Patents and other conditions of access to vaccines

This paper reviews the experience with access to vaccines during the pandemic. Its inquiry is the extent to which pharmaceutical patents have hindered or enhanced access when compared to other factors or conditions like health spending, manufacturing capacity, and regulatory competence. To conduct the review, the paper queries the regulatory governance perspective when it suggests a decentralised field of legal pluralism will maximise access. It recalls the pre-COVID-19 experience with antiretrovirals to provide pointers to the present situation. It then examines the experience with COVID vaccines under the headings of invention, production, procurement, and distribution. The review finds while patents may hinder access to vaccines, other, essential conditions for access, like independent manufacturing capacity and commitment to procurement, are not established. Regulatory governance must now adopt a much more concerted, coordinated approach, mobilising both patent regulation and other key conditions to further access. The review is an opportunity to gather some of the copious commentary on this issue.