A Fair Shot

From public pressure to saving lives

United States 2015 © Edwin Torres/MSF

Pneumonia is the top killer of children under five years old, despite the availability of a safe and effective vaccine against the disease. For years, the lifesaving pneumococcal conjugate vaccine (PCV) was priced out of reach for people in many low- and middle-income countries.

In 2015, MSF’s Access Campaign launched a public campaign to give children around the world “A Fair Shot” to get vaccinated. The campaign called on the pharmaceutical corporations Pfizer and GlaxoSmithKline (GSK), the only two manufacturers of the pneumonia vaccine, to drop the price. We argued that lowering the price of PCV would enable MSF, national ministries of health, and other health care providers to protect many more children against pneumonia. More than 400,000 people around the world signed a petition joining our demand for a lower price.


MSF Access Campaign: 20 Years of Advocacy in Action

In 2016, the campaign succeeded in getting Pfizer and GSK to significantly drop the price of the pneumonia vaccine for humanitarian organizations working in emergency settings. The story of “A Fair Shot” is just one example of how MSF’s Access Campaign uses public advocacy to speak out for our patients and help change global health policies for the better.

Here, Kate Elder, the Access Campaign’s vaccines policy advisor, shares some of the important lessons learned from this initiative. 

What was the genesis of the Fair Shot campaign?

Around 2007, MSF started talking with Pfizer and GSK about purchasing PCV for our operations. These were long, drawn-out, unsuccessful discussions. The companies didn’t want to lower their price but instead offered vaccine donations, which we didn’t want to accept because of the numerous issues brought by donations. MSF typically doesn’t accept donations in the form of medicines because of restrictive conditions on their use, and the risks associated with unsustainable or unpredictable supply. 

There was a lot of internal discussion about accepting this donation versus children going without the vaccine. Finally, after about five years of trying to get affordable access to the vaccine, MSF made an exception to accept one donation while at the same time raising public pressure on the companies to obtain a long-term access solution.

What was the goal of the campaign?

We set an ambitious and aspirational goal of having both Pfizer and GSK lower the price of their PCVs to $5 for all developing countries and humanitarian organizations for the three doses needed to vaccinate one child. We also called for both companies to publish the prices they charge countries, as well as the research and development costs, and for countries themselves to publish the prices they were paying for PCV.

How did the Access Campaign work together with MSF’s medical projects to carry out this public campaign?

In the long lead-up before the campaign, the Access Campaign supported MSF’s medical operations at the highest levels in direct negotiations with the companies. I think this was why MSF as a movement was ready to mobilize a public campaign: Because the engagement with companies had already been done hand in hand with our medical operations. The Access Campaign brought the policy and campaigning expertise, and the medical teams brought the reality of kids dying from pneumonia in our projects and a very strong case of why PCV is needed. 

What did the campaign achieve? 

Because of A Fair Shot, we finally had access to the lowest global price being paid by some countries, which was $9 for three doses, a price that had previously been inaccessible to us. Also achieved was the creation of the “Humanitarian Mechanism,” whereby nongovernmental organizations, regardless of where they are working, can purchase PCV at this lowest global price. I’d say that was the biggest achievement. MSF has widely used the Humanitarian Mechanism now. By the end of 2018, MSF had used 360,000 doses of PCV in 12 emergency vaccination campaigns in Central African Republic, Nigeria, Niger, South Sudan, and Syria. [In April 2019, MSF used the mechanism to launch a pneumonia vaccination campaign for refugee children stranded in Greece.]

What did we learn from doing this campaign?

We learned that there are hundreds of thousands of people around the world who agree that access to lifesaving vaccines is critical and want big pharma companies to change their way of doing business to enable lower prices. These people want to help and are looking for actions they can take to further the cause. If we can bring them ideas for these relatively small but meaningful actions in standing up to the pharmaceutical corporations, we can actually make a big difference.

Learn more about the campaign at afairshot.org