Key points

  • Richer countries are stockpiling vaccines, making people in poorer countries wait.
  • Countries covering 14% of the world’s populations have brought 53% of vaccine supplies.
  • 200 pharma companies are chasing profits from the estimated annual sale of £10bn – sales funded largely through the public sector.

The seemingly altruistic race to develop and test a vaccine to immunise the world’s population against covid-19 has been fascinating to witness, and is by no means over yet. But the roll-outs of the various end-products have so far displayed worrying signs of profiteering and geopolitical posturing. 

On 20 January Mariangela Simao – assistant director-general of the World Health Organization (WHO), which has negotiated supply deals with five manufacturers to supply 2bn doses via the Covax programme – excitedly told poorer countries, “No one needs to panic, you’re going to get a vaccine.”

But despite this optimism, and the undoubtedly welcome news that the US is returning to the WHO fold following Joe Biden’s ascent to the White House, the UN body’s director-general Dr Tedros Adhanom Ghebreyesus spoke a week earlier of a looming “catastrophic moral failure” in the world, suggesting one poor country (thought to be Guinea) had received just 25 vaccine doses, while 39m had gone to “at least 49 higher-income” nations.

 “Even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots,” said Dr Tedros, before adding, “Most manufacturers have prioritised regulatory approval in rich countries, where the profits are highest.” 

News from one key producer involved in the WHO-backed Covax programme – the Serum Institute of India – neatly summed up the situation when, weeks after countries in Europe had already begun vaccinating their citizens, it announced earlier this month that it would be unable to deliver to WHO clients until March or April, a potentially disastrous delay. 

US research organisation the Duke Global Health Innovation Center (DGHIC) estimates that there will not be enough vaccines to cover the world’s population entirely until 2023 or 2024

While many high- and middle-income countries have committed to funding the Covax programme – which aims to reach just 20 per cent of recipient countries’ citizens, a figure thought by some to be insufficient to stop transmission – many have also made direct deals with manufacturers to cover their own populations several times over (five times over, in the case of Canada). DGHIC estimates that high-income countries currently hold 4.2bn vaccine doses, while low- to middle-income countries, which often lack the infrastructure for mass immunisation campaigns, hold just 270m

The People’s Vaccines Alliance – a recently established coalition of scientists, activists and not-for-profits like Amnesty International, Oxfam and UNAids – makes a similar point, warning that 90 per cent of people in low-income countries won’t receive vaccinations any time this year, because their governments can’t compete with richer nations stockpiling vaccines for their own citizens. 

The alliance claims countries representing just 14 per cent of the world’s population have bought up more than 53 per cent of the most-promising vaccines – including 96 per cent of Pfizer/ BioNTech’s expected production.

Among the alliance’s aims is a drive to prevent monopolies by making public funding for R&D conditional on pharmaceutical companies freely sharing data and IP. But sadly, when India and South Africa asked the World Trade Organisation last year  to allow its member countries to ignore patents on covid-related vaccines – allowing the production of cheap, generic copies – until global immunity had been achieved, their proposal was blocked.

And another WHO programme, set up last year, for pharmaceutical companies to voluntarily share pandemic-related knowledge, attracted no contributions at all. 

The Medicines Patent Tool (MPP), another UN-backed platform, has also failed to negotiate any covid-19 deals. MPP executive director Charles Gore has said this represented a failure to tackle the pandemic in a global way, and claimed there was “a little too much of ‘me first’” going on. 

In response, one pharmaceutical industry spokesman archly defended the status quo, saying, “Circumventing IP rights will not solve perceived access challenges.” This despite all the major advances in vaccines over the past year having been supported by massive amounts of taxpayer investment.

“We’re socialising all the risk and privatising all the profit.”

Let’s take a couple of examples to see the impact of how this global supply imbalance is playing out. Africa, of course, faces huge challenges in accessing, let alone buying vaccines, but the Covax programme is yet to launch on the continent, and currently relies solely on the Pfizer/BioNTech vaccine which needs to be stored at -70C, obviously not ideal for many of the continent’s 1.2bn populace. 

Palestine, meanwhile, has been left to its own devices during the pandemic, with Israel reported to have “rebuffed” an informal request from the WHO to urgently supply vaccines to more than 4.5m Palestinian residents (including health workers) in the occupied territories of the West Bank and Gaza – ironically undermining the PR spin-off deriving from the success of Israel’s Pfizer/BioNTech-based vaccination programme for its own citizens (25 per cent of whom have already been inoculated) – merely citing a shortage of jabs.

But production problems experienced by the major vaccine suppliers –Pfizer/BioNTech and AstraZeneca – have hit rich and poor countries alike over the past few weeks. 

The increasingly disputed 12-week delay between administration of the first and second doses of the Pfizer/BioNTech vaccine in the UK has more than likely been driven by supply disruptions.

Similar disruptions have led to a reported drop of up to 50 per cent in vaccine deliveries from this manufacturer to other European countries, casting doubt on whether it will be able to deliver on its pledge last week to provide “up to” 40m doses to poorer countries (on a hard-to-challenge non-profit basis) any time soon.

And these production issues combine with a less-savoury aspect of the global covid vaccine supply chain, dulling the shine on any claims of commercial altruism.

The pandemic began in late-2019, but it was another four months before ‘Big Pharma’ announced plans for vaccine development. Over the following eight months more than 200 companies had followed suit, and almost 50 products were in clinical trials. The reason? Huge levels of public funding – £6.5bn from governments and £1.5bn from not-for-profits, according to research outfit Airfinity, although other sources suggest a total nearer $26bn – and the likely profits that would follow, arising from projected annual sales of vaccines up to $10bn. 

As the head of one US campaign group put it, with government cash funding high-risk research, “We’re socialising all the risk and privatising all the profit.” 

To finish, here are two more illustrations of the power of the dollar during the pandemic: New Republic magazine revealed last November how executives at vaccine suppliers Pfizer and Moderna appeared to be scheduling lucrative stock sell-offs to coincide with market rallies driven by the release of positive news about their employer’s covid-related products in development. 

And the Israeli vaccination programme, referred to earlier, is reported to have depended on a controversial deal to provide vast troves of medical data, triggering ethical and privacy concerns, to Pfizer/BioNTech in order to ensure ongoing supplies, even though – according to Israeli media – the country has paid at least 50 per cent more than other countries for those supplies.

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