{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T14:29:53Z","timestamp":1766068193759,"version":"3.41.0"},"reference-count":51,"publisher":"Cambridge University Press (CUP)","issue":"S1","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"unspecified","delay-in-days":103,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Law. Med. Ethics"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Scientific advances to fight infectious diseases have been remarkable. International law and global governance have sought, and often failed, to keep pace, secure equity, and stop outbreaks. We trace the law and governance model emerging from early failure in the AIDS response and identify four elements: use of law by national governments to compel sharing; decentralized generic manufacturing; mechanisms for voluntary sharing of patents and technology transfer; international funding. In combination, these created a remarkable new ecosystem. We find that when COVID-19 hit and mRNA vaccines were rapidly developed, global North governments opposed mobilizing this synergistic model. Instead, equity efforts focused on financing purchase of vaccines from originator companies with little use of law. Amidst monopolies and scarcity of doses, vaccine nationalism fatally undermined this effort. Whether more synergistic law and governance emerges from rapidly changing global health law will likely dictate the efficacy of future global infectious disease response.<\/jats:p>","DOI":"10.1017\/jme.2025.27","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T09:08:31Z","timestamp":1744621711000},"page":"23-28","source":"Crossref","is-referenced-by-count":2,"title":["Law and Global Governance of Infectious Disease: Access to Medicines on COVID-19, AIDS, and Beyond"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1751-4828","authenticated-orcid":false,"given":"Matthew M.","family":"Kavanagh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Gil","family":"Abinader","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"S1073110525000270_r5","doi-asserted-by":"crossref","DOI":"10.1057\/9781137312167","volume-title":"South African AIDS Activism and Global Health Politics","author":"Mbali","year":"2013"},{"key":"S1073110525000270_r1","doi-asserted-by":"crossref","first-page":"329","DOI":"10.4159\/9780674369870","volume-title":"Global Health Law","author":"Gostin","year":"2014"},{"unstructured":"26. Waiver, WTO : Waiver from Certain Provisions of the TRIPS Agreement for the Prevention, Containment and Treatment of COVID-19, IP\/C\/W\/684 (2020).","key":"S1073110525000270_r26"},{"unstructured":"41. \u201cLaunch and Scale Speedometer,\u201d Duke University Global Health Innovation Center, https:\/\/launchandscalefaster.org\/covid-19\/; TOI Staff, \u201cNetanyahu Bullish on Deal for Pfizer Vaccine after Talks with CEO,\u201d The Times of Israel, February 5, 2022, https:\/\/www.timesofisrael.com\/netanyahu-bullish-on-deal-with-pfizer-for-vaccines-after-talks-with-ceo\/; M. Stevis-Gridneff, \u201cHow Europe Sealed a Pfizer Vaccine Deal With Texts and Calls,\u201d The New York Times, February 5, 2022, https:\/\/www.nytimes.com\/2021\/04\/28\/world\/europe\/european-union-pfizer-von-der-leyen-coronavirus-vaccine.html.","key":"S1073110525000270_r41"},{"unstructured":"49. National Institute of Standards and Technology, Department of Commerce, \u201cDraft Interagency Guidance Framework for Considering the Exercise of March-In Rights,\u201d 88 FR 85593 \u00a7 (2023), https:\/\/www.federalregister.gov\/documents\/2023\/12\/08\/2023-26930\/request-for-information-regarding-the-draft-interagency-guidance-framework-for-considering-the.","key":"S1073110525000270_r49"},{"unstructured":"46. Baker and Hassan, supra note 33.","key":"S1073110525000270_r46"},{"unstructured":"47. Furlong, J. Kew , and Kresge, N. , \u201cMissed Warnings, $100 Vaccines and Red Tape \u2014 Why Mpox Was an Avoidable Emergency,\u201d Bloomberg, August 25, 2024, https:\/\/www.bloomberg.com\/news\/features\/2024-08-25\/mpox-outbreak-missed-warnings-vaccine-delays-fuel-global-emergency.","key":"S1073110525000270_r47"},{"key":"S1073110525000270_r19","article-title":"Global Fund Secures Deal to Slash HIV Treatment Price","volume":"24","year":"2023","journal-title":"France"},{"unstructured":"29. KEI, \u201cSelected U.S. Government COVID Contracts with Authorization and Consent to Non-Voluntary Use Of Third Party Patents\u201d (KEI, 2022), https:\/\/www.keionline.org\/bn-2022-1.","key":"S1073110525000270_r29"},{"unstructured":"27. WHO, \u201cCOVID-19 Technology Access Pool,\u201d https:\/\/www.who.int\/initiatives\/covid-19-technology-access-pool (last accessed August 22, 2024).","key":"S1073110525000270_r27"},{"unstructured":"18. UNAIDS, supra note 7.","key":"S1073110525000270_r18"},{"key":"S1073110525000270_r48","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1215\/03616878-10910269","article-title":"Intellectual Property and the Politics of Public Good in COVID-19: Framing Law, Institutions, and Ideas during TRIPS Waiver Negotiations at the WTO","volume":"49","author":"Fischer","year":"2024","journal-title":"Journal of Health Politics, Policy and Law"},{"unstructured":"34. Robbins, R. and Mueller, B. , \u201cCovid Vaccines Produced in Africa Are Being Exported to Europe,\u201d The New York Times, August 16, 2021, https:\/\/www.nytimes.com\/2021\/08\/16\/business\/johnson-johnson-vaccine-africa-exported-europe.html.","key":"S1073110525000270_r34"},{"unstructured":"39. Hassan, F. , \u201cThe Great COVID-19 Vaccine Heist,\u201d Daily Maverick, 2020.","key":"S1073110525000270_r39"},{"unstructured":"10. WTO, \u201cDeclaration on the TRIPS Agreement and Public Health,\u201d WT\/MIN(01)\/DEC\/2 WT\/MIN(01)\/DEC\/2 \u00a7 (2001), https:\/\/www.wto.org\/english\/thewto_e\/minist_e\/min01_e\/mindecl_trips_e.htm.","key":"S1073110525000270_r10"},{"unstructured":"25. Quesada, C.A. , \u201cLetter to Dr. Tedros Adhanom Ghebreyesus,\u201d March 23, 2020, https:\/\/www.keionline.org\/wp-content\/uploads\/President-MoH-Costa-Rica-Dr-Tedros-WHO24March2020.pdf.","key":"S1073110525000270_r25"},{"key":"S1073110525000270_r11","first-page":"1","article-title":"Driving a Decade of Change: HIV\/AIDS, Patents and Access to Medicines for All","volume":"14","author":"\u2019t Hoen","year":"2011","journal-title":"Journal of the International AIDS Society"},{"unstructured":"12. \u201cThe TRIPS Flexibilities Database,\u201d Medicines Law & Policy, http:\/\/tripsflexibilities.medicineslawandpolicy.org\/.","key":"S1073110525000270_r12"},{"unstructured":"31. \u201cEU Proposal Seeks to Derail TRIPS Waiver Discussions at WTO,\u201d Thrid World Network, February 6, 2022, https:\/\/www.twn.my\/title2\/wto.info\/2021\/ti210603.htm.","key":"S1073110525000270_r31"},{"key":"S1073110525000270_r22","doi-asserted-by":"crossref","first-page":"e145","DOI":"10.1016\/S2214-109X(22)00460-0","article-title":"Expanding Access to Biotherapeutics in Low-Income and Middle-Income Countries through Public Health Non-Exclusive Voluntary Intellectual Property Licensing: