ASA “Ending Vaccine Apartheid” AfricaNow! Roundtable

Atlanta, GA, November 26, 2025

Transcript of the presentation of PETER MAYBARDUK OF Public Citizen, “Looking

Forward to Africa's Vaccine Sovereignty: Challenges and Opportunities”

Introduced by Bonnie Holcomb, Moderator

It is our great pleasure to welcome Peter Maybarduk of Public Citizen who has

joined us today. He's the director of the Access to Medicines group at Public Citizen,

which helps partners worldwide make medicine available and affordable for all. So he

has a lot to offer us here. The group's work has shaped laws and executive action in the

United States and Latin America and, we can say confidently, changed the course of

international health and trade negotiations. Peter and his colleagues helped organize

the global movement for COVID vaccine access and have rallied support to expand

vaccine manufacturing and technology transfer in developing countries. So this is

precisely his area of expertise.

Just a little bit about his background. He studied technology at the University of

California Berkeley, anthropology at the College of William and Mary in Virginia. He

founded the International Professional Partnerships for Sierra Leone, a nonprofit

dedicated to supporting public sector development in one of the world's least developed

countries. He facilitates US and Global Civil Society Alliances on Vaccine on Access to

Medicines. His commentary appears in The New York Times, the Washington Post and

others. He sits on the governing board of the Medicines Patent Pool, a United Nations-

backed organization that negotiates licenses among drug makers to expand global

availability of affordable generics. He will speak on the topic “Looking Forward to

Africa's Vaccine Sovereignty: Challenges and Opportunities.”

Thank you, Peter, for joining us.

PETER:

Thanks so much Bonnie. I think – based on what I've heard today from the

fantastic presentations from the national level with Maziko talking with us about

challenges in Malawi up to David talking about patent wars at the World

Trade Organization and Sadia, your excellent bridging of the two with vaccine access

challenges across the African continent and some of the needed solutions -- what I can

best offer is 1) to get us synthesizing a quite broad range of challenges and 2) focus

how we think about our role in solutions and then 3) move us into the Q&A.

You know, we have a huge amount of work to do collectively.

I think it's useful to recognize something for all of us who were deeply engaged in the

COVID- 19 vaccine access fight -- something we all learned the hard way, if we didn't

have it already – is that these are actually complex challenges. Coming at it with one

angle, such as, trying to improve delivery systems or trying to fight or trying to win the

patent war, [will not succeed alone]. We can't just do any one of those things and

expect the others to line up. We have to be very thoughtful about how the pieces are

going to come together to support a whole because researching, producing funding,

and delivering vaccines in a way that communities are going to accept and scale up is

obviously you know that's there's a lot to do there.

I think it's helpful for us to distinguish between the goals of vaccine coverage and

vaccine sovereignty in terms of helping think about which piece we want to pick up and

how we're going to do it. because you know wWe've heard some about the [vaccine]

coverage problems where we might want to fight Trump's cuts and rebuild in donor

nations. The vaccine sovereignty is a little different where we're talking about actually

regionally producing vaccines and getting to scale that way.

A few lenses for the problems before us:

One is vaccination – vaccine access -- during pandemics. The problem that was put on

such display in COVID 19 access, it repeated during MPOX. Frankly, I'm going to skip

slides just in the interest of time, but we have one on MPOX vaccine access. If you look

at the US crisis in MPOX in 2022 and 2023 and compare its timeline in evolution to the

same or the most recent crisis across the African continent, the United States was

essentially benefiting from having about 400 times as many doses per case available as

African countries were. And it shows the magnitude of the continuing problem in

pandemics – trying to get vaccines out quickly when there's an emergency outbreak.

But there's a separate problem of routine immunization, as Sadia outlined for us, where

you have a widening global gap. We had routine immunization drop because of the

global COVID pandemic and because of the diversion of health workers and resources

to the fight against COVID. So that's sort of a second lens on the challenge we're trying

to overcome.

A third is the funding cuts. Since the COVID crisis, that we saw is the devastating cuts

that David outlined for us earlier, and that Maziko talked about, the effects that have

really wiped out some of the service delivery systems that we'd otherwise relied on and

very much hurt national as well as NGO budgets that work in these issues. How do we

rebuild from that? Because, even if we had the money, which we don't, it's not as simple

as just reinserting money into the system and expecting dead programs to come to

life.

