It’s unimaginable that more than two years into the pandemic with more than 15 million people killed, World Trade Organization (WTO) countries are still stuck debating whether WTO intellectual property barriers should be waived for COVID-19 vaccines, treatments and tests.

Actually, that’s not quite correct: The needed waiver has been scotched thanks to a few wealthy countries doing Big Pharma’s bidding.

Instead, the WTO staff is pushing for a deal on a rump text that experts at Doctors Without Borders and other groups conclude​ is unlikely to result in more vaccines being made or administered. It does not even apply to treatments and tests. Worse, it could undermine countries’ existing WTO flexibilities to make generic versions of medicines.

This is not what most countries want. More than 100 support a temporary waiver of the WTO’s monopoly rights for pharmaceutical corporations so that more of the most effective mRNA vaccines and life-saving treatments, like Paxlovid, can be produced in as many locations as possible.

President Joe Biden supported a WTO waiver of IP barriers for COVID vaccines. South Africa and India’s text that waives WTO’s Agreement on Trade-Related Intellectual Property (TRIPS) provisions has 65 country cosponsors.

Yet with our health and the world economy at risk from dangerously low vaccination rates and limited access to treatments in most developing nations, three WTO members—the European Union (EU), Switzerland and the U.K.—have blocked the rest of the world.

At the start of 2022, the WTO’s director general sought a way forward through talks among the EU, South Africa, India and the U.S. But that process failed as the EU defended the pharmaceutical industry position and refused to waive intellectual property monopolies while the U.S. insisted that any deal cover only vaccines not easier-to-produce treatments. The U.S. demand seems particularly ironic, cruel and out of step with the ever-changing COVID-19 situation, now that U.S. COVID strategy has changed to prioritize testing and treatment.

That text was so bad only the EU supported it. It was resoundingly rejectedworldwide. WTO rules have limited countries’ freedom to operate generic COVID-19 medicine production, thus the need for a waiver, not additional constraints.

But now, remarkably, even though South Africa, India and the U.S. did not support the EU’s no-waiver approach and most WTO countries support a waiver, the rump text has replaced the waiver as the focus of WTO negotiations.

Partners In Health, Oxfam and other groups urged Biden to reject this approach that wouldn’t deliver even on his limited vaccine waiver pledge.

Waiving IP barriers is as relevant as ever. What is described as a “glut” in developing nations is widely understood there as pharmaceutical corporations and wealthy countries dumping old and less effective vaccines that their citizens don’t want. If second generation versions of the most effect mRNA shots targeted to stop infection by recent variants like Omicron are only available in a few wealthy nations and mass outbreaks continue in the developing world, we will lose the next race between vaccines and variants.

What is needed is simple—a straightforward waiver, eliminating legal uncertainties, not raising new issues, so that any firm producing any of these badly needed vaccines, treatments and tests does not have to worry about being sued.

The principle of access to intellectual property in the face of an epidemic has long been accepted. It’s just that the drug companies are engaged (successfully) in foot dragging to maximize profits before more supplies eventually become available.

It’s horribly reminiscent of what happened in the 1990s HIV/AIDS epidemic. Millions of people in Africa suffered and died from AIDs while a few powerful developed countries blocked a WTO waiver for life-saving antiretrovirals.

Instead of focusing on saving lives, today in the lead up to the WTO’s major decision-making June 12 ministerial conference meeting, trade negotiators are being put under enormous pressure to ink an agreement, any agreement, to show that the WTO is still relevant.

No agreement is better than a bad agreement. Negotiators still have time to fix the situation. If the EU, U.K., Switzerland and the U.S. won’t agree, at a minimum they must commit to not attacking countries that act to save their citizens as developing countries and emerging markets must take the protection of their citizens in their own hands, doing whatever they can.

We should also recognize the anger felt in the developing countries over what has happened. It is part of the reason that many countries are not lending support to European and American defense of Ukraine against Russia’s outrageous attack. We seem to care about the lives of Ukrainians, but not those dying unnecessarily of COVID-19.

There is no need for more people to die, for more mutations—some more deadly and contagious—to arise or for more to fall into poverty as more livelihoods are destroyed. The upcoming WTO ministerial summit could save lives and livelihoods, rehabilitate the international rules-based system and make an important step for international solidarity by enacting a clean waiver for COVID-19 vaccines, treatments and tests.

What is at stake is not just this pandemic, but the next. Will the WTO and intellectual property monopolies over medicines again impede the global response, again causing unnecessary deaths, again exacerbating an economic downturn?

The ball is the hands of a few countries—the EU plus the U.K., Switzerland and the U.S.—who ironically hold themselves out as stalwarts of human rights. But what human right is more important that the right to live?