Considerations, Requirements, and Opportunities","volume":"11","author":"Morin","year":"2023","journal-title":"Lancet Global Health"},{"unstructured":"43. Kavanagh and Singh, supra note 28.","key":"S1073110525000270_r43"},{"unstructured":"32. WTO, \u201cMinisterial Decision on the TRIPS Agreement,\u201d WT\/MIN(22)\/30, WT\/L\/1141 (2022), https:\/\/docs.wto.org\/dol2fe\/Pages\/SS\/directdoc.aspx?filename=q:\/WT\/MIN22\/30.pdf&Open=True. F. Hassan, \u201cA New and Weak WTO Deal on TRIPS Is Not Fit for Purpose | Think Global Health,\u201d Think Global Health, July 1, 2022, https:\/\/www.thinkglobalhealth.org\/article\/new-and-weak-wto-deal-trips-not-fit-purpose.","key":"S1073110525000270_r32"},{"unstructured":"7. U ntangling the Web of Antiretroviral Price Reductions (M\u00e9decins Sans Fronti\u00e8res Access Campaign, July 2012), http:\/\/www.msfaccess.org\/content\/untangling-web-antiretroviral-price-reductions-15th-edition; 2024 Global AIDS Report \u2014 The Urgency of Now: AIDS at a Crossroads (UNAIDS, 2024), https:\/\/www.unaids.org\/en\/resources\/documents\/2024\/global-aids-update-2024.","key":"S1073110525000270_r7"},{"unstructured":"2. Centers for Disease Control & Prevention, \u201cAIDS Falls From Top Ten Causes of Death,\u201d press release, October 7, 1998, https:\/\/www.cdc.gov\/nchs\/pressroom\/98news\/aidsmort.htm.","key":"S1073110525000270_r2"},{"key":"S1073110525000270_r4","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1038\/d41586-020-02774-8","article-title":"COVID-19 Vaccines: How to Ensure Africa Has Access","volume":"586","author":"Nkengasong","year":"2020","journal-title":"Nature"},{"key":"S1073110525000270_r13","first-page":"56","volume-title":"Private Patents and Public Health: Changing Intellectual Property Rules for Access to Medicines","author":"\u2019t Hoen","year":"2016"},{"unstructured":"30. Sharma, K. , \u201cGilead Licenses Remdesivir Production to India and Pakistan,\u201d Nikkei Asia, May 13, 2020, https:\/\/asia.nikkei.com\/Business\/Pharmaceuticals\/Gilead-licenses-remdesivir-production-to-India-and-Pakistan.","key":"S1073110525000270_r30"},{"key":"S1073110525000270_r33","first-page":"244","volume-title":"Pandemics and the Illumination of \u201cHidden Things\u201d: Lessons from South Africa on the Global Response to Covid-19","volume":"2023","author":"Baker"},{"unstructured":"17. UNAIDS, supra note 7.","key":"S1073110525000270_r17"},{"key":"S1073110525000270_r28","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/1758-5899.13203","article-title":"Vaccine Politics: Law and Inequality in the Pandemic Response to COVID\u201019","volume":"14","author":"Kavanagh","year":"2023","journal-title":"Global Policy"},{"key":"S1073110525000270_r21","doi-asserted-by":"crossref","first-page":"575","DOI":"10.2471\/BLT.18.229179","article-title":"Patent Pooling to Increase Access to Essential Medicines","volume":"97","author":"Burrone","year":"2019","journal-title":"Bulletin of the World Health Organization"},{"key":"S1073110525000270_r37","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1016\/S0140-6736(21)01367-2","article-title":"A Beautiful Idea: How COVAX Has Fallen Short","volume":"397","author":"Usher","year":"2021","journal-title":"Lancet"},{"unstructured":"40. \u201cPandemic Transparency,\u201d Health Justice Initiative, September 18, 2023, https:\/\/healthjusticeinitiative.org.za\/pandemic-transparency\/; \u201cEntrega oficial de las copias de los contratos COVID 19,\u201d Instituto Anticorrupci\u00f3n, https:\/\/www.estudiosanticorrupcion.org\/covid-19\/; M. Davies