Neo-Colonialism In Context To Global Health And COVID-19
Neocolonialism followed nation's "liberation" from its colonizer.
Neocolonialism share many characteristics with its predecessor, the very
structure of oppression, suffering and humiliation. The people are economically
and socially reliant on the colonizers despite physical and political freedom.
The remains of damaging systems and continued control of the colonizers
normalizes
dependency. This can be palpably observed in foreign medical services.
International organizations penetrate localities without citizens' knowledge or
consent, through incorrect medical intervention which reinforces "Western"
supremacy. The ongoing pandemic unveils abundantly, yet again, the existing
neocolonialism in the global health scenario.
United States have been observed to implement 'vaccine redlining' policies,
which resulted in shortage and prolonged inaccessibility of sufficient vaccine
doses globally. This means that people living in many Global South countries are
not expected to have significant doses of vaccines administered until as late as
2024.
The U.S. and other high income countries have been noted to engage in dire
'vaccine nationalism', hoarding more than enough supplies to inoculate their
population several times over, leading to not just wastage of large number of
doses but also depriving poor countries of any substantial access to vaccines;
demonstrating supremacist attitude and heightening the visibility of
neocolonialism in the existing global healthcare scenario.
Additionally, monopolizing vaccines on prices and profit, big pharmaceuticals
have created an artificial limited supply which further exacerbates the issue of
inaccessibility and convoluted racism; which reasons why South Africa obtained
millions of vaccine doses at a cost of $5.25 per dose a price that is more than
double the $2.16 per dose that European Union countries paid to AstraZeneca.
Further, with the failure of global health schemes like COVAX, an initiative by
WHO to provide low and middleincome nations affordable and easy access to COVID
vaccine (requiring donations and financial contributions from high income
economies) and with TRIPS (Trade Related Aspects of Intellectual Property
Rights) representing important gains for the Pharma industry, including: an
extended period of protection to twenty years; the requirement that all
technologies receive equal treatment precluding lesser protection for
pharmaceuticals; and limits on compulsory licensing, the vaccine inequities are
becoming increasingly disturbing.
Prima facie, it appears that this vaccine alliance is fundamentally flawed,
depending on the charity of others to donate money or share vaccine surpluses
given the need for countries to vaccinate their entire population.
In February 2021, Ghana became the first country to receive vaccine doses under
this scheme. However, the late "timing and the relatively modest supply enough
for just 1% of Ghana's population point to major challenges." Indeed, by April
2021, COVAX "distributed 43 million doses of vaccine to 119 countriescovering
just 0.5 percent of their combined population of more than four billion."
Contrastingly, it seems unjust for wealthy countries to hoard the vaccines and
drive up the prices on one hand, and promise charitable donations (ever so
insufficiently) on the other. Into the bargain is the limited supply created
artificially by the Big Pharma's by monopolizing the prices and profit, further
aggravating the inequities. These vaccine monopolies make cost of vaccinating
the world against COVID at least 5 times more expensive than it could be.
A French news channel (namely LCI) on April 1, 2020, aired an interview between
Dr. Camille Locht, head of research at INSERM (Institut National de la Santé et
de la Recherche Médicale) and Dr. JeanPaul Mira, head of intensive care at the
Cochin Hospital in Paris. The interview covered ongoing trials of the BCG (bacille
CalmetteGuerin) a tuberculosis vaccine as a potential COVID19 prevention
measure, that were being conducted in Europeand Australia.
In an analogy to HIV research carried out among commercial sex workers who are
"extremely exposed and do not protect themselves," Mira questions whether such
studies "should not be undertaken in Africa, where there are no masks, no
medications, no intensive care." Locht wholeheartedly agrees, pointing out that
his team was already thinking about running a comparable experiment in Africa.
This upsetting exchange is notable because it effectively conveys a number of
fundamental characteristics and accepted standards of medical colonialism in
just a few short phrases. Mira has the same exploitative motivation as
colonialera doctors who regarded Africa and Africans as a source of raw
materials for research that would advance their careers when he advises that the
study be undertaken in Africa.
