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Neo-Colonialism In Context To Global Health And COVID-19

Neocolonialism followed nation's "liberation" from its colonizer. Neocolonialism share many characteristics with its predecessor, the very structure of oppression, suffering and humiliation. The people are economically and socially reliant on the colonizers despite physical and political freedom. The remains of damaging systems and continued control of the colonizers normalizes

dependency. This can be palpably observed in foreign medical services. International organizations penetrate localities without citizens' knowledge or consent, through incorrect medical intervention which reinforces "Western" supremacy. The ongoing pandemic unveils abundantly, yet again, the existing neocolonialism in the global health scenario.

United States have been observed to implement 'vaccine redlining' policies, which resulted in shortage and prolonged inaccessibility of sufficient vaccine doses globally. This means that people living in many Global South countries are not expected to have significant doses of vaccines administered until as late as 2024.

The U.S. and other high income countries have been noted to engage in dire 'vaccine nationalism', hoarding more than enough supplies to inoculate their population several times over, leading to not just wastage of large number of doses but also depriving poor countries of any substantial access to vaccines; demonstrating supremacist attitude and heightening the visibility of neocolonialism in the existing global healthcare scenario.

Additionally, monopolizing vaccines on prices and profit, big pharmaceuticals have created an artificial limited supply which further exacerbates the issue of inaccessibility and convoluted racism; which reasons why South Africa obtained millions of vaccine doses at a cost of $5.25 per dose a price that is more than double the $2.16 per dose that European Union countries paid to AstraZeneca.

Further, with the failure of global health schemes like COVAX, an initiative by WHO to provide low and middleincome nations affordable and easy access to COVID vaccine (requiring donations and financial contributions from high income economies) and with TRIPS (Trade Related Aspects of Intellectual Property Rights) representing important gains for the Pharma industry, including: an extended period of protection to twenty years; the requirement that all technologies receive equal treatment precluding lesser protection for pharmaceuticals; and limits on compulsory licensing, the vaccine inequities are becoming increasingly disturbing.

Prima facie, it appears that this vaccine alliance is fundamentally flawed, depending on the charity of others to donate money or share vaccine surpluses given the need for countries to vaccinate their entire population.

In February 2021, Ghana became the first country to receive vaccine doses under this scheme. However, the late "timing and the relatively modest supply enough for just 1% of Ghana's population point to major challenges." Indeed, by April 2021, COVAX "distributed 43 million doses of vaccine to 119 countriescovering just 0.5 percent of their combined population of more than four billion."

Contrastingly, it seems unjust for wealthy countries to hoard the vaccines and drive up the prices on one hand, and promise charitable donations (ever so insufficiently) on the other. Into the bargain is the limited supply created artificially by the Big Pharma's by monopolizing the prices and profit, further aggravating the inequities. These vaccine monopolies make cost of vaccinating the world against COVID at least 5 times more expensive than it could be.

A French news channel (namely LCI) on April 1, 2020, aired an interview between Dr. Camille Locht, head of research at INSERM (Institut National de la Sant� et de la Recherche M�dicale) and Dr. JeanPaul Mira, head of intensive care at the Cochin Hospital in Paris. The interview covered ongoing trials of the BCG (bacille CalmetteGuerin) a tuberculosis vaccine as a potential COVID19 prevention measure, that were being conducted in Europeand Australia.

In an analogy to HIV research carried out among commercial sex workers who are "extremely exposed and do not protect themselves," Mira questions whether such studies "should not be undertaken in Africa, where there are no masks, no medications, no intensive care." Locht wholeheartedly agrees, pointing out that his team was already thinking about running a comparable experiment in Africa.

This upsetting exchange is notable because it effectively conveys a number of fundamental characteristics and accepted standards of medical colonialism in just a few short phrases. Mira has the same exploitative motivation as colonialera doctors who regarded Africa and Africans as a source of raw materials for research that would advance their careers when he advises that the study be undertaken in Africa.

