The desire for profit and the opaque price becomes an obstacle in the way of vaccination

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This is a do or dies moment for our world. There is a race going on between the virus and its new variants and vaccination. The speed at which the novel coronavirus is mutating means that no one will be safe until every person in this world is safe. According to WHO, we need about 11 billion doses and these need to be delivered to the poorest and remotest places at the earliest. If this is not possible, then there is a possibility that this virus may mutate and come back in a new form, and then no one will be able to escape its wrath.

The issue is not the vaccine nor the world’s ability to make it. As of June 2021, more than 200 vaccine candidates are ready, and 102 of them have reached the clinical trial stage. According to WHO, the world will make about 14 billion doses by the end of 2021. Two of China’s vaccine makers – Sinopharm and Sinovac – plan to produce about 3 billion doses. Pfizer-BioNTech (US headquarter) has increased its capacity to 3 billion doses. Oxford-AstraZeneca has done the same. Apart from these, there are many other companies. So there is no shortage of vaccines.

The problem is related to the cost of the vaccine. Its price should be such that most of the people of the world can afford it. Vaccine pricing is very opaque because companies don’t want to miss any opportunity to make a profit. WHO does not track the cost of vaccines, and our only source of information is media reports. One review suggests that vaccines typically range in price from $2.50 (US) to $20 per dose, with Oxford-AstraZeneca being the cheapest. Interestingly, the European Union paid $2.50 per dose, while South Africa was charged $5.25.

The Sinopharm vaccine costs $15 per dose in Sri Lanka and $10 per dose in Bangladesh. In both cases, the orders for the vaccines have been given by the governments. But there are also reports that Sinopharm is selling its vaccine in Argentina for $40 per dose and Moderna’s in the US for $37. Vaccine companies want to continue this windfall. There are two ways to increase the efficiency of vaccine production. Pfizer has outsourced its legacy vaccine to other companies and is about to manufacture 30 million doses independently. Another way is to sign contracts with other companies to accelerate the supply of vaccines, but there is no reduction in prices and profits.

In all these cases, the control of the price of vaccines will be in the hands of the companies. Wherever they have offered exemptions, as in Astra-Zeneca in the European Union, they have done so because governments have invested in vaccine research and development. However, the officials of these companies have also said that this is a “pandemic price”, and the price of vaccines may increase manifold in the coming time.

Vaccine inequality, in this situation, is inherent and inevitable. Developing countries cannot afford the cost of the vaccine. The Indian government announced this month to vaccinate 1 billion of its people for free and ordered nearly 440 million doses (the total requirement is 2 billion) at Rs 150 per dose ($2), Serum Institute of India (Covishield) and Bharat Biotech (Covaxin). This will burden India’s economy, which is already reeling under the grip of the pandemic. Nevertheless, due to the low cost per dose of the vaccine, we can expect this universal vaccine program of India to be successful. Although other countries from Bangladesh to Cameroon will give vaccines to their people for free ($10-15 per dose), its chances are negligible.

So we have two paths before us. The first, favoured by Germany and the UK, is to buy the vaccine from their companies and supply it to the WHO Covax facility to distribute COVID-19 vaccines around the world. Boris Johnson, the host of the recently concluded G-7 summit, has said with much fanfare that his country will donate 100 million of the remaining vaccines that he bought more than it needs. 5 million of these vaccines will be shipped by September 2021. The G-7 has said that it will provide a total of 1 billion doses by the middle of 2022, of which we will give 500 million.

However, it is too late, and this camel’s mouth is full of cumin. Infections have started increasing in Africa. There is also no plan for how the world will bear the cost of universal immunization in this strategy of purchase and donation. Covax is already facing shortages and supply constraints. This is where the second option of providing a temporary exemption on Intellectual Property Rights (TRIPS) comes in. This will allow other companies to produce the vaccine on a large scale. And as was the case with HIV/AIDS drugs, this discount will bring down the price.

Lower prices will result in increased availability and accessibility. This makes the response to the pandemic truly global and makes vaccines a global good. But it does mean that the “free world” has to deepen its relationship with democracy. To fight what the US President has named “autocracy”, we have to restore the “people” in the people. At present, we have given full opportunity to the market to grow by isolating the state to empower our society. That hasn’t happened. The situation today is such because of this alliance of state-market-consumer society. It needs to be rebuilt for Covid-19 and beyond.

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