WORLD Trade Organisation (WTO)Director-General Ms Ngozi Okonjo-Iweala on Tuesday called on COVID-19 vaccine manufacturers to ramp up production in developing countries to combat the vaccine supply shortage.

In remarks to an event hosted by the British think tank Chatham House, Ms Okonjo-Iweala said cooperation on trade and action at the WTO, would help accelerate vaccine scale-up.

"The scarcity of COVID-19 vaccine supplies had led to a situation in which around 75 countries are able to move ahead with vaccination while 115 countries wait as people die," the DG said.

Not only was this morally "unconscionable," she said, it would prolong the pandemic and cause economic harm to all countries. Instead of restricting exports and bidding up prices, she argued, "it is in all of our self-interest to cooperate in dealing with this problem of the global commons."

The Director-General saw cause for hope in the first vaccine deliveries to developing countries by the COVAX facility, the global mechanism for procuring and equitably distributing COVID-19 vaccines. Nevertheless, production and delivery volumes remained too low.

"We have to scale up and scale out COVID-19 vaccine production, particularly in emerging markets and developing countries," she said.

Given the years required to build new manufacturing facilities from scratch, increasing production in the short-term means "making the most of existing manufacturing capacity" by finding existing sites and turning them around. Recent experience suggests that repurposing facilities and vetting them for safety and quality can happen in six or seven months, less than half as long as previously thought.

By bringing more production online around the world, she said, vaccine manufacturers would send a signal that they are taking action, and that people and governments in low- and middle-income countries can expect to get access to affordable vaccines within a "reasonable timeframe."

The WTO chief observed that companies in India and elsewhere were already manufacturing COVID-19 vaccines under licence but said that more such arrangements are necessary.

Discussions during the conference had highlighted three constraints to ramping up production, the Director-General noted: scarcity of raw materials, shortages of qualified and experienced personnel, and supply chain problems linked to export restrictions and prohibitions as well as excessive bureaucracy. The WTO's mandate on trade facilitation, quantitative trade restrictions, and trade policy monitoring were relevant to the latter challenges in particular.

Because vaccine production relies on sourcing components and ingredients from multiple countries, she said, trade restrictions would slow down production, and make it more expensive.

Nevertheless, DG Okonjo-Iweala noted, WTO rules do allow for export restrictions or prohibitions to be "temporarily applied to prevent or relieve critical shortages" of essential products. That said, such restrictions must be notified to all members. Restrictions should be transparent, proportionate to the problem at hand, and members should provide timelines for when they will be phased out, she said.

She reported that WTO monitoring indicates that 59 members and seven observers still had some pandemic-related export restrictions or licensing requirements in place at the end of February, primarily for personal protective equipment. It was welcome that these figures were lower than the 91 countries that had brought in such measures over the past year.

However, "not all pandemic-related export restrictions have been notified," she said. "Not all of them appear to be temporary. Not all of them are proportionate."

"We must strengthen our monitoring and reporting function," the DG said, explaining that her objective would be to encourage members to drop or reduce export restrictions, or set timelines for phase out, to help minimise problems in the vaccine supply chain.

On both export restrictions and trade facilitation, Ms Okonjo-Iweala noted, prospects for action at the WTO would improve as businesses are seen to step up efforts on vaccine production.

The Director-General referred to the ongoing debate at the WTO on a proposal to waive standard WTO intellectual property rules for COVID-related vaccines, therapeutics, and diagnostics.

"Many of the proposal's supporters are developing and least developed countries, deeply marked by the memory of unaffordable HIV/AIDS drugs," she told conference participants. Critics of the proposed waiver, she noted, say it could threaten investment and innovation, and other members have asked for more evidence that intellectual property protections are an inhibiting factor in vaccine scale-up.

While these "vitally important discussions are intensifying here in Geneva," she said, "the fact is that each additional day the vaccine shortage continues, people will pay with their lives."

She argued that it was possible to "walk and chew gum at the same time," continuing the search for solutions in the TRIPS debate, while simultaneously taking action to increase production, "especially in emerging markets and developing countries where such possibilities exist."