Concern is growing around low covid-19 vaccine rates in the Pacific.

People in developing nations are generally missing out due to accessibility issues, a slow roll out of vaccines, difficulties getting to remote areas, a lack health of resources and misinformation resulting in vaccine hesitancy.

But ChildFund director of programmes Quenelda Clegg said developed countries need to support the Pacific and also stop hoarding vaccines.

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The organisation has been raising awareness about vaccine inequity and the issues happening in the Pacific.

“We need to support our neighbours. They are having covid in their countries and we are starting to see those outbreaks,” she said.

“They do need more and there needs to be a continual supply to ensure they get their vaccinations up to double dose and they need to consider boosters and vaccinations for children.”

Papua New Guinea has some of the lowest vaccination rates in the world — only 3 percent of the population are double vaccinated. This is due to the high reluctance of more than 8 million people that live there, which resulted in many vaccines being dumped.

Solomon islands is only nearing 10 percent full vaccinated people and Vanuatu is about 44 percent.

Samoa is 63 percent double vaccinated and Kiribati is 50 percent double vaxxed.

New Zealand supplies
“The New Zealand government has given a good supply to Indonesia and Papua New Guinea, but they have committed to sending more so we must ensure they do that and hold them to account,” Clegg said.

COVAX, the worldwide initiative aimed at equitable access to covid-19 vaccines, needed to do more, she said.

A New Zealand Ministry of Foreign Affairs spokesperson said that a further 1.7 million doses had been donated to Pacific nations via the Covax scheme, but sourced outside the advance purchase agreement, meaning they did not count towards New Zealand’s share of 7.6 million doses.

A total of 211,200 AstraZeneca doses had been sent to island nations so far, with the bulk going to Papua New Guinea.

She said some developing countries — New Zealand excluded, were giving away vaccines when they were almost expired.

However, MFAT is yet to confirm what NZ plans to do with its latest batch of AstraZeneca vaccines which will expire this coming April.

“The support to COVAX needs to be strategic and meaningful. It can’t be when they’re just about to expire.”

She warned new variants could emerge “from the Pacific, if we don’t do something now”.

This article is republished under a community partnership agreement with RNZ.

When this novel coronavirus first swept the world last year, it was quickly obvious global vaccination was the only way out.

Governments invested billions in public funding and guaranteed pre-orders to corporations like Moderna, Pfizer/BioNtech, Johnson & Johnson, Novovax and Oxford/AstraZeneca to incentivise vaccine research and development.

Never before has a vaccine been created and tested so quickly. It was a tribute to human ingenuity and creativity, and a reminder of how powerful we are when we work together.

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Yet, a year after the first person was vaccinated, less than 2 percent of people in the poorest countries have benefited.

Ahead of their annual shareholder meetings earlier this year, major vaccine producers, Pfizer, Johnson & Johnson and AstraZeneca revealed they had paid out US$26 billion in dividends and stock buybacks to shareholders in the previous 12 months.

Nine individuals have become billionaires off the back of coronavirus vaccines. Just how are these pharmaceutical corporations and their shareholders making their money?

Pharmaceutical corporations will not share their covid-19 vaccine intellectual property. This means they have a monopoly over a precious resource everyone needs. This gives them the power to charge excessive prices to maximise their profit. And this is what they have done.

Governments paying 4 to 24 times more than cost
Governments worldwide are paying between 4 and 24 times more than the estimated cost of producing the covid-19 vaccines. Experts, including Imperial College London, estimate the Pfizer and Moderna mRNA vaccines can be produced for as little as NZ$1.70.

According to reported prices that are available, even COVAX — the international facility set up to buy vaccines especially for poor countries — is paying an average of five times this cost.

Pfizer/BioNTech are charging their lowest reported price of NZ$9.70 to the African Union but this is still nearly six times more than the estimated production cost.

Israel has paid the highest reported price for Pfizer/BioNTech vaccines at NZ$40.26 a dose – nearly 24 times the potential production cost. Some reports suggest they paid even more.

