Ms Winnie Byanyima:

Yes. My name is Winnie Byanyima. I lead the United Nations joint programme on HIV-AIDS. It is called UNAIDS. I am grateful for this opportunity to address the Joint Committee on Foreign Affairs and Defence on the critical issue of Covid vaccine equity. I am also happy to let the committee know that I am the proud daughter of Irish missionary sisters of St. Francis.

In the early years of the AIDS response, millions of lives, as Dr. McMahon said, were needlessly lost because life-saving treatment remained out of reach for people in poor countries as people in rich countries benefited from antiretroviral treatment and went on to live long, healthy lives. In poor countries 9 million people died waiting for the prices to come down. It was a deeply painful lesson that many of us know very personally and one that the world, it seems, is having to learn again.

Ten months ago world leaders declared that any Covid-19 vaccine would be a global public good, a people's vaccine, but we now face a situation that the South African Government has called a new global apartheid. Nine in ten people in the poorest countries are set to go without a vaccine this year. A small group of rich countries representing just 14% of the global population have bought up most of the supply of the Covid vaccines that are available until the end of 2021. I am sure the committee is as shocked as I am that pharma companies are charging developing countries more than they are charging rich countries, in some cases more than double. My country, Uganda, will pay $7 per dose of the AstraZeneca vaccine and South Africa will pay just over $5 whereas the European Union will pay just over $2 per dose.

The problem is not only one of money or unfair allocation; it is also that not enough vaccines are being made. Even rich countries face challenges over production quantities in this year. What the European Union is experiencing now is deeply troubling, and we empathise. It is a taste of what Africa, Asia and Latin America have been experiencing. This is why approaching vaccination as a competitive race between countries and regions means that everyone loses out. What Europe thought was defending Europe was really defending the profits of the owners of big pharmaceutical companies. The vital decisions of production, supply and price and, therefore, who gets the vaccine and when have been left in the hands of big pharmaceutical companies. How is that right? Our best chance of all staying safe from Covid-19 is to have vaccines, tests and treatment available for all, for the whole world. As the Irish President, Michael Higgins, noted when he and I spoke on the same platform at the UN last year, "Unless such medical tools are fully accessible to all on an equitable basis, the world remains at risk." Right now, however, big pharma is protecting its monopolies, technology and intellectual property and thus restricting production. We know how to solve this problem: it is to open up production.

Maximising global production can happen only if all companies that can produce vaccines have access to the vaccine technology, know-how and intellectual property. Pharma companies will not share unless pressed to do so. Governments have that leverage and there is a mechanism to enable the sharing that Dr. McMahon described, namely, the WHO's C-TAP. It is a one-stop-shop for pooling all data, know-how, biological material and intellectual property and then licensing production and technology transfer to other potential producers. So far, pharma companies have not joined C-TAP and the proposal presented by the Governments of South Africa and India at the WTO's Agreement on Trade-Related Aspects of Intellectual Property Rights, TRIPS, council for a temporary waiver of certain TRIPS obligations has been blocked by the rich countries that host the pharma companies with a vaccine.

This is not only about access for the poor. The longer the virus is left to ravage developing countries, the longer people in rich countries will remain at risk. The virus is mutating, as Dr. Harkin stated. This threatens the efficacy of vaccines, as we have seen with the so-called South African variant. Yesterday, the South African Government had to postpone its roll-out of the AstraZeneca vaccine because, having bought millions of doses, it realised that the vaccine did not have efficacy against the variant. The slow pace of vaccination everywhere means that we risk seeing more dangerous variants developing. As Dr. Mike Ryan of the WHO, a wonderful Irishman, often remarks, no one is safe until everyone is safe.

The economic cost is also great. New research from the International Chamber of Commerce predicts that delays to vaccine access in poorer countries will cost the global economy an estimated $9 trillion, with nearly half of that being the cost to wealthy countries. These vaccines were developed with public money and these companies depend on government support. Whenever we raise the question of leverage over companies, though, we are told by rich countries' governments that there is COVAX. While support for COVAX is welcome, it cannot solve the supply problem on its own. Indeed, COVAX can only complement C-TAP.

We need to ensure that constraints on licensing and know-how no longer obstruct mass production of Covid vaccines. We must make companies take part in C-TAP. It is their governments that can make that happen. We also need to speed up agreement on a waiver at the WTO, especially if C-TAP does not work. I hope that the Irish Government will consider joining C-TAP. I join Dr. Harkin and Dr. McMahon in urging the committee's parliamentarians to ask their Government to do so.

Like AIDS, Covid is revealing the underlying fissures of inequality, how they hurt all of us and how outdated rules and approaches obstruct us from overcoming them. Fixing them is a policy choice. It is a moral, public health and economic imperative to ensure that everyone gets vaccinated in 2021 and that no one is left behind.

I thank the committee for the opportunity to speak.