Priced out

Is greater transparency needed on vaccine contracts?

The pricing of drugs has never been transparent as pharmaceutical companies seek to divide the market based upon a country’s resources, offering lower prices to developing countries and demand high amounts from richer ones.

Despite these previous norms, in the midst of a global pandemic when contracts are being negotiated and signed in record time, calls for greater transparency on COVID-19 vaccine contracts are growing louder. An economist in Peru comments, “When deals are being hurried through, how can the public hold politicians accountable? It surely also introduces a risk of corruption.”

Furthermore, as stretched vaccine manufacturers miss delivery deadlines, there is an even greater call for transparency. For example, in the EU, where there was a public outcry after both Pfizer and AstraZeneca informed the EU that initial doses of the vaccine would be delayed.

It is not just the price per dose that is being wrapped in confidentiality clauses, information regarding production and logistics and liability clauses also contribute to the cost of a contract. A Peruvian epidemiologist with knowledge of the government’s negotiations confirms, “It is a mistake to only consider the cost per dose, you have to see all the different costs that are added to that drug.”

“It is a mistake to only consider the cost per dose, you have to see all the different costs that are added to that drug.”

Epidemiologist, Peru

Disagreement on such clauses led to negotiations between Pfizer and Peru collapsing, according to the Minister of Health, Pilar Mazzetti, “Some clauses were identified that required more in-depth analysis to determine compatibility with Peruvian laws and regulations.”

Contrary to what is happening in other countries in the region, such as Argentina or Chile, vaccination has not yet begun in Peru and the authorities have not been able to offer a secure schedule.

A public health official in Peru described the challenges facing countries like Peru, “Middle-income countries, such as Peru and Ecuador, have almost no negotiating leverage: we are neither poor enough nor rich enough to get vaccines quickly. Poorer countries, such as Bolivia, Haiti and Honduras, have priority access to the COVAX facility and larger/richer countries, such as Brazil, have much greater bargaining power.”

“Middle-income countries, such as Peru and Ecuador, have almost no negotiating leverage: we are neither poor enough nor rich enough to get vaccines quickly.”

Public health official, Peru

COVAX expects to deliver 35.3 million doses of the Oxford/AstraZeneca vaccine to 36 Latin American states from mid-February to the end of June. As part of the “First Wave” initiative, a global pilot programme to receive a limited number of doses of the Pfizer/BioNTech vaccine in advance of their total allotted quota, Bolivia, Colombia, El Salvador and Peru, are also to receive a total of 377,910 doses of the Pfizer/BioNTech vaccine from mid-February.

Despite this welcome news, there is still a long way to go, the Pan American Health Organization (PAHO) said the Americas region needed to immunise about 500 million people to control the pandemic.

 

 

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