MSF: Gavi must ensure COVID-19 vaccines produced through its new global fund for vaccine development are affordable for people everywhere

Pharmaceutical corporations that get money from Gavi for new COVID-19 vaccines must sell them at cost

South Sudan 2014 © Valérie Batselaere/MSF
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NEW YORK/GENEVA, JUNE 23, 2020—As the board of Gavi, the Vaccine Alliance, meets this week on June 24-25, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is demanding that any Gavi fund that would give pharmaceutical corporations money to create new COVID-19 vaccines must attach strings to the money they dole out to companies. The new mechanism at the top of Gavi’s board meeting agenda—the COVAX Facility—has been designed largely behind closed doors and with extremely limited input from civil society or treatment providers like MSF, which could lead to any new COVID-19 vaccines being priced out of reach for people everywhere.

In first proposing its role in securing volume commitments of vaccines, Gavi—which was set up 20 years ago to pay for vaccines for the world’s poorest countries—assured that manufacturers would be asked to commit to transparency regarding their costs and that Gavi would aim to set a price based upon cost of production with a marginal increase. Any vaccines created with this support from Gavi should be sold at the cost of production, said MSF. However, in the most recent version of the COVAX Facility’s technical guidance note, there are very few requirements obliging pharmaceutical corporations to be transparent, including about how they plan to price any future COVID-19 vaccines.

Additionally, Gavi has now introduced an alarming two-tier system of access to future COVID-19 vaccines bought through the COVAX Facility based upon countries’ economic standing.

The COVAX Facility, which includes an Advanced Market Commitment (AMC), is modeled on a previous AMC that was launched in 2009 to pay for pneumonia vaccines in developing countries. That previous AMC, which involved a $1.5 billion donor subsidized payout to two multinational pharmaceutical corporations—Pfizer and GlaxoSmithKline (GSK)—over a 10-year period, had a number of flaws that kept the lifesaving vaccine unaffordable for governments and treatment providers like MSF. When they received these funds, Pfizer and GSK were already reaping billions of dollars in sales for the pneumonia vaccine globally. MSF has urged Gavi and its donor governments not to repeat the mistakes of the previous AMC, primarily by urging governments and Gavi to demand that pharma sell any future COVID-19 vaccine at cost and also disclose the cost of making and producing these vaccines.

MSF, together with more than 40 civil society organizations, has written a letter to Gavi Board Members and the Gavi Secretariat ahead of the board meeting outlining civil society’s serious concerns with the COVAX Facility.

Kate Elder, senior vaccines policy advisor for MSF’s Access Campaign, said today:

“We can’t risk that the COVAX Facility be yet another big pharma giveaway with little to no strings attached to guarantee that future COVID-19 vaccines are affordable and shared equitably with people across the globe. Given Gavi’s previous Advance Market Commitment for pneumonia vaccines, where independent evaluations concluded that Gavi likely paid too much for the vaccine, we are very concerned. We need a smart negotiator and champion for countries that aren’t in a position to financially sponsor development of a vaccine and secure commitments.

“Gavi board members must step in and insist that Gavi works to improve this new mechanism by putting all countries on a fair playing field for future access, and demanding that pharma companies once and for all come clean about the cost of vaccine production by opening their books so we can all see how much it actually costs to make these vaccines. Some pharmaceutical corporations are pledging to sell future COVID-19 vaccines at a ‘not-for-profit’ price, but with pharma’s track record, why would we believe that when there’s no transparency to prove it? With governments professing left and right that future COVID-19 vaccines will be global public goods, we need to see some strong actions taken to actually make these proclamations a reality. COVID-19 vaccines must be sold at cost—now is not the time to try and turn a profit on the back of a global pandemic.”