The emergence of the Covid-19 pandemic causes serious risks for human beings and, therefore, challenges the human rights system and the capacity of governments to adopt quick and adequate measures. This new reality necessitates reflecting on the conditions of and the possibilities for such measures.\u00a0In view of the difficulties encountered in the implementation of immunization, this contribution defends the recognition of the right to a fair distribution of vaccines as a new human right. Taking Brazil as a case study, it deals with the necessary policies and actions to effectively promote immunization, as well as to support the strengthening of global health governance.<\/p>\n
The<\/strong> Lack of<\/strong> Adequate<\/strong> Global Sanitary Governance,<\/strong>\u00a0<\/strong>the R<\/strong>ight to Health and the Right to <\/strong>a F<\/strong>air Distribution of Vaccines<\/strong><\/p>\n Covid-19\u00a0rapidly spreads throughout the world causing serious impacts everywhere. The pandemic\u00a0imposes a reduction in the sociopolitical distance among\u00a0countries, more precisely requiring an approximation of the moral and human perspectives to fulfill human rights duties.\u00a0Human rights are designed to protect human beings from serious risks that may affect dignity, freedom, and equality. Especially those who are most vulnerable,\u00a0such as cultural, religious, and ethnic minorities, victims of structural inequality<\/u><\/a> and injustice<\/u><\/a>, urgently need measures that ensure their rights.\u00a0Therefore, the advent of a global health crisis requires consistent\u00a0and strong global health governance.\u00a0The failure of an adequate global health governance system had already led to the lack\u00a0of an efficient health response to the previous epidemics, such as Ebola and H1N1. These epidemics had caused a wide spread of diseases and high death rates, especially among\u00a0the most vulnerable.<\/p>\n In the context of extreme inequality and structural injustice that already spread around the world, the Covid-19 pandemic further pressured the basic need to protect human beings and minorities from two different angles:\u00a0The necessary measures to face the pandemic\u00a0require, on the one hand,\u00a0preventing further contagion. On the other hand, the sanitary crisis and the high rate of deceased affect the economy, education, social relations, and physical and mental health.\u00a0The Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, and most contemporary constitutions (about 1<\/u>36<\/u> constitutions establish some discipline on health, albeit in different ways<\/u><\/a>)\u00a0set the relevance of the right to health.\u00a0As will be seen, the right to fair distribution of vaccines is a specification of the right to health, especially in the context of pandemics.<\/p>\n The stage of vaccination around the world has shown that developed countries\u00a0have a more accentuated rate of immunization.\u00a0In contrast, developing countries fall short of the necessary infrastructure. This reflects the inequalities and structural injustices in the health system:\u00a0on January 26, 2021, just one nation among the 29 poorest had started<\/u><\/a> vaccinating against Covid-19. Projections indicate<\/u><\/a> that poor countries would only achieve immunization in 2024.\u00a0This challenge is not limited to a specific area or country. By\u00a0being a local and, at the very same time, a global issue, the Covid-19 pandemic can only be addressed\u00a0by convergent actions and policies. Art. 2 of the ICESCR requires States to use\u00a0all available resources and adopt\u00a0appropriate measures to ensure the right to health, thereby merging\u00a0the\u00a0duties of assistance and cooperation.<\/p>\n Luigi Ferrajoli (p. 73\u201374) supports<\/u><\/a> the view that vaccines should be considered global common goods and that every effort must be made to provide access outside free market conditions.\u00a0In this same vein, the costs of not realizing social rights, like health care, are immeasurable and intolerable, causing severe repercussions on human lives that exceed even the costs for fulfilment. The right to vaccination involves\u00a0the fair distribution of vaccines\u00a0produced worldwide, prioritizing risk groups based on scientific and social criteria, in which minorities must be considered.