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South Africa, Colombia and other middle-income countries affected by COVID-19 are lining up in richer countries for vaccines, hoping to avoid even more suffering. They are looking to buy cheaper doses of the vaccine from AstraZeneca Plc., As well as much more expensive ones from Moderna Inc.
Colombia, with an annual health budget of only $ 10 billion. $ 50 million for a population of around 50 million is one of the countries for which these immunizations are difficult to afford. Proponents of the health system argue that drug manufacturers dominate negotiations with governments that have limited resources and are not eligible for free doses of the vaccine. The protruding details only highlight the extent of that pressure.
Middle-income countries that do not have the tools and production capacity of rich countries like the United States and the United Kingdom urgently need vaccines to revitalize their economies and prevent a pandemic. However, they have to achieve those goals with the available healthcare budget, which has been extremely tight for many years.
States like Colombia are “pushed to the border,” said Carolina Gómez, one of the founders of an advocacy group representing the National University of Colombia to guarantee access to medicine and health care technology.
“They have no choice but to obey what the drug manufacturers say,” Gomez said.
“Major discrepancy”
The COVAX program, which aims to distribute vaccines fairly in all corners of the world, helps many poor countries implement the immunization process by providing donor-funded vaccines. But it cannot cover the cost of countries like Colombia or provide enough vaccines to protect the majority of the country’s population.
As a result, Colombia made direct transactions with pharmaceutical manufacturers Pfizer Inc., Moderna, AstraZeneca, Johnson & Johnson and Sinovac Biotech Ltd. to obtain doses to complement their purchases through COVAX. The country agreed to buy 10 million. vaccine doses from partners Pfizer and BioNTech SE at $ 12 per dose, based on regulatory documents. Meanwhile, the government pays about 295 million. $ 10 million. “Modern” dose, according to documents from the Ministry of Finance, cited by researchers from the Javeriana University, a private university in Bogotá. This equates to nearly $ 30 per dose, although logistics costs can be included in this amount. 20 million The cost of the doses purchased through the COVAX program is approximately 225 million. AMERICAN DOLLAR. This amount includes part of the transportation costs. Officials declined to provide further details.
In a pandemic, high- and middle-income countries will pay more for Pfizer than low-income countries, but at a significant discount from the “normal benchmark,” the company said. Pfizer says it will not benefit from supplying vaccines to the poorest countries. Modern pharmaceutical company did not respond to requests for comment.
Colombia reported around 2.3 million COVID-19 cases, or roughly two out of every hundred worldwide. Tighter restrictions imposed in major cities, with infection rates rising sharply earlier this year, have hampered recovery from the worst economic downturn in the country’s history, and the government now plans to raise taxes and cut public expenditure.
Middle-income countries face a “special dilemma,” says Anna Bezruki, a researcher at the World Health Center at the Graduate Institute for International and Development Studies in Geneva. For vaccine spending, “you get a bigger slice of the pie,” which may have gone to other health care system priorities, he said.
Several of those governments, including Latin American countries like Argentina and Peru, are particularly vulnerable, said Thomas Bollyky, director of the Global Health Program at the Council on Foreign Relations (CFR). Middle-income countries, with the exception of China, accounted for nearly half of the global coronavirus burden in February, but only 17 percent. vaccine doses, according to a report by the CFR Think Global Health initiative.
“It is in middle-income countries that the greatest mismatch is between the expanding pandemic and vaccine shortages,” says Th. Bollyky. “The distribution of different amounts of vaccines to different areas is not necessarily unfair, as long as those vaccines travel to where they can be most useful and where the crisis has shaken the most, but this is unlikely to happen.”
South Africa
AstraZeneca and its partner, the University of Oxford, have become the leading providers of vaccines for low-income countries and have vowed not to benefit from them. However, the vaccine they developed has been called into question for its safety and efficacy when, more recently, several European Union countries stopped using it due to concerns about reports of dangerous blood clotting incidents.
