MSF: Any future COVID-19 vaccines must be affordable and accessible for all

Governments are set to give pharmaceutical corporations billions to create new vaccines without attaching strings to make sure they are affordable or available for everyone, everywhere once they hit the market

Inpatient medical unit in Moria

Greece 2020 © Anna Pantelia

NEW YORK/GENEVA, JUNE 2, 2020—The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) urged leaders today to demand pharmaceutical corporations commit to selling any potential future COVID-19 vaccines at the cost of production. This comes as Gavi, the Vaccine Alliance is preparing to launch a global funding mechanism on the sidelines of Thursday’s third pledging conference for Gavi that would give corporations money to create such vaccines. Unfortunately, the mechanism fails to demand any products created be affordable or available to those who need them most.

Several heads of state have already referred to future COVID-19 vaccines as “global public goods” and “the people’s vaccine.” But the translation of these important political statements into concrete plans to purchase future COVID-19 vaccines—including for people in developing countries—is yet to be determined.

“Everyone seems to agree that we can’t apply business-as-usual principles here, where the highest bidders get to protect their people from this disease first, while the rest of the world is left behind,” said Kate Elder, senior vaccines policy advisor for MSF’s Access Campaign. “Governments must ensure any future COVID-19 vaccines are sold at cost and universally accessible to all across the world.”

Gavi, which was set up 20 years ago to pay for vaccines for the world’s poorest countries, is expected to attempt to spur the creation of a new COVID-19 vaccine by launching a mechanism called the COVAX facility to scale up manufacturing capacity for potentially successful vaccines and to finance these for a set of developing countries. How governments agree to distribute the vaccine equitably and ensure transparent and objective prioritization is also under discussion, with the World Health Organization leading a process to develop a global equitable allocation framework. MSF warned that the success of such efforts will hinge on governments adhering to this framework and putting the common good above individual nationalist interests. Broad access to these types of products is critical to end the pandemic for everyone, said MSF.

“We can anticipate that global demand will outstrip supply capacity of future COVID-19 vaccines, certainly at the very beginning,” said Dr. Sidney Wong, director of MSF’s Access Campaign. “While it’s encouraging that so many global leaders have claimed that future vaccines will be ‘global public goods,’ there is a real concern that nationalist interests could lead to a scramble for who can buy them first.”

To date, governments and philanthropies have given more than $4.4 billion to pharmaceutical corporations for research and development for COVID-19 vaccines. However, by and large, no conditions for access or affordability have been included as a precondition to any of that funding, so there is no guarantee whatsoever that pharmaceutical corporations will charge affordable prices.

It is crucial to set an at-cost price from the outset because, historically, once prices are agreed to, Gavi has not been in a strong position to negotiate lower prices later.

For example, a fund that was designed by Gavi, the Gates Foundation, the World Bank, and others in 2009 to pay for pneumonia vaccines suffered from pharmaceutical companies demanding a relatively high price for the vaccine—a price that is often unaffordable for governments. Despite a $1.5 billion subsidy that was largely doled out to Pfizer and GlaxoSmithKline in attempts to secure enough supply of their pneumonia vaccines for developing countries, there were still supply shortages at times over the course of the funding initiative. Additionally, humanitarian organizations such as MSF were completely left out of the mechanism. This resulted in MSF being unable to access pneumonia vaccines at the Gavi-negotiated price until 2017, after MSF spent years campaigning for access to the lowest global price for pneumonia vaccines.

“Governments and Gavi must adhere to a transparent and objective global allocation system that at the very least prioritizes access to vaccines for frontline healthcare workers and people at greatest risk of severe illness and death worldwide,” Wong said. “In our work around the world, MSF has witnessed too many people suffering and dying from diseases because of an absence of affordable medical tools. While we anxiously wait for an effective COVID-19 vaccine, let’s ensure that history does not repeat itself. We must rely on one another to do the right thing, and governments and civil society will have to hold each country to account.”