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A growing number of governments and health experts are urging pharmaceutical companies to loosen their tight grip on their COVID-19 vaccine technology as the world struggles with a worsening shortage of the vaccines.

The increasing talk of technology-sharing arrangements is fuelled by the extreme gap between wealthy and poor countries in vaccine supplies – a gap that could leave the virus circulating in much of the world for years, triggering the creation of dangerous new variants.

So far, more than three-quarters of vaccinations have occurred in 10 of the world’s biggest and richest economies, while almost 130 countries have yet to administer a single dose. At the current pace of vaccine deliveries, much of the developing world will be unable to immunize the majority of their populations until 2023 or 2024.

Anthony Fauci, the famed U.S. infectious disease expert, is one of a growing chorus of health leaders who are urging vaccine manufacturers to find ways to ease patent rules. In recent comments, he called for “co-operation from the pharmaceutical companies” to allow “relaxation” of their patents, so that vaccine production can expand.

He recalled the early days of HIV treatment, when millions of Africans were dying because they couldn’t afford drugs from the big pharmaceutical companies – including some of the same ones that are making COVID-19 vaccines today. The arrival of cheaper generics and global funding programs eventually helped to save millions of lives, and Dr. Fauci said the world’s wealthy countries have a “moral responsibility” to provide similar help today.

Some of the same activists who fought for cheaper HIV medicine in the late 1990s, in countries such as South Africa, are leading the battle for technology-sharing and patent waivers today. Many are supporting a proposal at the World Trade Organization, spearheaded by South Africa and India, to allow a temporary waiver of intellectual property rules for vaccines and other COVID-19 products during the pandemic.

About 100 countries are supporting the waiver. Canada, however, has joined a relatively small number of higher-income countries that have declined to support the plan. Instead, Canadian officials have asked a lengthy list of questions about the proposal at WTO meetings in recent months.

Christelle Chartrand, a spokesperson for Global Affairs Canada, insisted that Canada is not opposing the idea of a waiver. In a response to questions from The Globe and Mail this week, she said the government “will continue to engage” with supporters of the waiver plan, including at the next WTO meeting on Feb. 23.

Canada wants to identify “challenges” that WTO members might be facing in obtaining supplies during the pandemic, she said, “in order to develop a workable consensus-based solution.”

In practice, however, Canada’s stance means that it is opposing the waiver, analysts say. They note that Canada had also ordered a higher proportion of vaccines, relative to its population, than any other country in the world.

“In many ways, it appears that Canada has chosen to be part of the problem, instead of the solution,” said Marc-André Gagnon, an associate professor in Carleton University’s public policy school who studies the pharmaceutical industry.

“Canada plays a pretty good game of vaccine nationalism,” Prof. Gagnon told a parliamentary committee this month, citing the country’s stance in the WTO meetings. “Forget about global public health priorities. It’s every country for itself.”

This week, the African Union joined the calls for a temporary waiver of patents – partly because Africa has been more severely hit by vaccine shortages than any other region of the world.

Of the 151 million doses that have been administered worldwide, less than 800,000 were in the African continent, according to Our World in Data, a research publication based at the University of Oxford. Deaths from COVID-19, meanwhile, have surged by 40 per cent in Africa in the past month.

The directors of two United Nations agencies – UNICEF and the World Health Organization – issued a joint call this week for expanded vaccine production, including the transfer of technology to manufacturers to maximize global supply.

In a commentary in Foreign Policy magazine this month, WHO director-general Tedros Adhanom Ghebreyesus said governments and companies must overcome the “artificial scarcity” of vaccines by considering steps such as a temporary patent waiver.

“It’s very encouraging that the WHO director-general and Dr. Fauci are actually recognizing that we have a scarcity problem, and that one way of fixing the scarcity is sharing the technology, scaling up manufacturing and relaxing the patent system,” said Fatima Hassan, a South African lawyer and health activist who fought the pharmaceutical companies for cheaper HIV medicine in the late 1990s and is campaigning for expanded vaccine access today.

One major pharmaceutical company, Merck, said this week that it is in discussions to share its vaccine manufacturing capacity with other producers, after its own vaccines had poor results in early trials. Two European companies are doing the same for the Pfizer-BioNTech vaccine to boost production.

“One would hope that we’re at a point in this crisis where people do it voluntarily,” Ms. Hassan told The Globe. “But if not, civil society groups around the world will be asking their governments to take compulsory measures.”

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