Then finally, there is vaccine sovereignty, with its own lens of not just relying on

foreign donations and programming, but actually building up the African sector.

Despite those very heady challenges, we have a few developing opportunities. One is

those fights David outlined for us. They led to significant normative change. Even while

resources are collapsing, global agreement among health practitioners and the

agencies that support health and development has really coalesed around a set of

values that did not exist in such strength before the pandemic.

I'm talking about regional production, for example, which is now a globally shared goal.

It's sort of understood by everyone in the health and development and pharmaceuticals

game and agreed, if you're not a part of the backlash against vaccines, you're a part of

the emerging consensus that agrees we need each part of the world able, capable

resourced to produce its own vaccines and diagnostics and interested in trying to

support that change.

Something similar goes for technology transfer. This is a really emerging value where

we don't want global pharma corporations hoarding not only the doses, but also the

means to make those doses. This is something that has to be diversified and shared

among producers everywhere. So there's really been a shift in values that can help us

quite a bit.

There's also regional work for ambitious and different initiatives underway on the

continent. Africa CDC has its goal of 60% vaccine self-sufficiency by 2040. That's an

appropriately ambitious, and yet at least arguably realistic, goal if we really commit to it

to move to that position over time so that Africa is not just in this position of relying on

foreign donations or technology but has built up its own capabilities. And there have

been some excellent examples of this underway. You see uh institutions like the

Institute Pasteur at Dakar really gathering global attention and partnerships to make

vaccines. You had the first mRNA vaccine developed on the continent at Afrigen in

South Africa a couple years ago. The mRNA technology transfer program has partners

on every continent and is a South-South cooperation initiative to research vaccines

against new disease targets using mRNA unleash the power of mRNA and then work on

a sustainable marketing solution together. So -- excellent new ambitious

collaboratives. There's the Accra reset introduced by the President of Ghana and the

effort of seeing the development has to be in Africa's hands, particularly in light of the

cuts but as well as just the long legacy of properly anti-colonial politics. We have to find

a way to move

these initiatives on the continent,

So, with those sort of ideas in mind, what are the prime areas we have to work in to

achieve vaccine sovereignty? The first one is funding. We need funding solutions. And

that's true internationally, but it's also true nationally with a commitment of

greater budgets to both vaccine procurement and coverage and production.

And it's not just any one piece of this. If we want real sovereignty, we have to be

building up the regulatory structures so that vaccines can be easily approved and

moved. We have to be building up the productive capabilities. And then African nations

have to be buying African vaccines which sometimes might mean paying a slight

premium for example over Indian vaccines. But in order to develop a market for African-

made vaccines from regional sovereignty, then we need bodies on the continent that

can purchase vaccines from African makers and commit to that. And we need the

international donors also prepared to pay a bit of a premium for African vaccines to

build up those capabilities over time. There is also the pharma power challenge that

Dave mentions, where those of us at least working internationally have to continue to

put pressure on pharmaceutical corporations to license the technology that they have

and to lower prices so that with prices like MPOX you don't have a situation where really

global agencies can't have a hard time affording moving those vaccines where they

need to where they need to be.

There's a lot more to say about each of those things, but perhaps I'll try and get us to

discussion. I should also say two things first, if I may, before I close.

There is also a new chance to fight and a new something developing right now that I

think is very important for our collective awareness. And that is, you know, Trump's new

America First global health strategy. They're shopping it around to countries right now,

including a number of African countries. The US State Department is asking for

unfettered access to national health databases and pathogen information sharing

systems for the next 25 years in exchange for a very limited partial restoration of the

aid that was already flowing last year. It's the sort of proposal -- I can unpack that if it's

helpful – but it's the sort of proposal that really undermines the necessary unity and

solidarity to have better terms of trade, to have a health system of real benefit sharing

instead of just extraction from the global north. And countries are being asked to sign

these right now. I hear that Kenya and Uganda may sign these agreements with US

Department of State in the next few weeks. And there's a significant question about

whether um the rest of us can provide enough support and criticism that it's tenable

for African countries to reject such inequitable terms and just turning over everything

they have to the United States just to get back halfway to last year's status quo. When

it comes to development aid, t's not good enough. We have to push to do better.

That's a chance to fight right now I'm keen to talk about and there are some networks

we can help connect folks to that are engaged in this fight.