and R. Furneaux, \u201cVaccine Contract Forces a Government to Pay If Pfizer Makes Mistakes,\u201d Bureau of Investigative Journalism, October 3, 2021, https:\/\/www.thebureauinvestigates.com\/stories\/2021-03-10\/vaccine-contract-forces-dominican-republic-government-to-pay-if-pfizer-makes-mistakes; Transparency and Access to Medical Products (Medecins Sans Fronti\u00e9res, 2024), https:\/\/msfaccess.org\/sites\/default\/files\/2024-06\/MSF-AC_TransparencyReport_June2024_FINAL.pdf.","key":"S1073110525000270_r40"},{"unstructured":"6. Mbali, supra note 5, at 201.","key":"S1073110525000270_r6"},{"doi-asserted-by":"publisher","key":"S1073110525000270_r8","DOI":"10.1017\/CBO9780511491665"},{"volume-title":"The Price of Life: Hazel Tau and Others vs GlaxoSmithKline and Boehringer Ingelheim","year":"2023","author":"Beresford","key":"S1073110525000270_r14"},{"key":"S1073110525000270_r16","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1097\/QAD.0b013e32835521a3","article-title":"The History of Antiretroviral Therapy and of Its Implementation in Resource-Limited Areas of the World","volume":"26","author":"Vella","year":"2012","journal-title":"Aids"},{"key":"S1073110525000270_r9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1590\/S1806-64452005000200003","article-title":"TRIPS Agreement and Access to Drugs in Developing Countries","volume":"17","author":"Correa","year":"2005","journal-title":"Sur. Revista Internacional de Direitos Humanos"},{"unstructured":"42. \u201cCOVID-19 Data Explorer,\u201d Our World in Data, https:\/\/ourworldindata.org\/explorers\/coronavirus-data-explorer.","key":"S1073110525000270_r42"},{"unstructured":"38. COVAX: Key Learnings for Future Pandemic Preparedness and Response (Gavi, September 2022), https:\/\/www.gavi.org\/sites\/default\/files\/covid\/covax\/COVAX_Key-Learnings-for-Future.pdf; Berkley, supra note 36; WHO Concept for Fair Access and Equitable Allocation of COVID-19 Health Products (World Health Organization, September 9, 2020), https:\/\/www.who.int\/publications\/m\/item\/fair-allocation-mechanism-for-covid-19-vaccines-through-the-covax-facility.","key":"S1073110525000270_r38"},{"unstructured":"45. Berkley, Seth , \"Unprepared for the Big One,\" POLITICO, September 23, 2022, https:\/\/www.politico.com\/news\/magazine\/2022\/09\/23\/global-vaccine-outreach-after-covid-00058616","key":"#cr-split#-S1073110525000270_r45.1"},{"unstructured":"Open Consultants, \"External Evaluation of the External Evaluation of the Access To COVID-19 Access To COVID-19 Tools Tools Accelerator (ACT-A) Accelerator (ACT-A)\" (World Health Organization, October 10, 2022), https:\/\/www.who.int\/publications\/m\/item\/external-evaluation-of-the-access-to-covid-19-tools-accelerator-(act-a)","key":"#cr-split#-S1073110525000270_r45.2"},{"unstructured":"D. P. Mancini, \"Countries Weigh How to Buy Vaccines for the next Pandemic,\" Financial Times, February 1, 2022, https:\/\/www.ft.com\/content\/9147b3e4-7426-479d-881d-6b8731f3dba2.","key":"#cr-split#-S1073110525000270_r45.3"},{"unstructured":"24. Tu, L. , \u201cHow Advocates Pushed Big Pharma to Cut Tuberculosis Drug Prices,\u201d Scientific American, August 14, 2023, https:\/\/www.scientificamerican.com\/article\/how-advocates-pushed-big-pharma-to-cut-tuberculosis-drug-prices\/; Competition Commission of South Africa, \u201cCommission Initiates Investigation Against Johnson & Johnson (PTY) LTD and Janssen Pharmaceutica (PTY) LTD,\u201d media statement, September 15, 