Mira's claim that the reason for doing a research in Africa is that the area lacks resources "no masks, no intensive care" and the presumption of general lack of hygiene, health and health standards, so that any action should be seen as a benevolent and admirable deed is blatant saviourism. Another such recent instance was in June 2020, when University of Oxford conducted trial of its vaccine in Johannesburg, South Africa where "the people chosen as volunteers for the vaccination, they look as if they're from poor backgrounds, not qualified enough to understand" the risks of trial.

The trend of taking resources from Black and other people of colour for therapeutic trials that involve experimentations have a long, sordid history grounded in prejudicial and racists beliefs. Following such studies, new medications and therapies are created using the knowledge gained from it. However usually, the study participants and their communities do not profit equally from these breakthroughs.

Since economic reliance, exploitation, injustice, and the depiction of communities of colour as disposable are its primary motivators, it is not a stretch to say that medical neocolonialism is a close cousin to historical colonialism. South Africa is a prime illustration of vaccine apartheid. South Africans should have had more posttrial access and advantage since they first took part in clinical trials for the creation of the medicine.

South Africa instead had to pay extra for time sensitive and necessary medication like the COVID vaccine, strengthening the burden. The South African instance effectively demonstrates how "the rewards of medical and technological progress are stored for some and withheld from others. In addition, these traits of neocolonialism are not restricted to clinical trials and limiting accessibility to vaccines through monopolizing pricing and distribution.

The crisis situation of COVID19 highlights the ways in which developed nations control vaccine accessibility through international laws regulating intellectual property rights (IPR). The goal of TRIPS Agreement is to "protect and enforce intellectual property rights [so] as to assist in the development of technical innovation and the transfer and diffusion of technology," according to Article 7 of the Agreement.

Similar to the above, TRIPS Article 66(2) additionally requires industrialized nations to "give incentives to firms and organizations inside their territory to promote and support technology transfer to leastdeveloped countries". Although the phrase "transfer of technology" may appear advantageous or innocuous, in reality it is not.

Regarding medications, patented health/medicinal products are generally costly due to high demand and low inventory. Under the relevant provisions of TRIPS, such items can't be manufactured, marketed, or sold in any country without consent of the concerned IP rights owner. This represents a possibly critical obstruction to importation of drug items primarily by developing nations.

The obvious solution to this is the production of generic or offpatent medicines (by third world countries) for cheaper and in large quantities for domestic use and exportation. TRIPS framework allows such production and exportation under 'TRIPS Flexibilities'. However, it comes with its own limitations and are insufficient in dealing with the current pandemic, especially for countries that lack manufacturing capability in the pharmaceutical sector.

Carmen Gonzalez has demonstrated that when development goals are included in international legal frameworks and institutions, they become enmeshed in frameworks that may limit their capacity for transformation and perpetuate NorthSouth power inequalities.

These limitations are placed on development goals by capitalistimperialist systems, adaptations are made to legitimize colonial actions, and mobilization via racial distinctions. Even in the 21st century, these institutions still form the foundation of international law. The legal and regulatory frameworks that enable international law as well as the broader socioeconomic strokes made on the global economy continue to be animated by colonialist patterns.

The response to the Global South Global North disparity to intellectual properties and associated inaccessibility to vaccines among developing nations is "Third World approaches to International Law" (TWAIL). The goal of TWAIL is to dissect and reveal transformative and retrogressive aspects of international law.

Therefore, in order to attain and advance global justice, "international law must be transformed from a discourse of oppression to a vocabulary of emancipation." This may be done by deconstructing a narrative that is centered on colonial past, power, identity, and issues of Third World countries, as well as by generating interest in the Global South.

