As we buckle in for our third national lockdown, many people believe that the end is in sight thanks to the discovery of effective Covid vaccines. These vaccines are a game-changer in the global pandemic, offering freedom from the cycles of lockdowns and social restrictions which have crippled economies and societies. In fact, they are such a crucial tool in the fight against Covid that they should be designated global public goods – produced in mass quantities to meet global demand, affordable to all countries, and free to the public.

But we are nowhere near this point. In spite of the vast amounts of public funds that have paid for research, development, and manufacturing, the vaccines that have been approved in the UK are the privately-owned assets of a profit-driven industry that has been more than willing to sell most of their stock to the highest bidders.

Wealthy countries like the UK, the US, and the EU have been racing ahead to hoard potential vaccines over the past year, and now have enough doses to vaccinate their entire populations nearly three times over by the end of 2021. Meanwhile, nearly 70 low-income countries will only be able to vaccinate one in ten people against Covid-19 this year. Studies show that some low-income countries could even be waiting up to 2024 before they get the vaccine.

We are in this situation because there are not enough supplies, and in the face of scarcity, it’s those with the deepest pockets that get to hoard.

But the real question we need to ask is this: why are we facing scarcity for a product that the world so desperately needs? Pharmaceutical companies operate on monopolies for their products, which means only they can sell them. This is enforced through patents which prevent any other company from making or selling that medicine. They also defend their monopolies through keeping their technological know-how under wraps: only they know the recipe for Covid-19 immunity.

Keeping out the competition is great for bumper profits but devastating for human lives. At a time when the global death toll is moving towards the two million mark, how can this be acceptable? The hope and anticipation of being Covid-free should be for all, and not just for the richest countries on the planet.

Ensuring there are enough vaccines for everyone, everywhere is crucial to avert even higher death rates. Academic research shows that we could avert 61 percent of deaths globally if vaccines are distributed fairly, compared to 31 percent if rich countries hoard vaccines. Ultimately, hoarding is self-defeating: leaving the virus to spread unabated in large parts of the world allows it to mutate, potentially rendering the effective vaccines of today useless tomorrow. No one is safe until everyone is safe.

Countries in the Global South are acutely aware of the inequality of vaccine access, and so last autumn, the governments of India and South Africa tabled a ground-breaking proposal at the World Trade Organisation (WTO) to suspend the global rules on patents for Covid-19 health products. The proposal would break pharmaceutical monopolies on much-needed vaccines and treatments, as well as other health equipment, and in doing so, expand production and mobilise as many manufacturers as possible to ensure sufficient quantities and lower prices for all countries.

The discussions on this proposal are scheduled to continue through to March, but the plan needs unanimity between all the members of the WTO for approval. While 100 countries support it, including many low- and middle-income countries, there is a small group of rich countries opposed, including the UK, the US, and the EU. Those that oppose this proposal have already secured vaccine stocks in advance and are now blocking a practical, effective way to help expand production and increase supplies for other countries. The level of hypocrisy is not just breathtaking. It’s deadly.

These countries argue that patents are not a problem – but we have seen a long history of patent-based monopolies that have prevented global equitable access to much-needed treatments and vaccines, from the height of the HIV/AIDS epidemic in the mid-1990s to recent struggles over expensive cancer treatments. In recent months, governments have also faced problems with accessing masks, ventilator valves, and reagents for testing kits because of patents and monopolies.

The wealthy countries also argue that existing rules allow governments to issue compulsory licenses to overcome access problems. These effectively override patents and enable governments to give licenses to other producers to make non-branded versions of patented products. However, these licenses must be issued on a country-by-country, case-by-case basis, which is cumbersome and time-consuming, especially if licenses are needed for not just for the final product but also for the pharmaceutical ingredients.

But even if generic companies were granted the right to produce, they would still have issues accessing the technological knowledge to copy vaccines. Compulsory licensing can be a powerful tool to gain access to much-needed treatments, but when states in the Global South have used them, they have often faced bullying and threats by pharmaceutical companies and rich countries.

This is not a case of either/or; we need both the active use of compulsory licensing and a suspension of intellectual property rules for Covid-health products. In the face of a pandemic, we need to use all the tools at our disposal to save as many lives as possible.

The global rules around patents have long been a problem for public health – while they provide the monopolies that help Big Pharma rake in bonanza profits, they also lock people out of lifesaving drugs and vaccines. As many countries face second and third waves, with no hope of getting hold of any Covid vaccines, rich governments need to stand down and stop blocking a proposal that would put saving lives ahead of corporate profiteering.