In September 2021, Germans will vote for a new government – and a new Chancellor after nearly 16 years of being led by Angela Merkel. Merkel, who has been a strong global health proponent, investing in multilateral health and taking a strong stance on tackling the Ebola epidemics, is faltering on the global Covid19 pandemic. What needs to change and what does Chancellor Merkel need to do immediately, so that Germany does justice to the call to take a stronger global health leadership role – and does not become a new veto player?
In 2020, Germany took a clear and strong position in tackling the Covid19 pandemic. It quickly followed WHO guidance on testing, tracing, distancing and hygiene measures, as well as masking and lockdowns. It called for and supported a strong role for WHO as the global coordinating body. It emphasised the key roles that CEPI and Gavi, the vaccine alliance, could play in incentivising and distributing vaccines.
Political hesitancy kicks in
But as funding calls by these multilaterals (and the partnership formed around them specifically for Covid19 vaccines, COVAX) grew louder, Germany hesitated. The main reason was that Germany itself was bypassing COVAX, pre-purchasing vaccines directly from pharmaceutical companies.
With regional elections, and an upcoming federal election, politicians were adamant that vaccines needed to reach (potential) voters first.
Funds, slowly, and a few doses
Only in May 2021 did Germany significantly stock up funding for global vaccine purchases, pledging a total of €1.08 billion, and by June 2021 pledging to share 30 million vaccine doses from its own stockpiles. At this point, 50% of the German population had received a first vaccine dose and prioritisation had been removed.
Already in early 2021, however, it had become clear that funding was not the main bottle neck to global vaccine distribution. Instead, any additional production was immediately being bought up by rich countries through bilateral deals – and vaccines that had been planned for low-income countries through COVAX were kept back in their production location, as the Indian crisis spiralled out of control.
COVAX is now sitting on funds, but is still unable to get access to sufficient amounts of vaccine doses.
Germany, the veto player
In May, experts such as those from the Independent Panel for pandemics issued a call for rich countries to immediately donate vaccines, or to begin negotiations at WTO to adopt a patent waiver. Such a waiver would allow production, sales, pricing, and donations to be less dependent on just a few pharmaceutical companies and production facilities.
Germany, however, has been adamant in its stance blocking a Trips waiver, arguing that the quality of and incentives for vaccines can only be protected through patents. The European Commission (led by a German national close to Merkel, Ursula von der Leyen) has toed this line, despite support for the Trips waiver by the European parliament, large member states such as France, and the majority of citizens in the EU.
Germany has, in effect, become a veto player on Covid19 vaccines for low-income countries.
BioNTech and Curevac
Tied to the German federal election calculations are the close ties of Merkel’s party, the Christian Democrats (CDU), to business, and in particular pharmaceutical companies and lobbyists.
Initially, two vaccine producers were located and producing in Germany: BioNTech (in partnership with Pfizer) and Curevac. Curevac’s efficacy recently put its production on hold (and large production facilities for mrna vaccines remain at standstill, instead of being operated by other pharmaceuticals – the vaccines of which could be directly donated to COVAX).
BioNTech, which has a direct line to the Chancellery, appears to be following the position of Pfizer, whose “Chief Executive Officer Albert Bourla bets Covid-19 will become endemic, requiring people to get regular shots for years to come.” Those shots will go to countries that pay more – not to COVAX which has negotiated not-for-profit prices for doses.
Ending the global pandemic and putting a stop to new variants would be bad for business, so the thinking at pharmaceutical companies.
The UK’s Prime Minister Johnson today on 5 July stated that “we must learn to live with Covid19”, while ending masking and distancing regulations in the UK, despite a rise in Delta and Delta Plus variants in the UK (and a double vaccination rate of 50.4%, leaving half of the population at high risk).
Germany has not yet been considering such (frankly, irrational and dangerous) measures, but with its current position on global vaccine coverage, it is de facto also accepting that Covid19 will be here to stay.
German citizens, too, will require more vaccinations – possibly boosters, and at current rates increasingly likely also adapted or new vaccines as ever more variants arise.
The main beneficiary of this current situation is becoming increasingly clear: pharmaceutical companies and their profits.
The main losers are low-income countries, such as those in sub-Saharan Africa, which are unlikely to see any vaccines at scale any time soon – or perhaps ever.
What must change?
It is highly unlikely that G7 countries will begin donating vaccines at scale any time soon, as boosters and variants continue to dominate discussions. G20 members will also continue to primarily produce vaccines for themselves, unless COVAX is able to secure large vaccine deals directly with China or Russia.
Germany could, however, become a game changer for global Covid19 vaccines if:
- Chancellor Merkel on 15 July in Washington DC together with President Biden announces that Curevac’s facilities will be used to produce vaccines for donation to COVAX only, using mrna pharmaceuticals such as BioNTech/Pfizer (together with Amsterdam’s production plant, this could result in more than 600 million vaccines, possibly a billion, by 2022);
- Germany’s BioNTech together with Pfizer supports the African tech transfer hub launched by WHO, South Africa, and France in June 2021, bringing production capacity to scale, and commencing a transfer of technology and know-how;
- Germany drops its veto of and in Trips waiver negotiations, allowing for an opening of production capacity to fully meet global vaccine demand; and
- Germany places ending Covid19 globally front and centre of its 2022 G7 Presidency, with a focus on collective, concrete and rapid action and accountability (not lofty principles and empty words).
The world does not need to learn to live with Covid19 as a global pandemic. Germany and Chancellor Merkel must decide whether to continue in its role as veto player, or take on a leadership role as game changer.