Restoring trust

Last week, Los Angeles hosted the Summit of the Americas amid a thorny period between the governments of the region. While long-running tensions over which countries were invited to attend risked overshadowing the event, the summit was a unique opportunity for Latin American leaders to come together and for President Joe Biden to mend relations with them.

The crisis induced by the Covid-19 pandemic has devastated Latin America. We as a region have not been able to measure, understand and prevent the loss of human life, but it is estimated that Latin America has one of the highest mortality rates in the world. By putting the impact of the pandemic front and centre our governments can exercise the leadership our citizens need today in a region that is already the most unequal in the world.

Comprised of mostly middle-income countries, Latin America’s governments have found themselves truly caught in the middle. They do not have resources comparable to those mobilised by wealthy countries in response to the pandemic. But neither can they benefit from international support programmes often targeted only at low and lower-middle-income countries.

As pharmaceutical companies have prioritised selling doses where they can secure the highest profits and without a shared approach to advance the interests of the region as a whole, accessing Covid-19 vaccines has been an uphill struggle for the continent. As a result, more than 200 million people remain unvaccinated across the region.

A combination of large urban populations, heavy chronic disease burden, weak health systems, and a seriously unequal global vaccine rollout has led some experts to warn that Latin America could be the most vulnerable region in the world to the emergence of a new variant. This is not just a Latin American problem, but a problem for everyone.

With nearly all Latin American governments supporting exemption from intellectual property rules on Covid-19 vaccines, tests and treatments; and considering that some countries in the region have the capacity to manufacture vaccines and modern treatments – US government support for easing patent protection for vaccines, antiviral treatments and life-saving tests could be a game-changer.

The delayed World Trade Organization (WTO) negotiations, currently bogged down with proposals that are actually worse than the status quo when it comes to access to medicine, have led countries to seek their own solutions. Countries like Brazil proposed a bill to bypass intellectual property rules, but those efforts too have stalled. Over two years since the appearance of the coronavirus, there is a fear of repeating the same mistakes of the past. We are not cooperating as a region; we are letting the profits of US companies take control.

The behaviour of US pharmaceutical giants has not earned goodwill in the region. Sweeping demands were made of governments and aid programmes in return for supplying desperately needed materials.

Now that lifesaving oral antiviral treatments for COVID-19 have been developed, the World Health Organization (WHO) has warned that the world is repeating the mistakes made in the first stages of the pandemic. Rich countries are quickly buying the world’s initial supply of these treatments, while low- and middle-income nations are unlikely to see any before 2023. Contracts remain shrouded in secrecy. Unicef allegedly had to agree to not disclose how much it had paid Pfizer to access doses of anti-viral treatment Paxlovid. And the company has been publicly condemned by the WHO for a “lack of transparency”.

After overwhelming pressure from global health activists, Pfizer and Merck have partnered with the Medicines Patent Pool to license their antiviral Covid-19 pills to lower-income countries. But the licences issued exclude nearly all of Latin America, as does Pfizer’s recent pledge to sell a slew of drugs at a ‘nonprofit’ price.