\u00a0Given\u00a0the political, health, social, and economic contexts, the human right to a fair distribution of vaccines must be recognized based on the\u00a0fundamental\u00a0principles of cooperation, precaution, and based on\u00a0the right to health.\u00a0The human right to health encompasses rights to access to health care systems, to medication and, among others, to vaccination. The right to vaccination presupposes, in a context of global pandemic, the fair distribution of vaccines and, as such, depends on a global sanitary governance.<\/p>\n Vaccination in Brazil<\/strong>: Barriers and Prospects<\/strong><\/p>\n These general considerations shall now be assessed against the case study of Brazil. Brazil\u2019s health crisis has continuously worsened: it is currently the second country with the highest number of infected<\/u><\/a> and deceased<\/u><\/a>. This is due to the federal\u00a0government\u2019s stance\u00a0of denying the severity of Covid-19. The federal government commonly\u00a0questions the recommended\u00a0scientific sanitary measures, such as wearing masks, social distancing, and suspension of some economic activities. Additionally, the government discredit<\/u>s<\/u><\/a>\u00a0the safety and efficacy of vaccines, inflating anti-vaccine movements.\u00a0The result is\u00a0a national disarticulation of policies and measures (see here<\/u><\/a>).\u00a0Thus, the government\u2019s omissions concerning the containment of the virus\u2019 spread impose\u00a0atypical\u00a0federalism of confrontation and are contrary to the adopted constitutional model of cooperative federalism.<\/p>\n Addressing the lack of an efficient global health governance, the right to a fair distribution of vaccines requires overcoming national regulatory barriers. For example, the Brazilian health authority (Anvisa) required that phase 3 of vaccine testing<\/u><\/a>\u00a0be carried out in Brazil. Thus, according to\u00a0Medida Provis\u00f3ria n\u00ba 1.026\/2021<\/u><\/a>, Anvisa authorized the import and distribution of vaccines that were registered at only some sanitary agencies, namely European, British, American, Chinese,\u00a0or Japanese agencies.\u00a0As a result, there was no adequate and efficient planning for the purchase and distribution of vaccines.\u00a0This\u00a0caused continuous interruptions<\/u><\/a> in the immunization\u00a0of priority groups in many cities, making Brazil<\/u><\/a> the 19th country in the number of doses administered per 100 inhabitants.<\/p>\n Consequently, state governments and other institutions appealed to the Federal Supreme\u00a0Court (STF). In important lawsuits, such as ADPF 770<\/u><\/a>, ACO 3452<\/u><\/a>, ADI 6661<\/u><\/a>, ACO 3477<\/u><\/a>,\u00a0and ACO 3482<\/u><\/a> (see STF Covid-19 Case Law Compilation<\/u><\/a>),\u00a0they\u00a0claimed\u00a0for the unconstitutionality of\u00a0the above-mentioned\u00a0regulatory measures restricting the acquisition and distribution of vaccines. Moreover, they demanded\u00a0the imposition of\u00a0the following measures: for the federal government\u00a0to facilitate the purchase and distribution of vaccines, or at least import and directly distribute\u00a0to the state governments even if not registered by Anvisa. If a medicine or vaccine is not registered by Anvisa, its distribution is prohibited.\u00a0In these lawsuits, the state governments claimed that as long as efficiency and safety are recognized by other regulatory agencies beyond the ones established by Medida Provis\u00f3ria 1.026\/2021 (like Russian and Argentine regulatory agencies, for example),\u00a0the vaccine should be imported and distributed without rely on the\u00a0federal government. The complaints referred, directly or indirectly,\u00a0to the right to a fair distribution of vaccines\u00a0as stemming\u00a0from the right to health. They also highlighted the importance of scientific knowledge as a basis for health decisions and cooperation\u00a0among countries.<\/p>\n Along with\u00a0recent\u00a0rulings by the\u00a0STF (like the es at ADPF 672<\/u><\/a> and ADI 6341<\/u><\/a>),\u00a0these lawsuits, the coordinated measures adopted by state\u00a0governments and\u00a0the mobilization of the\u00a0National Congress,\u00a0were essential for the federal government to react.\u00a0Anvisa started\u00a0to accept phase 3 of vaccine testing carried out in other countries. Besides, on March 10, 2021,\u00a0the National Congress passed L<\/u>aw<\/u>\u00a0<\/u>No. <\/u>14124<\/u><\/a>\u00a0by exceptional and temporary procedure.