In New Zealand, while the details are not public, we do know that in the 2021 Budget the Government set aside NZ$1 billion for vaccines. Assuming we have paid for all the vaccines that we have pre-purchase agreements for from this amount, (which is probably a generous assumption), we have paid at least nine times more than production costs.

As we consider the need for booster shots, Pfizer has suggested raising prices further.

I don’t buy the argument that pharmaceutical corporations have to charge so much because they invest in risky research and development. As stated, billions of public dollars went into the research and development of covid-19 vaccines.

Previous public investment
These vaccines would not be possible without decades of previous public investment in research and development.

Over the past 80 years, the US’s National Institutes of Health alone invested almost US$900 billion in biotech and pharmaceutical research, and continues to put in US$30 billion a year.

It is not pharmaceutical corporations investing in the risk of uncertainty, but governments across the world.

Besides that, pharmaceutical corporations spend more on marketing than on research and development. In 2013, Johnson & Johnson spent more than twice as much on sales and marketing than on R&D: US$17.5 billion versus US$8.2 billion.

For Pfizer, it was US$11.4 billion on marketing versus US$6.6 billion on R&D. Marketing costs are also tax deductible.

Further, economist Mariana Mazzucato reports pharmaceutical corporations put their profits into dividends and share buybacks that increase stock prices and CEO pay. That is precisely what we are seeing during this pandemic.

Put simply, the public fund the bulk of pharmaceutical research and development. Pharmaceutical corporations get the intellectual property and know-how, then force the public to pay again for vaccines, at prices far above a reasonable profit.

Money goes to already wealthy individuals
The ultimate result is public money going into the pockets of already wealthy individuals.

While they get rich, millions fall back into extreme poverty – living on less than NZ$2.70 a day – and the coronavirus continues to circulate and mutate, potentially rendering these vaccines obsolete and holding us all to ransom for years to come.

Soon negotiations will be under way again at the World Trade Organisation (WTO) to get consensus among governments to waive the intellectual property rights for covid-19 vaccines.

New Zealand supports this waiver, but the challenge is to persuade countries such as Germany and the UK. If this can be achieved, it will break the pharmaceutical corporations’ monopoly and allow vaccine supply to expand and the cost to drop.

The work doesn’t end there. How can we recreate our system to develop essential medicines and get them to everyone, using public funds for collective well-being, and avoid creating another handful of billionaires?

Dr Jo Spratt is the advocacy and communications director at Oxfam Aotearoa. This article is republished with the permission of the author and Oxfam.

A mad race to produce a vaccine against covid-19 has begun with the world’s superpowers leading the pack. At stake are millions of lives and billions of dollars.

Among the frontrunners is the United States with its futuristic-sounding Operation Warp Speed. Europe and China also have their own leading candidate vaccines.

As the race heats up, cheering and waiting on the sidelines for the crumbs are the less developed Asian, Asia-Pacific, African and South American countries, where most of the clinical trials for the vaccines will be or are being conducted already.

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Normally, it takes at least four years to develop a vaccine before it is marketed. But in the covid-19 age, health experts are optimistically predicting a vaccine in one year or less.

There is a sense of urgency and we hope for an early breakthrough.

Meanwhile, at the head of the line waiting for the vaccine, expected to be ready by the end of the year, are the populations of the Western countries. They are, of course, the priority for their governments which funded the research in the first place.

Developing world as trial labs
Poor Asian countries and the rest of the developing world, unfortunately, have to wait at the end of the line. That is why some of them have agreed to be guinea pigs for the vaccine trials in the hope that they will be given preference when the vaccines are rolled out for use. Beggars cannot be choosers.

Mid-August President Rodrigo Duterte committed the Philippines to participate in the phase 3 trials of Russia’s Sputnik V vaccine. Joining the Philippines in the clinical trials are Saudi Arabia and the UAE. However, the Philippine President’s rash acceptance of the Russian offer of clinical trials in the country might be a catastrophic mistake because the Russian project is suspect.

Indonesia has started a late-stage human trial of a Chinese-made covid-19 vaccine that will involve as many as 1,620 patients. No less than the Indonesian President Joko Widodo launched the trial at a ceremony in Bandung, West Java, in mid-August.