Mira's claim that the reason for doing a research in Africa is that the area
lacks resources "no masks, no intensive care" and the presumption of general
lack of hygiene, health and health standards, so that any action should be seen
as a benevolent and admirable deed is blatant saviourism. Another such recent
instance was in June 2020, when University of Oxford conducted trial of its
vaccine in Johannesburg, South Africa where "the people chosen as volunteers for
the vaccination, they look as if they're from poor backgrounds, not qualified
enough to understand" the risks of trial.
The trend of taking resources from Black and other people of colour for
therapeutic trials that involve experimentations have a long, sordid history
grounded in prejudicial and racists beliefs. Following such studies, new
medications and therapies are created using the knowledge gained from it.
However usually, the study participants and their communities do not profit
equally from these breakthroughs.
Since economic reliance, exploitation, injustice, and the depiction of
communities of colour as disposable are its primary motivators, it is not a
stretch to say that medical neocolonialism is a close cousin to historical
colonialism. South Africa is a prime illustration of vaccine apartheid. South
Africans should have had more posttrial access and advantage since they first
took part in clinical trials for the creation of the medicine.
South Africa instead had to pay extra for time sensitive and necessary
medication like the COVID vaccine, strengthening the burden. The South African
instance effectively demonstrates how "the rewards of medical and technological
progress are stored for some and withheld from others. In addition, these traits
of neocolonialism are not restricted to clinical trials and limiting
accessibility to vaccines through monopolizing pricing and distribution.
The crisis situation of COVID19 highlights the ways in which developed nations
control vaccine accessibility through international laws regulating intellectual
property rights (IPR). The goal of TRIPS Agreement is to "protect and enforce
intellectual property rights [so] as to assist in the development of technical
innovation and the transfer and diffusion of technology," according to Article 7
of the Agreement.
Similar to the above, TRIPS Article 66(2) additionally requires industrialized
nations to "give incentives to firms and organizations inside their territory to
promote and support technology transfer to leastdeveloped countries". Although
the phrase "transfer of technology" may appear advantageous or innocuous, in
reality it is not.
Regarding medications, patented health/medicinal products are generally costly
due to high demand and low inventory. Under the relevant provisions of TRIPS,
such items can't be manufactured, marketed, or sold in any country without
consent of the concerned IP rights owner. This represents a possibly critical
obstruction to importation of drug items primarily by developing nations.
The obvious solution to this is the production of generic or offpatent medicines
(by third world countries) for cheaper and in large quantities for domestic use
and exportation. TRIPS framework allows such production and exportation under
'TRIPS Flexibilities'. However, it comes with its own limitations and are
insufficient in dealing with the current pandemic, especially for countries that
lack manufacturing capability in the pharmaceutical sector.
Carmen Gonzalez has demonstrated that when development goals are included in
international legal frameworks and institutions, they become enmeshed in
frameworks that may limit their capacity for transformation and perpetuate
NorthSouth power inequalities.
These limitations are placed on development goals by capitalistimperialist
systems, adaptations are made to legitimize colonial actions, and mobilization
via racial distinctions. Even in the 21st century, these institutions still form
the foundation of international law. The legal and regulatory frameworks that
enable international law as well as the broader socioeconomic strokes made on
the global economy continue to be animated by colonialist patterns.
The response to the Global South Global North disparity to intellectual
properties and associated inaccessibility to vaccines among developing nations
is "Third World approaches to International Law" (TWAIL). The goal of TWAIL is
to dissect and reveal transformative and retrogressive aspects of international
law.
Therefore, in order to attain and advance global justice, "international law
must be transformed from a discourse of oppression to a vocabulary of
emancipation." This may be done by deconstructing a narrative that is centered
on colonial past, power, identity, and issues of Third World countries, as well
as by generating interest in the Global South.
The initiative, from developing and underdeveloped nations, to challenge and
amend such international laws resonate in the joint submission made by India and
South Africa to significantly reshape the TRIPS regime, thereby allowing a
detailed technology transfer of efficacious COVID19 diagnostic tests,
therapeutics, and vaccines. The joint proposal includes a wide range of topics,
including not just patents but also copyright, industrial designs, and
unpublished information, including technical expertise and trade secrets.
With the interim prohibition, numerous actors would be allowed to begin
production as opposed to manufacturing being restricted to the few present
patent holders, which restricts access making a sizable number of world
population disposable.
Bibliography:
1) Rubbini, Michele. "Global health diplomacy: Between global society and
neocolonialism: The role and meaning of "ethical lens" inperforming the six
leadership priorities." (2018) 8.34 Journal of Epidemiology and Global Health at
110.
