The fact that Pfizer and Moderna won the race did not help vaccine equality in the world

The fact that Pfizer and Moderna won the race for a corona vaccine, while AstraZeneca and Johnson & Johnson were left behind, appears to be an unfortunate result from a social point of view. Because no matter how much the vaccine giants spoke of fair distribution and prices, they hardly contributed to equality in the global distribution of vaccines. In fact, a lot of money was earned from the health of society. Together, Moderna, Pfizer and its partner BioNTech made a profit of $ 75 billion with the corona vaccines in 2021 and 2022.

This is evident from a report published Monday of the Foundation for Research on Multinational Enterprises (SOMO), which, among other things, looked at the annual reports of pharmaceutical companies. AstraZeneca and Johnson & Johnson said several times that they would sell the vaccines on a non-profit basis – and they stuck to that, as far as the SOMO researchers could determine. Pfizer and Moderna, on the other hand, went “purely for profit,” says researcher Esther de Haan. In the pharmaceutical industry – one of the most profitable industries out there – a profit rate of 25 to 30 percent is common. Moderna, Pfizer and BioNTech used percentages of 49 to 66 percent. AstraZeneca and Johnson & Johnson made “low” profits on their vaccines, the report shows (the exact percentages could not be traced), but the vaccines of these companies were not very successful.

Substantial delay

The corona vaccines were mainly supplied to richer countries in the first nine months. De Haan: “The best negotiators with the biggest wallets were there.” Prosperous countries have been “greedy,” she says, sometimes purchasing six or seven times more vaccines than necessary. Pharmaceutical companies then preferred those countries. It increased global inequality at the time, according to De Haan. The corona vaccines are now available almost everywhere – but that was not the case when they were most needed.

And that while the pharmaceutical companies, including Moderna and Pfizer / BioNTech, were full of promises about vaccine equality. So they signed one declaration stating that they would strive for equitable and affordable distribution worldwide. Especially in the first nine months of 2021, poorer countries were ignored. Moderna promised Covax – an international initiative to distribute vaccines also in poor countries – 34 million doses in 2021. None of these reached the initiative in those first months.

Johnson & Johnson behaved “relatively well”, according to De Haan: it did not make profits in the order of Pfizer/BioNTech and Moderna and distributed more to poorer countries. But it failed to deliver any of the 200 million doses promised to Covax over the same period. Vaccines were better distributed in 2022, although it is unclear to what extent pharmaceutical companies actually kept to the promised numbers, says De Haan. In any case, this resulted in a significant delay in poorer countries compared to richer countries.

‘There was panic’

From one earlier report of the Access to Medicine Foundation already showed that pharmaceutical companies often overlook the poorest countries. That report also showed that AstraZeneca did show solidarity: it shared knowledge about the Covid vaccine with local pharmaceutical companies in India, Mexico and South Africa so that they could produce it themselves.

The high profits on corona vaccines are especially bad because part of the development of the vaccines has been financed with public money, according to the SOMO report. Governments invested about 5.8 billion dollars in subsidies in vaccine development, SOMO calculated on the basis of the annual reports of pharmaceutical companies. In addition, a large part was financed with so-called ‘Advanced Purchase Agreements’ (APAs), agreements that state that a government purchases a certain number of vaccines and co-finances their development in advance. If the vaccine fails, the risk is for the government. It is difficult to find out exactly how much money was invested in this way, but SOMO estimates, based on public and leaked documents, that pharmaceutical companies received about USD 86.5 billion in this way.

For Pfizer and Moderna, these turned out to be useful investments to say the least: the vaccines did their job. But how could that public money have been prevented from turning into big profits for the pharmaceutical giants? By setting conditions for subsidies and financing in advance, says De Haan. “Make agreements about transparency, profit margins and worldwide distribution.” The fact that this did not happen during the corona pandemic is, according to De Haan, the result of governments’ poor negotiating position. “There was panic. Everyone wanted that deal.”

Meanwhile, Pfizer/BioNTech and Moderna continue to raise prices. Pfizer’s commercial price goes up to $110 to $130 per dose. Previously it was about $20. Moderna previously announced to be between $ 64 and $ 100 per dose – but also increased that to $ 110 to $ 130 last month. Previously, a dose of the Moderna vaccine cost $16.50.

Negotiations are currently underway within the World Health Organization on a Pandemic Agreement, for such “catastrophic failure” with regard to solidarity, such as during the corona pandemic, to prevent a subsequent pandemic. Conditions for receiving public money are already described in a first draft. De Haan: “If that becomes binding, we may prevent a similar situation in the future.”