2023, https:\/\/www.compcom.co.za\/wp-content\/uploads\/2023\/09\/Media-Statement-Commission-investigates-Johnson-Johnson-15-September-2023.pdf; MSF & HJI, \u201cMSF Responds to Groundbreaking News That Johnson & Johnson Will Not Enforce Patents on Key TB Drug Bedaquiline in Low- and Middle-Income Countries,\u201d press release, September 30, 2023, https:\/\/www.msfaccess.org\/msf-responds-groundbreaking-news-johnson-johnson-will-not-enforce-patents-key-tb-drug-bedaquiline.","key":"S1073110525000270_r24"},{"unstructured":"44. \u201cOnly 1 in 4 African Health Workers Fully Vaccinated against COVID-19,\u201d World Health Organization: African Region, November 25, 2021, https:\/\/www.afro.who.int\/news\/only-1-4-african-health-workers-fully-vaccinated-against-covid-19.","key":"S1073110525000270_r44"},{"doi-asserted-by":"crossref","unstructured":"35. S. Sekalala and B. Rawson, \u201cManufacturing Inequality: Examining the Racial-Capitalist Logics behind Global Pandemic Vaccine Production,\u201d Afronomics Law (2023); Adikari, AACJ and Wijesinghe, S.S. , \u201cMaking Intellectual Property a Common Good to Combat Global Pandemics and the COVID-19 Technology Access Pool (C-TAP): Responding to the Challenges Exerted by Big Pharma and Some High-Income Countries,\u201d Journal of Business Research and Insights 7, no. II (2021); A. Pushkaran, V. K. Chattu, and P. Narayanan, \u201cA Critical Analysis of COVAX Alliance and Corresponding Global Health Governance and Policy Issues: A Scoping Review,\u201d BMJ Global Health 8, no. 10 (2023): e012168; Kavanagh and Singh, supra note 28.","key":"S1073110525000270_r35","DOI":"10.1136\/bmjgh-2023-012168"},{"unstructured":"36. Berkley, S. , \u201cCOVAX Explained,\u201d Gavi, September 3, 2020, https:\/\/www.gavi.org\/vaccineswork\/covax-explained.","key":"S1073110525000270_r36"},{"key":"S1073110525000270_r15","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1177\/097325860600100205","article-title":"HIV\/AIDS Treatment Legal and Political Choices for India","volume":"1","author":"Menghaney","year":"2006","journal-title":"Journal of Creative Communications"},{"unstructured":"23. Accelerating Access to Hepatitis C Diagnostics and Treatment (World Health Organization, January 27, 2021), ISBN 978-92-4-001900-3, https:\/\/www.who.int\/publications\/i\/item\/9789240019003.","key":"S1073110525000270_r23"},{"unstructured":"20. Ministerio de Salud y Protecci\u00f3n Social, \u201cUn Hito En La Lucha Contra El VIH: Minsalud Declara de Inter\u00e9s P\u00fablico El Dolutegravir,\u201d Bolet\u00edn de Prensa, October 4, 2023, https:\/\/www.minsalud.gov.co\/Paginas\/un-hito-en-la-lucha-contra-el-vih-minsalud-declara-de-interes-publico-el-dolutegravir.aspx.","key":"S1073110525000270_r20"},{"volume-title":"How AIDS Changed Everything: MDG: 15 Years, 15 Lessons of Home from the AIDS Response","year":"2015","key":"S1073110525000270_r3"}],"container-title":["Journal of Law, Medicine &amp; Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1073110525000270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T09:07:29Z","timestamp":1749200849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1073110525000270\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":51,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2025]]}},"alternative-id":["S1073110525000270"],"URL":"https:\/\/doi.org\/10.1017\/jme.2025.27","relation":{},"ISSN":["1073-1105","1748-720X"],"issn-type":[{"type":"print","value":"1073-1105"},{"type":"electronic","value":"1748-720X"}],"subject":[],"published":{"date-parts":[[2025]]}}}