\u00a0This legal act accepted\u00a0the import, acquisition, and distribution of vaccines approved by a broader range of foreign health authorities, including directly by state governments, if demonstrated\u00a0a)\u00a0a non-compliance by the federal government with the National Vaccination Plan or b)\u00a0the inability to provide sufficient vaccination coverage. In these conditions, it is now possible\u00a0to have quick access to vaccines proved to be safe and effective.<\/p>\n Conclusion<\/strong><\/p>\n It is time to recognize a new and fundamental human right to a fair distribution of vaccines. The\u00a0obligation to promote and fulfill the right to health in the context of epidemics and pandemics is based on this new fundamental human right.<\/p>\n The right to a fair distribution of vaccines, in a perspective of development of global health governance, requires a) recognizing the possibility of vaccines approved for use according to basic guidelines of a uniform protocol, whose criteria of safety and effectiveness have been attested by the scientific community, exempting approval of national health agencies; b)\u00a0setting up a global fund for the distribution of vaccines, which may go through the improvement of the COVAX Consortium<\/u><\/a>; c) establishing an obligation for\u00a0distributing vaccines to developing\u00a0countries to a greater extent than to rich countries,\u00a0since the latter have lower demand on\u00a0the health care systems\u00a0and less risk of collapse; d) defining\u00a0the criteria to prioritizing risk groups, in which minorities\u00a0must be included; e) determining\u00a0that laboratories establish more favorable and differentiated purchasing conditions for vaccines designated\u00a0to\u00a0developing countries, according to the Guiding Principles on Business and Human Rights<\/u><\/a>\u00a0and\u00a0f) institutionalizing compulsory licensing of vaccines, according to TRIPS<\/u><\/a> or even beyond TRIPS,\u00a0for\u00a0developing countries.<\/p>\n If in Brazil one can see some perspective to faster vaccination in a few months after problems of intergovernmental incoordination have arisen, it is uncertain whether\u00a0this will happen for other developing countries and, above all, for the poorest countries in the world.\u00a0The feasibility of the proposed measures, aiming at the implementation of the new human right to a fair distribution of vaccines, requires the effective development\u00a0of adequate global health governance and the establishment of\u00a0a cooperative network based on ground principles of scientific and humanistic development.\u00a0It is a difficult task, but we cannot postpone it any longer.<\/p>\n","protected":false},"excerpt":{"rendered":" The emergence of the Covid-19 pandemic causes serious risks for human beings and, therefore, challenges the human rights system and the capacity of governments to adopt quick and adequate measures. This new reality necessitates reflecting on the conditions of and the possibilities for such measures.\u00a0In view of the difficulties encountered in the implementation of immunization, […]<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[6639],"tags":[],"authors":[6732],"article-categories":[3572],"doi":[],"class_list":["post-12941","post","type-post","status-publish","format-standard","hentry","category-uncategorized","authors-miguel-calmon-dantas","article-categories-symposium"],"acf":{"subline":"The Right to a Fair Distribution of Vaccines"},"meta_box":{"doi":"10.17176\/20210326-182933-0"},"_links":{"self":[{"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/posts\/12941","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/comments?post=12941"}],"version-history":[{"count":1,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/posts\/12941\/revisions"}],"predecessor-version":[{"id":12943,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/posts\/12941\/revisions\/12943"}],"wp:attachment":[{"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/media?parent=12941"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/categories?post=12941"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/tags?post=12941"},{"taxonomy":"authors","embeddable":true,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/authors?post=12941"},{"taxonomy":"article-categories","embeddable":true,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/article-categories?post=12941"},{"taxonomy":"doi","embeddable":true,"href":"https:\/\/voelkerrechtsblog.org\/de\/wp-json\/wp\/v2\/doi?post=12941"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}