Maybe I can coordinate with Bonnie offline on that as is helpful.

Final word just about the politics, right? I mean, what does this take? It takes unity.

Obviously, the goal of like continental strength and unity is long-standing.

I wouldn't want to paint it as simple. This is obviously complex for good reason. Nor is it

my place to try and pick any winners and losers in that. But I will say that like the efforts

of agencies like Africa CDC to have a continentwide politics that says. “Here is how we

stand up to pandemics and here's how you know, here's how we develop our own

regional sovereignty”. Those are important, right?

And initiatives that that can help African nations to pool resources and invest in health,

invest in procurement and production as well as vaccine coverage are all important. So

there's that regionally, nationally, we’ve got to increase commitments.

Yeah, we have to fight the power of the pharmaceutical industry and but perhaps right

now even more importantly, we’ve got to fight to restore aid and development funding

and find a way of thinking about the world that helps lift us all up. A lot of

considerations on the table, but that's what I've got for now. Thanks. Thanks so much

for all of your presentations.

Q&A – Bonnie Moderating

It's really a pleasure to have input from all of you on this topic. It is especially good to

end with the suggestion from you Peter that we have specific actions to take.

There were other panels earlier in this conference that suggested that we start with

Africa’s role in the process of accounting for the development of vaccines. I'm hoping

that some of the participants here will speak to that issue. But to have some

specific actions is really very good.

So we it's time for Q&A. We'll take questions from people here in the room responding

to these papers. I think we still have all of participants on the line. We will take

questions in the chat from those of you who have joined by Zoom.

We start with this question.

Audience member: one case that I'm thinking about that I haven't heard anything about

yet is the SAN Vaccine Institute. Its intervention in Rwanda was with experimental

candidate vaccines for the Marberg outbreak. There is another Marberg outbreak

happening as we speak in Dinka, Ethiopia. I understand it's a different case from

childhood immunizations and where the patents might already be expired. But I'd like to

know how we might put pressure on the SAN Vaccine Institute to release more

of its kind of vaccine.

Bonnie: Were you able were you able to hear that question online? Speakers?.

Panelists: Yes.

Bonnie: Are there other questions in the room? Yes.

Audience member Thompson: I work with intellectual property rights on seeds and I

have two quick question quick questions of clarity. D um definitions really make a

difference in how you count. I was wondering (I'm pretty sure) that the vaccines that

came from China were not counted. I in other words, is itwhat is considered where a

vaccine

comes from? or Sso that's one question because I know many in southern Africa who

got a Chinese vaccine. My other question of clarity is how long is the patent? How long

is the intellectual property ? Because we're finding out that they're much longer than

seeds should have them. I'm sure vaccines are dated, what? two years later, three

years later? So, what is the intellectual property length of vaccines for that?

Peter, I very much like your talking about opportunities.

Dave, your idea of connecting with Africa’s diaspora, and the US is really important, but I

really don't see any point in challenging big pharma at this point until we change US

capitalism and I mean that profoundly. Where I see the opportunity that Peter is talking

about is South-South cooperation and as Americans exposing what the government and

Big Pharma is doing, but facilitate the vaccination capability in countries of the South

because they are the idea of a regional self-sufficiency. I don't like the word

“sovereignty;” that's ridiculous. Regional self-sufficiency. We, as Americans, can expose

what Big Pharma is doing and then join hands with South countries like India and Brazil

who are providing vaccines and that's exactly what is working in the farmer-managed

seed systems and the international movement to protect farmers seeds. You don't try to

change- Big Aagriculture in the US. It doesn't matter who we put in Congress, who we

put into the Ppresidency, including Obama. T, they're 1000 % for Big Corporate

Farming, Big Food Industry. And it's the same with Big Pharma. So I like the

diaspora bringing it in, but let's not focus on the US government. Let's focus

on joining hands with Ssouth self-cooperation as something new different

from antiarth

Peter: Yep. Excellent. Excellent questions. So, are Chinese vaccines counted? How

long is the intellectual property? And also the comment about the method of operation.

Okay. So we have these two specific questions. Any other from the floor?

Okay. Are there any online? Yeah, there's one here. Peter. Do you mind if we take one

more question in the room? Sure. Sure.

Following up on the focus on regional self-sufficiency, Peter, you spoke of perhaps

being able to influence our government to financially help production in the South. Is

that at all likely politically since foreign aid has always been first and foremost to

benefit the country giving it?

