Through his hallowed foundation, the world’s de facto public health czar has been a stalwart defender of monopoly medicine.
by Alexander Zaitchik
Part 6 - Gates has been tacitly and explicitly defending the legitimacy of
knowledge monopolies since his first Gerald Ford–era missives against
open-source software hobbyists
This winter, while Gates assured the world that intellectual property was a red herring, a bloc of developing countries at the WTO explained the need for a waiver on certain intellectual property provisions by pointing to the “rather large gap [that] exists between what COVAX or ACT-A can deliver and what is required in developing and least developed countries.”
The forceful statement continued:
The model of donation and philanthropic expediency cannot solve the fundamental disconnect between the monopolistic model it underwrites and the very real desire of developing and least developed countries to produce for themselves.… The artificial shortage of vaccines is primarily caused by the inappropriate use of intellectual property rights.
The model of donation and philanthropic expediency cannot solve the fundamental disconnect between the monopolistic model it underwrites and the very real desire of developing and least developed countries to produce for themselves.… The artificial shortage of vaccines is primarily caused by the inappropriate use of intellectual property rights.
Another statement by a different bloc of countries added, “COVID19 reveals the deep structural inequality in access to medicines globally, and a root cause is IP that sustains and dominates industry’s interests at the cost of lives.”
Gates is certain he knows better. But his failure to anticipate a crisis of supply, and his refusal to engage those who predicted it, have complicated the carefully maintained image of an all-knowing, saintly mega-philanthropist.
COVAX presents a high-stakes demonstration of Gates’s deepest ideological commitments, not just to intellectual property rights but also to the conflation of these rights with an imaginary free market in pharmaceuticals—an industry dominated by companies whose power derives from politically constructed and politically imposed monopolies. Gates has been tacitly and explicitly defending the legitimacy of knowledge monopolies since his first Gerald Ford–era missives against open-source software hobbyists.
He was on the side of these monopolies during the miserable depths of the 1990s African AIDS crisis. He’s still there today, defending the status quo and running effective interference for those profiting by the billions from their control of Covid-19 vaccines.
His latest move is to institutionalize the ACT-Accelerator as the central organizing institution in future pandemics. The shortages have made this effort a little awkward, however, and Gates is now forced to reckon with the question of technology transfer. This is an aspect of the equitable access debate that doesn’t concern intellectual property as commonly perceived—as a simple matter of patents and licenses—but access to the components and technical knowledge related to practical manufacture, including biological material and other areas otherwise protected under the category of intellectual property known as trade secrets.
The global south and civil society groups have been calling for tech transfer for months—either mandatory tech transfer that could have been written into contracts or through a voluntary mechanism associated with C-TAP—but Gates has predictably arrived on the scene with a more familiar plan in hand.
In early March, senior Gates staff joined pharma executives for a “Global C19 Vaccine Supply Chain and Manufacturing Summit” convened by Chatham House in London. The main agenda item: plans for a new arm within the ACT-Accelerator, the Covid Vaccine Capacity Connector, that seeks to address the tech-transfer question within the usual frame of monopoly rights and bilateral licensing.
“The tech transfer debate is being decisively seized and shaped by those who want to set the terms and conditions under which knowledge can be transferred,” writes Priti Patnaik in her Geneva Health Files newsletter. A Gates-directed tech-transfer mechanism without meaningful input from WHO members states, she writes, would be a “body blow” to C-TAP and similar future initiatives that promote open licensing and knowledge sharing to maximize production and access.
There are signs of overdue scrutiny of Gates’s role in public health and lifelong commitment to exclusive intellectual property rights. But so far these are blips. More common is the deference on display in a March 21 New York Times article about the U.S. government’s role in developing the mRNA vaccines now under the monopoly control of Moderna and Pfizer. When the piece turned to Gates’s inevitable cameo, the Times reporter was hovering right over the target—and somehow managed to miss wide by a mile. Instead of probing Gates’s central role in preserving this paradigm, the paper linked to gentle boilerplate about pricing and access found on the Gates Foundation website. In response to a request for comment, a Gates Foundation spokesperson pointed me to a piece by its CEO, Mark Suzman, arguing that “IP fundamentally underpins innovation, including the work that has helped create vaccines so quickly.”
Any change in media coverage of Gates’s second career may produce a delayed echo within the world he has come to dominate. Here Gates not only controls the narratives, he controls most of the payroll. This may sound conspiratorial or overblown to outsiders but not to campaigners who have witnessed Gates’s ability to shift gravity on major issues.
“If you said to an ordinary person, ‘We’re in a pandemic. Let’s figure out everyone who can make vaccines and give them everything they need to get online as fast as possible,’ it would be a no-brainer,” says James Love. “But Gates won’t go there. Neither will the people dependent on his funding. He has immense power. He can get you fired from a U.N. job. He knows that if you want to work in global public health, you’d better not make an enemy of the Gates Foundation by questioning its positions on I.P. and monopolies. And there are a lot of advantages to being on his team. It’s a sweet, comfortable ride for a lot of people.”
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