According to AstraZeneca, after a comprehensive review of all available safety data for the millions of people vaccinated with COVID-19, it did not identify any increased risks associated with the vaccine, and the World Health Organization (WHO) is also advocating the vaccine. saying it’s safe.
South Africa, which budgeted $ 19.3 billion. scars ($ 1.3 billion) vaccinated two-thirds of its population, faced a similar problem. After a small study showed that the AstraZeneca vaccine provided minimal protection against mild to moderate illness caused by a new strain, the country had to change course.
The government has decided to buy Johnson & Johnson single-dose vaccines and Pfizer-BioNTech vaccines for $ 10 per dose, the country’s health department said. He promised to buy AstraZeneca vaccines made by the biotech company Serum Institute of India Ltd. for $ 5.25 a dose. Moderna offered vaccines for $ 30-42 per dose, but South Africa did not place any requests.
“Lupic prices”
For countries like South Africa or Colombia, these costs may not seem particularly high given the size of their economies and the overall costs of a pandemic, but they only compound the headaches of these governments.
Another example is Malaysia, which has estimated its spending on vaccines at around three billion ringgit ($ 730 million). The budget of the country’s Ministry of Health for 2021 is estimated at about 33 million. the country’s population is less than 8 billion. AMERICAN DOLLAR.
These agreements contribute to the high sales of Moderna and Pfizer vaccines. Moderna said it has signed advance purchase agreements for more than $ 18 billion. The dollars for which vaccines will be delivered this year; meanwhile, Pfizer expects to make $ 15 billion this year. dollars in revenue from its vaccine, developed in conjunction with BioNTech.
The prices paid for vaccines in some low-income countries are “unfair,” said Lawrence Gostin, professor of global health law at Georgetown University, calling them “useless, a product they desperately need to recover.”
COVAX, a program led by organizations like WHO, solves only part of the problem. The initiative aims to protect at least a fifth of each participating population by the end of 2021, and dozens of countries, including Colombia and South Africa, must pay for the vaccines they receive through the program.
Countries that purchase vaccines through the COVAX program have committed to paying an estimated average price of $ 10.55 per dose, according to the documents. Contract negotiations are ongoing and COVAX seeks to negotiate prices similar to or lower than those offered to individual parties by companies that transact directly with them, says GAVI, Vaccine Alliance, another proponent of the initiative.
While COVAX is a “significant achievement,” the program faces limited dose limits and a lack of funding, said Th. Bollyky of the Council on Foreign Relations.
Missing dose of vaccine.
“In an environment of incredible demand and limited supply, it is difficult to see how the price dynamics can change,” he said.
Due to vaccine shortages, the suspension of intellectual property protections for vaccines has been called for in order to expand production. But last year, the United States, the European Union, Switzerland and other countries vehemently rejected an offer from India and South Africa that sought to abandon some trade rules.
Colombia began looking for vaccines in mid-February through direct agreements with manufacturers. Of the first COVAX shipment to Latin America, 117,000 doses of the Pfizer vaccine arrived in Colombia in early March. South Africa and other countries have also started to take care of the vaccines that enter their markets.
However, the gap is still large. The United States, United Kingdom and the EU have started seizing vaccines, without knowing yet which ones will be effective. The UK has already injected more than 26 million. vaccine doses and plans to offer immunizations to all adults by the end of July. Colombia, meanwhile, has injected about 840,000 doses of the vaccine, by comparison.
As the problem worsened, China and Russia were quick to conclude deals for the supply of their vaccines. The Russian Sputnik V vaccine has sparked interest in several countries, including some countries in central and eastern Europe where infections are not decreasing.
Rich nations have been able to break into the forefront, in part because they can afford to take responsibility for vaccines that have yet to be approved, says Safura Abdool Karim, a public health attorney and researcher at the Wits School of Public Health in Johannesburg.
“Low- and middle-income countries cannot afford to take such risks,” he said. – Until now, the current image was defined by accessibility. In the long term, it will be increasingly defined by affordability. “
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