Children Are Dying From Pneumonia, but Greed Is the Real Killer

More than 920,000 children died of pneumonia in 2015, according to the World Health Organization. For 2015, Ian Read, the chairman and CEO of Pfizer who earned a salary of $23.3 million, reported that the pharmaceutical giant turned a $7.7 billion profit, driven in part by a 53 percent growth in revenue from the Global Vaccines division.

These figures are not unrelated.

Pfizer is the leading manufacturer of a vaccine that can prevent the contraction of pneumonia, a respiratory infection responsible for taking the life of 1 out every 6 children who dies before the age of 5. That vaccine is called Prevnar and it is making very rich people lots of money, generating over $6 billion in revenue last year alone.

“If anyone is looking for high and consistent cash flow, and strong profit margins, Pfizer has it,” noted Tony Scherrer, research director at Smead Capital Management, when the company released news of its latest haul in February.

So why, then, with its consistent cash flow and steady profits – just under $16.9 billion over the last two years – is the world’s second largest drug company so stingy when it comes to providing the developing world affordable access to a life-saving vaccine? When the bulk of its cash flow comes from sales at a premium price in the wealthy, industrialized world, why is it quite literally allowing children to die in the world’s most impoverished places?

The company does sell it for much less in the country’s where it’s needed most. “They have quoted us a price in Niger of $15.60 a dose,” Kate Elder, a Vaccines Policy Adviser with the medical aid organization Doctors Without Borders (MSF), said in an interview with teleSUR. A child needs three of those doses, meaning the cost of inoculation in the West African country – with a population of more than 19 million and a gross domestic product, according to the World Bank, that at $8.1 billion is about equal to what Pfizer made in profit last year – would be $46.80.

For that reason, “We have not bought Pfizer’s vaccine because it is too expensive,” said Elder. “It’s pretty obscene.”

And, for that reason, MSF is calling on Pfizer to slash the price that it’s charging. “A Fair Shot” is the name of the campaign, and the demand is straightforward: “We call on you to lower the price to $5 per child for all developing countries and humanitarian organizations.”

To #fightpneumonia in developing countries, the vaccine should be affordable. https://t.co/tTXsV5LIbc #askpharma pic.twitter.com/A2Jm3KNOsq

– MSF Access Campaign (@MSF_access) November 18, 2015

Just looking at Niger: Over the last decade, more than 950,000 children under the age of 5 died, according to the WHO, with roughly 15 percent of those deaths – around 140,000 – attributable to pneumonia. That is 140,000 children who, if vaccinated, might be alive today.

Around the world over the last 10 years, that number rises to nearly 10 million children who have died a preventable death.

For slashing the price on the vaccine that could have prevented deaths that are largely unheard of in the developed world, where the vaccine is abundant (if not cheap), “There is, medically, a case just from the data,” said Elder. Preventing children from dying of pneumonia – “Cost,” according to Elder, “is the primary access barrier” – would also prevent people from dying of other causes, as it would free up limited medical resources to treat others who, instead of being dead, would be contributing to the culture and economy of the world’s poorest countries.

That all lends itself to the moral case: As it stand now, tens of thousands of children, and tens of thousands of others, are dying in Niger and developing countries around the world because those who have already made billions off the pneumonia vaccine, more than recuperating their costs, want to make a few billion more.

Many countries may not be able to afford high-priced vaccines (like the pneumonia one) after losing donor support. pic.twitter.com/8vIwe9Acv8

– MSF Access Campaign (@MSF_access) February 23, 2016

If companies wish to gouge, there would appear to be ample opportunity to do so in the countries that can most afford it. According to the US Centers for Disease Control and Prevention, three doses of Prevnar – the number required to be inoculated – sells on the private market for just under $160; the US government pays just under $117.

Gavi, the Vaccine Alliance, a public-private initiative with the stated aim of “creating equal access to new and underused vaccines,” reportedly gets its pneumonia vaccine from Pfizer for $3.30 a dose, which comes out to just under $10 a child.

But it isn’t free – and it isn’t charity. “Oh, it’s not a loss,” said Elder. “They’re still making a profit. They’re not doing this altruistically.”

Neither Pfizer nor GSK have said what it actually costs them to produce a vaccine, so it is impossible to verify how much – or, as they maintain, how little – they are making on its sale, though both have benefitted from at least $1.5 billion in subsidies from international donors, helping easing the corporate pain of bringing prices down.

“The price of Prevnar 13,” according to Pfizer, “reflects the fact that it is one of the most complex biologic products ever developed and manufactured.

GlaxoSmithKline, a British pharmaceutical company, also manufactures a pneumonia vaccine. It, too, is making lots of money: $10.3 billion in profit last year alone. But it also sells that vaccine for more than the $5 a child MSF says it can afford.

Gwynne Oosterbann, director of GSK’s Vaccines and Global Health Communications division, pointed teleSUR to a statement on its website. “We offer our lowest prices to Gavi and UNICEF, which purchase vaccines for the world’s poorest children,” it states. “These prices can be as little as 10 percent of developed world prices.”

As MSF’s Rohit Malpani put it in a statement, “A deeply discounted price when compared with a developed country price may look good, but really it reflects the unaffordable prices of vaccines in developed countries more than it reflects developing countries getting a good deal.” if money is still being made at $10 a child, then these companies are making a whole lot of it in the developing world. Indeed, Pfizer says growth in its pneumonia vaccine sales was driven by the United States, where revenues grew by 102 percent.

“It costs 68 times more to fully immunize a child now than it did in 2001,” according to MSF, “and the expensive pneumonia vaccine accounts for much of that increase.

Plenty of money – literally billions of dollars – is being made in the developed world off this one vaccine while millions of children who need it the most, in underdeveloped areas where malnutrition and armed conflict exacerbate the risks of pneumonia, go without. What MSF and others are asking for is not communism, alas, but a sort of reparations: You’ve made enough off the poor, and more than enough off the relatively rich, globally speaking, so now it’s time to share the wealth with those who centuries of greed have hurt the most.

Pfizer and GlaxoSmithKline might well contend that they are just complying with the economic laws of the global economic system that we have today; they’re just following the orders of capitalism, which dictates that maximizing quarterly profits and shareholder value is quite literally more important that little children dying. And they wouldn’t be wrong. But for capitalism to kill, it’s needs capitalist killers and there’s no evidence that those growing wealthy from this lethal economic arrangement feel too bad about what they do.

We are long past the age when we lacked the resources to prevent people dying from preventable diseases. In the 21st century, it is not pneumonia that is leading hundreds of thousands of kids under 5 to an early grave every year, but another malady – cut-throat, kid-killing capitalism – that has sickened millions, ideologically, and killed millions more. There may be no vaccine, and to be sure there have been many a snake-oil salesman hawking a false cure, but the eradication of greed-is-good as an ethos, allowing a select few to privatize the gains of scientific advancement, is humanity’s best hope for a remedy to this planet’s many ills.