The Indonesian decision to be a clinical trial partner with China might be a better bet because China is a leader in the race to produce a vaccine.

The vaccine candidate produced by Sinovac Biotech is among the few in the world to enter phase 3 clinical trials, or large-scale testing on humans — the last step before regulatory approval. CoronaVac, is undergoing a late-stage trial in Brazil and Sinovac expects to test it in Bangladesh also.

Asia is the favourite destination of drug manufacturers for clinical trials for several reasons. Among them are medical expertise in specific therapeutic areas, availability of vast patient pools, excellent laboratories and infrastructure, comparable quality and lower costs. Another factor is comparable incidence and prevalence of Western diseases. (1)

There is likewise worldwide data acceptability. Data from clinical trials in Asia are routinely accepted by the regulatory agencies — US Food and Drug Administration (USFDA) and European Medicines Agency (EMA). Also, the costs in Asia for procedures, diagnostic tests and visits are generally 30-40 per cent lower than in the US and Europe.

Science must trump politics
As the race heats up, a word of caution is in order. Scientists must not sacrifice scientific integrity for politics but should follow the strict protocols for scientific research and production. Governments must put science over politics in the race to the vaccine.

“Scientists must not sacrifice scientific integrity for politics but should follow the strict protocols for scientific research and production.”

– Crispin Maslog

Safety and effectiveness are crucial to vaccine development. A blunder in the clinical trials caused by rushing procedures, for example, could lead to deaths that will set back research and development by many years.

As it is, there is already “vaccine hesitancy” among the public everywhere, especially among the uninformed. Polls show that US citizens have become less confident about the safety of vaccines.

Polling by the opinion and data company YouGov in May found 55 percent of US adults saying that they would get a covid-19 vaccine. By the end of July, that figure had dropped to 41 per cent — well below the 60—70 percent experts think will be needed to achieve “herd immunity”.

There is also substantial scepticism against vaccines in other countries, according to a recent study by the Wellcome Trust. In France, less than half of people believe vaccines are safe. In Ukraine — the most sceptical country in the world — the figure is just 29 percent.

Let us not feed this vaccine hesitancy with instances of failure.

Who gets the vaccines first?
As the superpowers rush to the finish line, the rhetorical question arises: who gets the vaccines first? Rhetorical because, unless an international body intervenes, we know the poor will get it last.

Some Asian and African countries have negotiated agreements, but not most of Asia and Africa. And even for those who negotiated for agreements, there are no guarantees, and whether the amount of doses that will be obtained will be enough to cover the majority of the population.

Unless governments subsidise the vaccines partially or fully they will be unaffordable for the poor. Early reports say the Chinese vaccines will cost US$145 per shot in the open market, while those from Oxford, UK, will only cost US$4-10 because they will be subsidised.

Some countries plan to provide free vaccinations, and even pay people to be vaccinated to ensure herd immunity, about 70-90 per cent of the population.

There is hope on the horizon via COVAX, a consortium of 172 economies now being organised and “working with vaccine manufacturers to provide countries worldwide equitable access to safe and effective vaccines, once they are licensed and approved”. (2)

“It is the only global initiative that is working with governments and manufacturers to ensure that covid-19 vaccines are available worldwide to both higher-income and lower-income countries,” say the organisers in a news release. (2)

Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations, one of the organisers of COVAX, says: “In the scramble for a vaccine, countries can… come together to participate in an initiative which is built on enlightened self-interest and also equity, leaving no country behind.” (2)

This is a welcome development and we hope it succeeds. May the best developed vaccines and humanity win. No shortcuts, please.

Dr Crispin C. Maslog is a former journalist with Agence France-Presse, is an environmental activist and former science journalism professor at Silliman University and the University of the Philippines Los Baños, Philippines. He is a founding member and now chair of the board, Asian Media Information and Communication Centre, Manila. This article was produced by SciDev.Net’s Asia & Pacific desk and is republished by the Pacific Media Centre with the permission of the author.

References
1. Asia: Preferred Destination for Clinical Trials: A Frost and Sullivan White Paper.
2. COVAX News Release Geneva/Oslo, 24 August 2020