Category: Healthcare Politics and Regulations

Vaccine Patent Waivers are No Silver Bullet, Experts Argue

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Rather than a World Trade Organization (WTO) patent waiver, COVID vaccine equity requires improvements to manufacturing and distribution of vaccines in the Global South and compulsory licensing mechanisms, according to a statement by ALLEA, the European Federation of Academies of Sciences and Humanities. 

They state that the low level of COVID vaccination in the Global South is ethically unacceptable and risks prolonging the pandemic. At the end of 2021, access to Covid-19 vaccines is still a priority. Only 5.9 % of people in low-income countries have received at least one dose (on 29 November 2021, compared with 0.3% on 14 April), with numbers in Africa remaining very low, save for Morocco. The patent waiver being discussed within the WTO since 2020 will not solve these vaccination bottlenecks in the short-term. For instance, the waiver as proposed by South Africa and India would in practice require unanimity between the 164 WTO Members to be adopted – to achieve this in practice would simply delay the waiver until after the pandemic.

Rather, measures should be undertaken to accelerate local manufacturing and distribution of vaccines in low- and middle-income countries (LMICs), ramp up investment in vaccination campaigns, and facilitate the compulsory licensing of patents and knowledge transfer.

In particular, the statement advocates for (i) practical measures that could accelerate the production, export, distribution, and administration of vaccines worldwide and ii) an international mechanism affording additional scrutiny of the manufacturing bottlenecks combined with new measures in the intellectual property (IP) framework such as flexibility for the compulsory licensing of patents.

According to the experts, the current co-sponsored waiver proposal at the WTO is “not well-tailored to the urgent vaccine problem” and needs additional national legislation to have any practical effect. A WTO waiver would only remove the obligation for WTO Member States to grant IP protection, but would not ensure that stakeholders can effectively benefit from the invention and related know-how.

“A waiver (in the sense of the co-sponsored proposal at the WTO) of IP protection, including of trade secrets, would never make this know how publicly accessible, but only remove the possibility for companies enjoying confidentiality protection to sue for trade secret infringement”, the experts argued.

Other IPR measures need to be considered instead, with the WTO waiver debate raising other IP fixes that are needed in the field of health. The WTO rules on compulsory licensing of health-related patents should be amended. Important adjustments to patents and trade secret protections should also be adopted by the EU, its Member States, and other countries. In particular, improved procedures and institutional design should help to streamline the process for compulsory licensing on pharmaceutical products, including vaccines.

Source: ALLEA

A Trend of Amalgamations is Underway for Medical Schemes

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A trend of amalgamations is underway in the South African private healthcare industry, in the face of growing challenges and the impending introduction of National Health Insurance (NHI).

Escalating healthcare inflation and costs, a declining and ageing membership, the impact of the COVID pandemic and a growing burden of disease are all impacting the not-for-profit Medical Scheme industry, which is highly regulated.

Medical scheme consolidation is one of the prominent trends, particularly given the prospect of NHI on the horizon, where smaller schemes will not compete, said Lee Callakoppen, principal officer of Bonitas Medical Fund.

The Council for Medical Schemes (CMS) advises that schemes that cannot compete sustainably on price should consider amalgamation partners, Callakoppen said.

“The trend towards amalgamations is not only for the sustainability of the medical scheme but for the benefit of members who ‘own’ the fund’.

“It is not only the call from CMS for schemes to join forces but also strict regulations around minimum solvency ratios and reserves which are more difficult for smaller schemes to maintain.”

It is a requirement of the Medical Schemes Act that medical schemes shall at all times maintain their business in a financially sound condition. They need to have sufficient assets for conducting business, providing for liabilities and having the prescribed solvency requirements of 25%, said Callakoppen.

“It’s a big ask for small schemes in this volatile and uncertain healthcare market,” he said.

A trend of amalgamation for small schemesThe CMS provides regulatory supervision of more than 80 medical schemes registered in the country and oversees amalgamation prospects.

One proviso for amalgamation is that schemes should complement each other and provide a more comprehensive offering to members.

“One clear indicator of risk is the size of the pool of lives being covered,” said Callakoppen. “Schemes with smaller risk pools are struggling to survive and experience more volatile claims”.

“Amalgamation into a bigger scheme means cross-subsidisation of costs. It is a trend I believe will continue, if not accelerate. In fact, in the past decade, we have seen 28 amalgamations approved by the CMS and the Competition Commission.”

The NHI has been criticised for potentially stifling innovation in healthcare, as well as not actually being able to fix the country’s flawed and unequal healthcare system.

Source: BusinessTech

Meet the Two Women in the Running for SA’s Top Medical Job

Photo by Markus Winkler on Unsplash

Health Minister Dr Zweli Mkhize is in hot water over alleged procurement fraud for a R150 million COVID contract, and is widely expected to step down shortly.

President Cyril Ramaphosa is reportedly weighing up two candidates to replace Dr Mkhize as health minister.

The candidates are the former Gauteng health MEC Dr Gwen Ramokgopa, (who took over following the Life Esidimeni tragedy) and Dr Nkosazana Dlamini-Zuma, who, as Health Minister saw the overhaul of the country’s apartheid-era healthcare systems.

As an anti-Apartheid activist, Dr Ramokgopa held various leadership positions. She qualified as a medical doctor (MBChB) in 1989 and obtained her Master’s in Public Health (MPH) in 2007. She worked as a Medical Officer at the Dr George Mukhari (then Ga-Rankuwa) Hospital until 1992.

Having served once as the Gauteng health MEC in 1999,  Dr Ramokgopa took on the role deputy health minister from 2010 to 2014. She succeeded Qedani Mahlangu as Gauteng health MEC following the shameful Life Esidimeni tragedy involving the deaths of at least 94 mental health patients released from private mental healthcare facilities to 27 unlicensed facilities. In a  statement, she vowed to tackle waste and corruption.

Dr Nkosazana Dlamini-Zuma completed her MBChB at the University of Bristol in 1978, and took part in underground ANC activities. During Mandela’s presidency, she was appointed Minister of Health, and courted controversy by voicing support for Virodene, an ‘HIV cure’ which attracted heavy criticism and which was never approved.

She then served as Minister of Foreign Affairs from 1999 to 2009, and then Minister of Home Affairs to 2012, where she turned around a department mired by mismanagement. Despite stubborn resistance from French-speaking nations, she was elected the African Union’s (AU) Chairperson from 2012 to 2017 and was praised for focusing on gender issues. After this, she began vying for the ANC presidency as an MP. In 2019, she was appointed Minister of Cooperative Governance and Traditional Affairs.

During South Africa’s lockdown, she memorably rose to internet fame for using “zol” to refer to cannabis when giving reasons for the tobacco ban.