Understand + with science I Is Spain leading a shift towards pandemic justice?

WHO’s strategy to provide developing countries with tools against covid launches with a CSIC immunity test. The institution will not charge for its use in poor countries. Other technologies, especially vaccines, can follow this path, to alleviate pandemic inequality.

a immunity test against covid, developed by the Higher Council for Scientific Research (CSIC), can be marketed to cost price in developing countries since November. With this device, the strategy of the World Health Organization (WHO) is launched so that low and middle-income countries can access expensive technologies against the coronavirus. This plan, called C-TAP (Covid 19 Technology Patent Pool), was activated in May 2020. The organizations that adhere waive the collection of royalties for their products, when they are marketed in developing countries.

In theory, nobody loses and everyone wins. These countries would never be able to pay their manufacturers for these products, who then do not lose money by forgoing their royalties. At the same time, the whole world benefits from better global control of the pandemic. However, no company or research center has joined the C-TAP before the CSIC. The Government expressed its support for the initiative with the presence of the Minister of Science, Diana Morant, at the signing ceremony, November 23.

The WHO trusts that other organizations will follow in the footsteps of the CSIC. The most valuable technology for the C-TAP would be a vaccine. That would have the potential to offset the scandalous global inequality in immunization that explains, at least in part, the emergence of new variants.

What is the CSIC test?

It is a highly reliable serological test. It does not detect the virus but the antibodies. “The special thing is that it can differentiate between immunity by infection and by vaccination & rdquor ;, explains Miguel Rodríguez Frade, a researcher who participated in the development. “In countries that have few vaccines, this allows them to be used well, by distinguishing between those who have antibodies and those who do not,” explains Javier Maira, CSIC’s head of commercial strategy, in charge of the operation. The test uses blood samples. The result can be read by eye or with a reader (which provides more information). The CSIC licensed it to a Salamanca company, which has sold it mainly in Spain.

Contrary to usual, this license was not exclusive. “From the beginning of the pandemic, it was clear to us that what we developed [en el CSIC] against covid should reach society& rdquor ;, explains. Maira discovered the C-TAP option during a congress, in a conversation with a representative of the Medicines Patent Pool (MPP). That organization was the pioneer in achieving affordable HIV antivirals for developing countries and is in charge of putting into practice the WHO strategy. The CSIC granted a license for the kit to the MPP and the latter launched a call to which any company in the world could apply. Erika Dueña Loayza, who is responsible for the project at WHO, assures that there have been responses from the beginning. The companies selected by the WHO and the MPP will receive a transfer process from the CSIC: that is, biological material and advice to manufacture the kit. The institution will not charge royalties as long as the tests are marketed in low- or middle-income countries. In addition, companies will adjust their margin so that the final price is affordable. Maira estimates that it should be well below the 40 euros it costs in Spain.

Un hito

“It is an exciting and promising milestone, also because of its political and symbolic value. Something financed with public funds can be exploited for the global welfare & rdquor ;, affirms Esteban Burrone, of the MPP. “This license is very important: it is the first for the C-TAP and it is important that a European public institute do it,” says Dueñas, from the WHO. “The Spanish government has shown leadership that we want to see from other governments, which have financed vaccines and therapies,” says Ellen t’Hoen, a lawyer and medical activist, not involved in the process. “It was one of the best news: C-TAP represents a different way of doing things. Let’s hope that more centers and technologies will join in & rdquor ;, affirms Irene Bernal, from the activist organization Salud Por Derecho, also not involved. The MPP obtained, outside of C-TAP, two antiviral licenses from Merck and Pfizer, but limited respectively to 105 and 95 countries. The CSIC license, on the contrary, the global one. Some companies have entered into agreements that are beneficial to developing countries, but generally they are private and confidential, explains Burrone.

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By when a vaccine?

The MPP declares itself ready to do the same with a vaccine. Even if they are innovative drugs, the transfer should not be so difficult, according to Bernal and t’Hoen, who estimate that a good company could be ready to manufacture messenger RNA vaccines in as little as 6 weeks. However, “vaccines are so profitable that companies want to stay in control and make all the money they can. Their shareholders tell them not to license. That is why governments have an important role to play & rdquor;, says t’Hoen. The CSIC intends to make other technologies available to the MPP, including a possible vaccine, says Maira, who says that the system could be extended to all its health technologies, even those not related to the pandemic. On the other hand, Dueñas assures that there are negotiations underway with Bharat, an Indian pharmaceutical company that produces a vaccine against covid.


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