Doctors Without Borders rejects Pfizer’s free pneumonia vaccines

Markson Farley, right, checks a child's temperature during a training in Liberia to help workers spot pneumonia. (2013 Credit: Direct Relief)

Pharmaceutical giant Pfizer offered to give Doctors Without Borders free pneumonia vaccines that would provide protection against one of the leading child killers. The medical charity turned them away.

Executive Director Jason Cone explained the decision in a piece published to Medium earlier this month. The donation offer was generous but harms the long-term goal of lower prices, he wrote. For years, Doctors Without Borders (MSF) has pressured Pfizer and GlaxoSmithKline, the only two producers of the vaccine, to lower their prices for humanitarian groups and developing countries.

Cheaper vaccines mean the children who need them the most can get them. GlaxoSmithKline recently lowered the vaccine price. Pfizer discounts doses to Gavi, formerly known as the Global Alliance for Vaccines and Immunization. But Pfizer won’t budge on its price to other humanitarian organizations. They just offer a free donation.

It sounds like a really good deal – a vaccine to prevent the disease that kills nearly 1 million children a year from doing its worst saves lives. Literally. Those free doses will save lives, right now.

But there is a major trade-off, Cone argued.

“Donations can also undermine long-term efforts to increase access to affordable vaccines and medicines,” he wrote. “They remove incentives for new manufacturers to enter a market when it’s absorbed through a donation arrangement. We need competition from new companies to bring down prices overall – something we don’t have currently for the pneumonia vaccine.”

Pfizer reaped $13.1 billion in profits last year, a fair amount is attributed to its three-dose pneumonia vaccine. A single dose costs $136 – $408 for all three doses – for people in the U.S. Offering a cheaper vaccine price to humanitarian groups and developing countries should not significantly harm Pfizer’s profit margin, advocates argue. The company says it is open to making a deal.

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“Pfizer is committed to making vaccines available to as many people as possible, particularly those needing emergency humanitarian assistance,” said Sally Beatty, a spokeswoman for Pfizer, in an email to Humanosphere. “We are actively exploring a number of new options to enable greater access to our pneumococcal vaccine to aid NGOs facing humanitarian emergency settings.”

MSF refuses donations from companies that profit from the “production and/or sale of tobacco, alcohol, arms, pharmaceuticals, and/or mineral, oil, gas or other extractive industries.” Those companies are in opposition to the charity’s long-term goals, it says. The uncertainty associated with pharmaceutical donations make it hard to properly plan programs and encourage maintaining higher prices.

Pfizer thinks they are wrong.

“Pfizer strongly disagrees with MSF’s stated policy and believes product donations play a crucial role in addressing humanitarian crises around the world,” said Beatty. “We reiterate our offer of 1 million free doses and continued supply to meet these urgent, emergency needs.”

Vaccine prices are on the rise. It is 68 times more expensive for MSF to fully vaccinate a child today than it was in 2001, according to MSF research. About 45 percent of the total cost ($45.59) is attributed to the pneumonia vaccine. That is why MSF called on the two makers of the three-dose vaccine to lower the price to $5 per child.

Update: GlaxoSmithKline announced its net profit increased by 50 percent to $986 million for the third-quarter of this year. Most of the rise is attributed to strong sales of its vaccines.

There are occasional exceptions to the rule. In 2014 MSF accepted a one-time donation of pneumonia vaccines from Pfizer and GlaxoSmithKline. Negotiations to lower prices dragged on for five years with no result. MSF made a temporary deal for cheaper or free vaccines to help children “caught in on-going crises.”

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Last month, GlaxoSmithKline announced it would offer a special reduced price to humanitarian organizations at $3.05 per dose. It is a major reduction in cost that MSF welcomed. It called on Pfizer to at least match the total price of $9.15 per child – still nearly double the $5 goal. Pfizer already offers that price to Gavi, an organization that works with governments and the private sector to bring cheap and free vaccines to developing countries.

It is still not good enough, Cone said. Only Gavi gets the cheaper price, and it is still a major burden on the alliance. Then there is the fact that more than one-quarter of the countries currently eligible for Gavi support will lose it starting this year. Angola, for example, will soon have to buy the pneumonia vaccine itself, leading to a 1,500 percent increase in cost per dose. Bolivia and Indonesia will also see massive cost increases.

“We can no longer live in a world where a vaccine that protects children against pneumonia is a luxury; too many young lives are at stake. Doctors Without Borders does not believe that our medical work, nor the work of other humanitarian organizations or governments trying to serve their people, should be at mercy of the voluntary ‘goodwill’ of pharmaceutical corporations,” Cone wrote.

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About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.