Peter: Yeah. So, I'm happy to take a shot at each of those questions to the extent I can

remember them. Very, very good.

So start with the last one and work my way back. I mean, there's obviously only so

much we can do under Trump, right? I mean, Trump has just decimated foreign aid.

There there's not a lot we can do about that except to fight it. And fight our way to the

status quo. As you know, Dave indicated to us at the beginning of his comments. There

are places where the regime is sort of vulnerable and will pare back its excesses when

opposition raises its head. So, when the rep Republican senator said no to the cuts, you

know, we were able to stop some of those cuts. So, we have to keep doing that. But in

terms of making new affirmative contributions, no, I agree with you. We we're not

making progress with this government. However, I think it's somewhat underrated how

much progress we made in the Biden administration, particularly in the last

two years, including including, yes, funding production in the south and also

paring back Big Pharma's power and also sharing technology with the global

south. Those are all areas where the Biden administration made major commitments in

its last two years to reduce trade and we were in dialogue with him to reduce trade

pressures on other governments. Now actually the Trump administration has confirmed

the National Institutes of Health are the world's leading funder of biomedical

research and development about $50 billion a year. There's a new policy that was

developed over several years issued under Biden, rescinded briefly, and then recently

confirmed under Trump, we understand confirmed by the White House that says that

and it's now effective as of October 1st. Going forward now, any company that relies on

a federal invention, federal technologies, these are like government-owned patents,

which includes a lot of the key technology in the NIH COVID - 19 vaccine is actually

federal technology. If you're a drug maker or vaccine maker, if you're Moderna and you

want to rely on that technology, you want to license it from the federal government, you

now have to file an access plan with the National Institutes of Health saying, “Here's

how we are going to support access to this.” NIH can turn it down. NIH can work

with Moderna to sort of make those policies better. And you know, it's not as

comprehensive as we want it to be.

There's a lot of shortcomings I could outline. But the point is that if that policy which

is now in effect had been effect in 2020, the US government would have had quite a bit

more leverage to insist on global vaccine equity with MANA and helped save many lives

that were that were ultimately lost. Those are political. and

I could point to several more policies. Those are politics that advanced as a result of all

of our advocacy. As a result of the world's experience with vaccine apartheid and

inequity during Covid-19.

Now we're dealing with the backlash under Trump in other ways but this is an example

of the kind of normative progress that I was pointing to where, despite capitalism,

despite Trump, despite the power of Big Pharma, is actually taking a lot of losses right

now in the with the US government and internationally in a way that would not have

been possible 15 years ago and some of them really speak to these global equity

matters that that I do think we should keep working with them internationally. It's also

the case that sometimes you get voluntary concessions or negotiated concessions.

That's what I work on in the Medicines Patent Pool where licensed health bodies we are

talking to both generics manufacturers and Big Pharma to say on what terms can we

get generics out to developing countries. Obviously it's not going to be everything that

we want, but you know those are all life-saving improvements on the status quo that

can also move the needle of justice as well.

On the Marberg candidate, I don't know enough about it. You've got me intrigued, so I'm

going to look into it. If it's the case that it is a patented, important vaccine, then there are

usually ways we can lean either on the company or on the governments that enshrine

the relevant patent rights either for licensing or for price reductions. Ultimately, we'd like

to have it out there so that others can produce it, um, either through a negotiated

commitment from Sabin and any companies that are involved. If we push for that,

sometimes even if we don't get it or don't get it on the terms we want, we can win price

reductions. So that's what happened in MPOX, where the resolution right now is

not everything we want, but you have not only the Europe-based Bavarian Nordic

producing but also the Serum Institute in India and maybe others that will produce

MPOX vaccines and price reductions from Bavarian Nordic from $300 to $65. It is still

pretty expensive but a lot better than it was. So, I don't know. I guess the uh the short

the long and short of that is I agree that for this stuff, I actually do agree that the

primary focus really is in Africa and it's what we can do. It's what African governments

can do and what regional organizations will do to stand up change.

And then internationally, we have responsibilities to facilitate that. That includes fighting

the cuts. But I actually do think there are areas where we can make key inroads that that

save lives on both Pharma and the wealthy governments involved. Thanks. Some

comments, too.

A Proposed Strategy for Contributing to End Vaccine Apartheid. How did we get here?