Advocates of a people's vaccine responded critically to an announcement Thursday from AstraZeneca that the British-Swedish pharmaceutical giant saw its profits double last year, even while supplying its coronavirus vaccine at no profit—which it has pledged to do for the duration of the pandemic, as defined by the company.
"The performance last year marked a significant step forward for AstraZeneca. Despite the significant impact from the pandemic, we delivered double-digit revenue growth to leverage improved profitability and cash generation," CEO Pascal Soriot said in a statement about the company's 2020 results. "The consistent achievements in the pipeline, the accelerating performance of our business, and the progress of the Covid-19 vaccine demonstrated what we can achieve."
The coronavirus vaccine that AstraZeneca developed with the University of Oxford is one of several being rolled around the world. Given the company's pledge to not profit from the vaccine during the pandemic and its commitment "to provide the vaccine on a nonprofit basis in perpetuity to low- and middle-income countries," CNBC explainedThursday that "its current earnings did not include vaccine sales."
Even so, Nick Dearden, executive director of the U.K.-based advocacy group Global Justice Now, noted that countries have paid different rates for AstraZenenca doses.
"AstraZeneca's bumper profits today show the company can easily afford to provide its Covid-19 vaccine at cost price during the pandemic and beyond," Dearden said. "But despite this pledge, it has yet to address the question of why lower-income countries like South Africa and Uganda are paying several times more per dose than the European Union. This is not the 'equitable access' AstraZeneca has been trumpeting in its press releases."
"This global inequality cannot continue," he added. "If a booster shot is required to deal with Covid-19 variants, will AstraZeneca commit to providing it at the same price to all countries, including as a condition of any sub-licensing agreements? It is an outrage that the countries with the least resources are being charged the most in the midst of a global health emergency."
As Common Dreams reported last month, while a Belgian minister revealed that E.U. members are paying $2.16 per dose for the AstraZeneca/Oxford vaccine, and the company had said it would cap the price around $3 per dose, South Africa's deputy director general of health, Anban Pillay, confirmed the country was quoted $5.25 per dose by vaccine-maker Serum Institute of India (SII).
"We were advised that SII has applied a tiered pricing system, and given that [South Africa] is an upper-middle-income country, their price is $5.25," Pillay told Business Day at the time. "The explanation we were given for why other high-income countries have a lower price is that they have invested in the [research and development], hence the discount on the price."
South Africa on Sunday suspended plans to start inoculating people with the AstraZeneca doses in its possession after a limited trial awaiting peer review found that the vaccine "provides minimal protection against mild-moderate Covid-19 infection" from a more contagious variant of the virus in the country.
South African Health Minister Zweli Mkhize announced Wednesday that the country would begin distributing doses of the Johnson & Johnson vaccine, which "has been proven effective against the 501Y.V2 variant" that was first identified in South Africa but has started spreading to other countries.
As for the one million AstraZeneca shots South Africa received from SII—from which another 500,000 doses have been purchased—Agence France-Presse reported that "South Africa is considering either selling or swapping these doses with countries facing the original strain of coronavirus, said the minister, insisting that nothing would go to waste."
Meanwhile, the Ugandan government said last week that it ordered 18 million doses of the AstraZeneca vaccine from SII, whose spokesperson subsequently told Reuters that "while discussions are ongoing, there has been no finalization of price or volumes" for the country, located in east-central Africa.
According to Reuters:
The institute is supplying doses of the vaccine to Brazil, Saudi Arabia, and South Africa at $5.25 per dose.
The Ugandan government statement said each person would receive two doses separated by 28 days, and Uganda is purchasing the vaccine from the manufacturer at $7 per dose.
After reporting on that rate sparked a wave of criticism, a senior Ugandan health official defended the $7 price last week to Switzerland-based Health Policy Watch.
"You cannot compare prices directly between countries because there are many factors to consider. Prices have to vary anyway," said Alfred Driwale the manager of the Uganda National Expanded Programme on Immunization (UNEPI) at the Ministry of Health. "You can not expect a country with a big population to pay the same price, the big country will definitely have a higher bargaining power."
The debates on dose prices and AstraZeneca's soaring profits come as world leaders continue to face pressure to forego vaccine nationalism and focus on inoculating the world's most vulnerable people first, regardless of their home country.
University College London professor Mariana Mazzucato and Costa Rican economist Rebeca Grynspan wrote for Newsweek on Thursday that "the world will not emerge from the pandemic without a People's Vaccine that can be produced rapidly, at scale, and made available for all people, in all countries, free of charge. But with national interests prevailing over global interests, bilateral deals continue to undermine the purpose and progress of COVAX, which has only secured enough doses to vaccinate 20% of the populations of the 92 participating low- and middle-income countries."
COVAX is a global vaccination effort led by Gavi, the Coalition for Epidemic Preparedness Innovations, and the World Health Organization (WHO).
U.S. President Joe Biden, who has opted to engage with the WHO and COVAX, "is uniquely placed to rise to the challenge to deliver the People's Vaccine and convert the lessons of the crisis to build a new, transformative economy centered on the shared prosperity of humankind," argued Mazzucato and Grynspan. "That can be achieved by recognizing that 'health is wealth,'—that we are only as healthy as our neighbors and no one is protected until everyone is protected."
The Newsweek opinion piece came hours before Biden announced the purchase of 100 million more doses of a vaccine developed by Pfizer and BioNTech as well as 100 million more doses from Moderna—which both require two doses—potentially enabling the U.S. to inoculate 300 million people by the end of this summer.