14 April 2021

Speaker: Charles Gore

Throughout this pandemic, we have seen the same challenges unfolding health technology after health technology (personal protective equipment (PPE), then diagnostics, then vaccines). As soon as a technology proves to be effective, demand increases substantially, supply is unable to meet demand, equity issues arise, with low- and middle-income countries (LMICs) often losing out, and manufacturing countries placing constraints on exports. Part of it seems inevitable. It is hard to predict what will work, what is needed. Once a technology is known to work, we need very large quantities, almost immediately.

There is clearly no magic bullet against that. Supply cannot be provided overnight for any technology. Not even for masks, let alone for far more complicated vaccines. Nevertheless, there are ways to try and address the current crisis. Significant efforts have clearly been made, with an unprecedented number of agreements between companies to try to increase manufacturing capacity. Massive investments have been made at risk by companies, as well as by governments. Repeatedly, the concept of broad licensing has been proposed as a way to expand supply, make use of existing manufacturing capacity across the globe and enable a more geographically diverse supply base.

The importance of public health licensing has also repeatedly been flagged, by which I mean licensing that is developed with a clear objective to meet public health goals. Public health licensing, together with appropriate technology transfer, as practised by the Medicines Patent Pool over the past 11 years, is about seeking the right – and often difficult – balance between the legitimate commercial interests of innovators, the need for sustainability for the recipients of licences and the critical public health needs of society. And we can achieve this balance because we are a public health institution that is not commercially driven but which fully understands commercial realities. The result has been that these licences do indeed address public health needs.

I would like to highlight some of the guiding principles under which we operate, MPP’s licences need to be:

• driven by the public health requirement for affordable, high-quality health technologies;
• focused on accelerating access by enhancing manufacturing capacity that is specifically geared towards addressing the needs of the most vulnerable, those that often otherwise lose out;
• non-exclusive, facilitating price reductions through competition and making use of the wide geographical footprint of suppliers around the world to ensure supply security and local production;
• transparent, as that is critical to achieving trust;
• flexible to adapt to the specific needs and circumstances;
• additional and complementary to other access approaches; and
• voluntary, counting on the commitment of all parties.

It is not just a theoretical construct. This approach is currently in use in global health and has succeeded in delivering over 18 billion pills in over 140 countries. I will end by saying that the Medicines Patent Pool believes its public health licensing model can be part of the solution and will therefore continue to put its expertise and experience in this area at the disposal of the international community.