COVID-19 vaccines: African countries get very few doses at very high prices

This is a number of shame and disgrace: 25. Just 25 doses of vaccines against the novel coronavirus disease (COVID-19) have been given to one of the lowest-income countries in Africa. Not 25 million, 25 thousand, or even 25 hundred. A total of just 25! A shaken Tedros Adhanom Ghebreyesus, head of the World Health Organization (WHO), told the executive board meeting of the organisation in January. It was later revealed that the country is Guinea, one of the world’s 29 low-income countries, all but five of which are in Africa.

Ghebreyesus believes that the world is on the brink of a catastrophic moral failure and the price as usual will be paid by the poorest countries, where lives and livelihoods have already been wiped out. After all the hopes that were raised in 2020 by the many initiatives launched by WHO to ensure equitable access to COVID-19 vaccines, such as the ACT Accelerator and COVAX, a global collaboration designed to speed up the development, manufacturing and equitable distribution of new vaccines, history is being repeated once again.

We only have to hark back to the HIV/AIDS pandemic 40 years ago to understand the stark inequalities in access to critical medicines — there is still no vaccine for the disease —that allowed millions to die in Africa. The medicines that were developed went only to the rich and it was only after a decade — thanks primarily to a pathbreaking generics company in India, Cipla, and its gutsy boss — that people in poor nations could access the life-saving medicines.

Here’s how the great vaccine grab has played out in COVID-19 times. With rich nations and drug companies rushing to sign bilateral deals instead of giving priority to COVAX, it’s a great time for vaccine makers to make a fortune while poor nations can only look on. With 44 bilateral deals signed last year and more than a dozen this year, according to WHO, it means that even younger, healthier adults in rich countries are vaccinated before the health workers and older people in poorer countries get their shots.

COVAX, funded by philanthropists and a clutch of rich countries, has managed to secure 2 billion doses from five producers and will hopefully get another billion doses. But the rollout has still not started, which has prompted many an African nation to scramble for supplies on their own, signing deals at very high rates that are three times the price paid by the European Union (EU) for the AstraZeneca vaccine. For instance, South Africa, with one of the highest cases of COVID-19, bought 1.5 million doses from the Serum Institute of India (SII) at $5.25 per dose compared with $2.50 per shot negotiated by the Europeans.

The logic used to extract this price from South Africa was that Serum Institute, a huge contract manufacturer, was applying a tiered pricing system based on the income category of the buyers. South Africa is an upper-middle-income country but still way behind the EU nations, which come in the high-income category. The explanation given to South Africa is that these countries were given a discount for their investments in R&D. Then what explains the purported $7 per dose sought from Uganda, since it is still a low-income country? There has been global outrage over this, but who really cares for vaccine equity?

This was first published in Down To Earth’s print edition (dated 16-28 February, 2021) 

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