2) Patti, Lorenzo. "International Medical Service Trips: Colonialist Roots and
Ethics Of Global Health Today." (2021).
3) Francesco Guarascio, "WHO Vaccine Scheme Risks Failure, Leaving Poor
Countries with No COVID Shots Until 2024", Reuters (16 December, 2020), online:
(on file with the Columbia Law Review).
4) Peter S. Goodman, "One Vaccine Side Effect: Global Economic Inequality, N.Y.
Times (25 December, 2020), online:
www.nytimes.com/2020/12/25/business/coronavirusvaccinesglobaleconomy.html (on
file with the Columbia Law Review)>(last updated Dec. 31, 2020)
5) Helen Sullivan, "South Africa Paying More than Double EU Price for Oxford
Vaccine", Guardian (22 January, 2021), online: www.theguardian.com/world/2021/jan/22/
southafricapayingmorethandoubleeupricefor oxfordastrazenecavaccine[https://perma.cc/8MRG8YQ2];>
6) Rouw, Anna, et al. "COVAX and the United States." KFF Issue Brief 18 (2021).
7) Boaventura De Sousa Santos and Cesar A. RodriguezGaravito, Law and
Globalization from Below, Chapter 5, published inUnited States of America by
Cambridge University Press, New York, 2005
8) Danielle Paquette & Emily Rauhala, First Vaccine Doses Distributed by Covax
Land in West African Nation of Ghana, Wash.Post. (24 February, 2021), online:
www.washingtonpost.com/ world/africa/covaxghana astrazenecavaccine/2021/02/24/558d31bc761711eb9489
8f7dacd51e75_story.htIml >
9)Tedros Adhanom Ghebreyesus, Opinion, I Run the W.H.O., and I Know that Rich
Countries Must Make a Choice,
N.Y. Times (22 April, 2021), online: www.nytimes.com/ 2021/04/22/opinion/whocovidvaccines.html>
(on file with theColumbiaLaw Review).
10) Anna Marriott & Alex Maitland, "The great vaccine robbery" (29 July , 2021),
online (pdf): Amnesty online:
11)Fofana, Mariam O. Decolonising global health in the time of COVID19. Global
Public Health, (2021) 16(89). at 11551166.
12)Tilley, Helen. Medicine, empires, and ethics in colonial Africa. AMA Journal
of Ethics, (2016). 18(7), at 743753.
13) Makoni, Munyaradzi. COVID19 vaccine trials in Africa. The Lancet Respiratory
Medicine, (2020). 8(11), e79e80.
14)Cara Anna, "Protest vs. Africa's 1st COVID19 vaccine trial shows fears",
CityNews 680 (July 1, 2020), online
15)Archibong, Belinda, and Francis Annan. 'We Are Not Guinea Pigs': The Effects
of Negative News on Vaccine Compliance.(2021). Available at SSRN 3765793.
16)Cho, Hae Lin, Marion Danis, and Christine Grady. Posttrial responsibilities
beyond posttrial access. The Lancet, (2018).391(10129), 14781479.
17)Vanni, A. On intellectual property rights, access to medicines and vaccine
imperialism. TWAIL Review. (2021).
18)Gonzalez, Carmen G., and Sumudu Atapattu. "International environmental law,
environmental justice, and the Global South."Transnat'l L. & Contemp. Probs. 26
(2016): at 229.
19)Chimni, Bhupinder S. The articles on state responsibility and the Guiding
Principles of shared responsibility: A TWAILperspective. European Journal of
International Law, (2020). 31(4), at 12111221.
20)Eslava, Luis, Michael Fakhri, and Vasuki Nesiah, eds. Bandung, global
history, and international law: critical pasts andpending futures. Cambridge
University Press, (2017).
21)Chapter 4: Medical technologies: the access dimension, online: <https://www.wto.org/english/tratop_e/trips_e/trilatweb_e/ch4c_trilat_web_13_e.htm>
22)Zaman, Khorsed. The waiver of certain intellectual property rights provisions
of the TRIPS for the prevention, containment and treatment of COVID19: A review
of the proposal under WTO jurisprudence. European Journal of Risk Regulation,
(2022).13(2), at 295310.
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