Related Aspects of Intellectual Property (TRIPS) waiver on COVID-19 vaccines, initiated by South Africa and India, is a helpful start, but there is more that is necessary: a transfer of vaccine technology, and help with overcoming short-term equipment and raw material shortages.
While both the long-term solution—a public pharmaceutical system—and the short-term solutions—the IP waiver and vaccine technology transfer—may seem difficult to achieve, the alternative is to place our lives in the hands of a company like J&J; a company that is “committed to respecting human rights” as long as they get to determine who qualifies as human.
A. Kayum Ahmed is Division Director at Open Society’s Public Health Program and Adjunct Assistant Professor at Columbia University’s School of Public Health, New York, USA.
Achal Prabhala is the coordinator of the AccessIBSA project, which campaigns for access to medicines, and a fellow of the Shuttleworth Foundation, in Bangalore, India.
Julia Greenberg is Director, Governance and Financing, Public Health Program at Open Society Foundations, USA.
Ames Dhai is Visiting Professor of Bioethics and Health Law at the Wits School of Clinical Medicine, Specialist Ethicist at the Office of the President and CEO of the South African Medical Research Council, South Africa.
Usuf Chikte is Emeritus Professor, Division of Health Systems and Public Health at Stellenbosch University, South Africa.