The initiative, from developing and underdeveloped nations, to challenge and amend such international laws resonate in the joint submission made by India and South Africa to significantly reshape the TRIPS regime, thereby allowing a detailed technology transfer of efficacious COVID19 diagnostic tests, therapeutics, and vaccines. The joint proposal includes a wide range of topics, including not just patents but also copyright, industrial designs, and unpublished information, including technical expertise and trade secrets.

With the interim prohibition, numerous actors would be allowed to begin production as opposed to manufacturing being restricted to the few present patent holders, which restricts access making a sizable number of world population disposable.


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2) Patti, Lorenzo. "International Medical Service Trips: Colonialist Roots and Ethics Of Global Health Today." (2021).

3) Francesco Guarascio, "WHO Vaccine Scheme Risks Failure, Leaving Poor Countries with No COVID Shots Until 2024", Reuters (16 December, 2020), online: (on file with the Columbia Law Review).

4) Peter S. Goodman, "One Vaccine Side Effect: Global Economic Inequality, N.Y. Times (25 December, 2020), online: (on file with the Columbia Law Review)>(last updated Dec. 31, 2020)

5) Helen Sullivan, "South Africa Paying More than Double EU Price for Oxford Vaccine", Guardian (22 January, 2021), online: southafricapayingmorethandoubleeupricefor oxfordastrazenecavaccine[];>

6) Rouw, Anna, et al. "COVAX and the United States." KFF Issue Brief 18 (2021).

7) Boaventura De Sousa Santos and Cesar A. RodriguezGaravito, Law and Globalization from Below, Chapter 5, published inUnited States of America by Cambridge University Press, New York, 2005

8) Danielle Paquette & Emily Rauhala, First Vaccine Doses Distributed by Covax Land in West African Nation of Ghana, Wash.Post. (24 February, 2021), online: world/africa/covaxghana astrazenecavaccine/2021/02/24/558d31bc761711eb9489 8f7dacd51e75_story.htIml >

9)Tedros Adhanom Ghebreyesus, Opinion, I Run the W.H.O., and I Know that Rich Countries Must Make a Choice,

N.Y. Times (22 April, 2021), online: 2021/04/22/opinion/whocovidvaccines.html> (on file with theColumbiaLaw Review).

10) Anna Marriott & Alex Maitland, "The great vaccine robbery" (29 July , 2021), online (pdf): Amnesty online:

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12)Tilley, Helen. Medicine, empires, and ethics in colonial Africa. AMA Journal of Ethics, (2016). 18(7), at 743753.

13) Makoni, Munyaradzi. COVID19 vaccine trials in Africa. The Lancet Respiratory Medicine, (2020). 8(11), e79e80.

14)Cara Anna, "Protest vs. Africa's 1st COVID19 vaccine trial shows fears", CityNews 680 (July 1, 2020), online

15)Archibong, Belinda, and Francis Annan. 'We Are Not Guinea Pigs': The Effects of Negative News on Vaccine Compliance.(2021). Available at SSRN 3765793.

16)Cho, Hae Lin, Marion Danis, and Christine Grady. Posttrial responsibilities beyond posttrial access. The Lancet, (2018).391(10129), 14781479.

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18)Gonzalez, Carmen G., and Sumudu Atapattu. "International environmental law, environmental justice, and the Global South."Transnat'l L. & Contemp. Probs. 26 (2016): at 229.

19)Chimni, Bhupinder S. The articles on state responsibility and the Guiding Principles of shared responsibility: A TWAILperspective. European Journal of International Law, (2020). 31(4), at 12111221.

20)Eslava, Luis, Michael Fakhri, and Vasuki Nesiah, eds. Bandung, global history, and international law: critical pasts andpending futures. Cambridge University Press, (2017).

21)Chapter 4: Medical technologies: the access dimension, online: <>

22)Zaman, Khorsed. The waiver of certain intellectual property rights provisions of the TRIPS for the prevention, containment and treatment of COVID19: A review of the proposal under WTO jurisprudence. European Journal of Risk Regulation, (2022).13(2), at 295310.

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