Poorer Countries May Have to Wait Years for a COVID Vaccine

Part of the Series

Despair and Disparity: The Uneven Burdens of COVID-19

A COVID-19 vaccine appears to be on the way, raising plenty of questions about how much vaccines will cost and who get will get them first.

On Monday, Moderna announced initial results from a clinical trial showing that its COVID-19 vaccine is 94.5 percent effective. That’s promising news for people in the United States, where COVID-19 is surging and the government invested heavily in developing the vaccine.

However, consumer advocates warn U.S. taxpayers will ultimately pay twice for Moderna’s vaccine if it’s approved by regulators. A $2.5 billion public investment by the Trump administration covers the cost of bringing the vaccine to market — and pays for the vaccine itself. This gives Americans quick access to the vaccine once it is approved in the U.S., but much of the world could be left behind during a pandemic that knows no borders.

Disparities in global vaccine sales and distribution exacerbated by propriety control of manufacturing technologies are expected to create a “global vaccine apartheid,” in which wealthy countries distribute COVID-19 vaccines within their borders for months, if not years, before poorer nations have access, according to Peter Maybarduk, director of the Access to Medicines program at Public Citizen.

“If we fail to act, potentially billions of people around the world will experience a longer pandemic, and that, of course, will mean many deaths, but also economic devastation for vulnerable communities, as well as potential political instability,” Maybarduk said in an interview.

As Truthout has reported, private pharmaceutical companies have neglected vaccine research for decades because other medicines are more profitable, leaving the job up to governments and public research institutions. Since the COVID-19 pandemic hit, Moderna and other companies racing to develop vaccines have received billions of dollars in development aid from wealthy governments and international foundations working with the World Health Organization (WHO).

Maybarduk said these funders are responsible to the public, not a pharmaceutical company’s profit margins, and they should leverage their stake in any future vaccines to make them affordable and widely available on a global scale.

“In the worst health crisis in a century, vaccine funders must use every tool at their disposal to share technology and teach the world to make vaccines,” Maybarduk said. “Governments and foundations must learn to use their power and tell pharmaceutical corporations what to do if we are to prevent a global vaccine apartheid.”

The U.S. enjoys a significant stake in leading vaccines thanks to publicly funded research and development shared with private industry. Along with Pfizer, which announced this week that its vaccine is both safe and 95 percent effective, Moderna relied on technology developed by the National Institutes of Health (NIH) — and paid for by taxpayers — that stabilizes coronavirus “spike” proteins for research. Johnson & Johnson, Novavax and other companies in the race to develop a vaccine are also using the technology, according to Public Citizen.

Moderna’s vaccine quest also benefited from nearly $1 billion in federal research and development aid, which covers 100 percent of the cost of bringing the vaccine to the Food and Drug Administration for approval. Even after that investment, the Trump administration agreed to pay an additional $1.5 billion for 100 million doses of the vaccine. The U.S. has the option of buying another 500 million doses, which translates to $8 billion in profits for Moderna.

“This is the people’s vaccine. The NIH’s vaccine. It is not merely Moderna’s vaccine,” Maybarduk said. “Federal scientists helped invent it and taxpayers are funding its development. We all have played a role. It should belong to humanity.”

President Trump believed approving a vaccine ahead of the election would benefit his reelection chances, and he repeatedly lied to voters about when a vaccine would be available while attempting to take credit for development efforts. The Trump administration redirected billions of federal dollars earmarked for personal protective equipment and public health agencies battling the pandemic to fund a partnership between the government and private vaccine developers.

The Trump administration clearly took an “America First” approach to vaccine development. Unless people in all countries have access to vaccines, the global pandemic could drag on for years. Even in the unlikely event that the five leading vaccines are approved, two-thirds of the world’s population will not have access until at least 2022, according to Oxfam International.

Moderna says it can produce 1 billion doses of its vaccine by the end of next year, but 78 percent of those doses have already been sold to the U.S. and wealthy nations in Europe representing only 12 percent of the world’s population, according to Global Justice Now, an international group aligned with social movements.

However, Moderna was one of several beneficiaries of a $1.1 billion investment by the Coalition for Epidemic Preparedness Innovations (CEPI), which co-leads the WHO’s COVID-19 vaccine access facility with support from the World Bank and wealthy foundations.

In a new report, Public Citizen argues that Moderna appears to be violating CEPI’s “equitable access policy” that prioritizes vaccine access by public health need, instead of the ability to pay, by securing purchase agreements with only the U.S. and other wealthy nations.

“We welcome any good news when it comes to a coronavirus breakthrough, but sadly most of the world cannot celebrate today,” said Global Justice Now Director Nick Dearden, in a statement. “Moderna’s is predicted to be the most expensive potential vaccine on the market, at around $35 a dose, even though it has been made with vast public support.”

While those prices may be lower in the U.S., taxpayers have already invested millions into Moderna’s vaccine, and Moderna plans on turning a profit, according to Public Citizen. President-Elect Joe Biden has said a vaccine will be available to everyone in the U.S. “free of charge,” but Trump’s refusal to accept the election results and allow for a transition between his administration and Biden’s could hinder a vaccine rollout. In any case, a vaccine would first be distributed to health workers and vulnerable patients before the public at large.

Maybarduk said both administrations should engage with CEPI and use the U.S.’s stake in vaccine development to ramp up global production and distribution. Human rights groups say Moderna and other leading vaccine developers must share technology and insight for manufacturing any vaccines that come to market with the world. No single corporation has the capability of distributing a vaccine globally, and many countries will need knowledge and technology currently held by private companies that received public support.

“The U.S. government has tremendous power to do this and frankly save the world, we’re talking about that level of thing,” Maybarduk said.

While Moderna has pledged not to enforce its vaccine patents during the pandemic, potentially allowing governments and drug makers to replicate its vaccine production methods, it remains unclear how Moderna will define the “end” of the pandemic.

Stephen Cockburn, the head of economic and social justice programs at Amnesty International, said Moderna and other profit-seeking vaccine makers must be held accountable to global public health needs during this unprecedented crisis.

“Having already sold most of its potential 2021 vaccine supply to rich countries, Moderna must follow through on its promise to allow others to make the vaccine, and provide the knowledge and technology to do so, once the vaccine has proven to be safe and effective,” Cockburn said in a statement on Monday.