Covid-19 vaccines are crucial to help end this pandemic. But as wealthy countries roll out vaccine programmes, countries in the global south are left with little or none. Even though billions of pounds of public funding has paid for research, development and manufacturing, the vaccines that have been approved in the UK are the privately-owned assets of a profit-driven industry that has sold most of its stock to the highest bidders. We need to push Big Pharma to lift patents and share their knowledge to ensure Covid-19 vaccines reach everyone, everywhere. We need a People’s Vaccine.

“...The world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.”7 Dr Tedros Adhanom Ghebreyesus, director general of the World Health Organisation

Free the Vaccine CC

BY-NC

-SA

July 2020: Free the Vaccine and UAEM activists and allies take part in a Carnival March through London to persuade UK universities involved in Covid-19 research to sign the OpenCOVID Pledge.

Supporter briefing

Fighting for a People’s Vaccine February 2021

2 I Fighting for a People’s Vaccine

Governments across the world are pinning their hopes of ending this pandemic on Covid-19 vaccines. But instead of being produced as global public goods – manufactured in mass quantities, affordable to all countries and free to the public – supplies are restricted and distributed by wealth.

Wealthy nations like the UK, US and EU have bought up enough doses to vaccinate their entire populations nearly three times over by the end of 2021 if those currently in clinical trials are all approved for use. Meanwhile, nearly 70 low-income countries will only be able to vaccinate one in ten people against Covid-19 this year.1 Studies show that some low-income countries could even be waiting up to 2024 before they get the vaccine.2

No one is safe unless everyone is safeEnsuring there are enough vaccines for everyone, everywhere is crucial to avert even higher global death rates. Academic research shows that we could avert 61 percent of deaths globally if vaccines are distributed fairly, compared to 31 percent if rich countries hoard vaccines.3

Ultimately, hoarding vaccines is self-defeating: leaving the virus to spread unabated in large parts of the world allows it to mutate, potentially rendering the effective vaccines of today useless tomorrow.

It is also economically short-sighted. The International Chamber of Commerce estimates that leaving developing countries without vaccines will cost rich countries $4.3 trillion in lost income in 2021.4

Why aren’t there enough vaccines?Pharmaceutical companies operate monopolies for their products, which means only they can sell them. This is enforced through patents which prevent any other company from making or selling that medicine. They also defend their monopolies through keeping their technological know-how under wraps – only they know the recipe and process for making their vaccine.

Monopolies mean bumper profits. Market analysts predict the industry is set to make at least $10 billion in profits each year from Covid vaccines.5 But this will be devastating for human lives. At a time when the global death toll has moved beyond the two million mark this is simply unacceptable.6 The hope and anticipation of being Covid-free should be for all, and not just for the richest countries on the planet.

Profiteering versus public health The global situation is tragic and exposes a contempt for the lives of those in the global south but it is also not surprising. We have a global pharmaceutical industry that prioritises profiteering over public health. We saw this at the height of the HIV AIDS epidemic of the 1990s where millions of people in the global south could not access the expensive treatments that could save their lives. And we have seen this more recently with global struggles to access treatments for conditions like cancer, hepatitis C and cystic fibrosis.

Decisions about which diseases to invest in are based on the areas of greatest financial returns rather than on the areas of greatest public health needs. That’s why public health priorities such as vaccines for infectious diseases, antimicrobial resistance and treatments for conditions that affect communities in the global south get very little attention from the industry. Instead, it is more profitable to focus on drugs for chronic diseases that

Free the Vaccine CC

BY-NC

-SA

Student activists call for a People’s Vaccine

Fighting for a People’s Vaccine I 3

require repeated use as well as modifying existing drugs that provide no additional health benefit.

For many, this is a system where who gets to live and who dies is based on wealth, and medical treatments are treated as consumer luxuries rather than necessities that are a vital part of every person’s right to health.

What can be done? The global pharmaceutical system has not been fit for purpose for decades and this pandemic has exposed the cracks once again. As Covid-19 has claimed millions of lives as well as crippled societies and economies, this is the time to push governments and Big Pharma to take the steps needed to overhaul the system. The following sets out the key steps to do this:

1. Big pharma and governments should join the Covid-19 Technology Access Pool

No one company can satisfy global demand, so the way to overcome restricted supplies is for pharmaceutical companies to share their technological know-how and the rights to make the vaccine with other companies. Mobilising more manufacturers will increase global supply so that more people can access the vaccine and prevent price gouging.

The World Health Organisation launched a mechanism last year – the Covid-19 Technology Access Pool (or C-TAP)8 – to facilitate the sharing of know-how and intellectual property to enable any manufacturer or government to produce Covid-19 vaccines, treatments and other health technologies. The UK has not joined yet but Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, supports the pool 9- opening up hope a Biden administration may join. Meanwhile pharmaceutical companies have condemned the scheme, with the Pfizer boss deriding the initiative as ‘nonsense.’10

This reaction may not be that surprising. After all, why would profit-making companies ever give away their commercial secrets and intellectual property to competitors? But the vaccines that have been approved have all benefited from billions in public funding. Some estimates show €93 billion of public funds has been poured into vaccine research and development.11

These publicly funded vaccines should belong to the public and be produced by as many manufacturers as possible to meet global demand. It’s scandalous that publicly funded vaccines have effectively been privatised, and could now be used to profiteer by a few corporations.

Distribution of leading vaccine candidates that have been approved or in final stages of clinical trials (as at February 2021)

Vaccine Candidate Distribution of doses (by end 2021)12 Approximate price Public funding

Pfizer/ BioNTech

Total under contract: 2.02 billion doses High income countries: 1.5 billion doses (74%)Low and middle income countries: 524 million doses (26%)

$19.50 a dose in the US and $18.90 in the EU (two dose regimen).13 Estimated to represent up to 80% profit margin.14

€375 million to BioNTech from the German government15 and €100 million from the EU in debt financing.16 $2 billion contract with the US government.17

Moderna

Total under contract: 822 million High income countries: 100% Low and middle income countries: 0%

Reports range from $1218 to $3019 a dose (two dose regimen).

$1 billion from the US government for research and development and supply contract worth up to $1.5billion.20

Table 1:

4 I Fighting for a People’s Vaccine

Vaccine Candidate Distribution of doses (by end 2021)12 Approximate price Public funding

Astra Zeneca/ Oxford

Total under contract: 3.14 billion High income countries: 1.01 billion (34%)Low and middle income countries: 2.09 (66%)

$3-$5 a dose from the licensed Indian Serum Institute two dose regimen and no profit during pandemic.21 No profit to low income countries in perpetuity.22 Recent concerns have been raised that South Africa has been charged more than double the amount paid by European countries.23

Over $1.7 billion from US and UK governments, CEPI AND GAVI.24

Novavax

Total under contract: 2.02 billion High income countries: 1.51 billion (75%) Low and middle income countries: 509 million (25%)

$16 a dose25 Nearly $2 billion in US government funding26

Johnson & Johnson

1.4bnHigh income countries: 800 million (57%)Low and middle income countries: 600 million (43%)

$10 a dose, ‘non-profit’– (one dose regimen)27

$1.5 billion from US government for research, development and manufacturing28

Sanofi/GSK

Total under contract: 1.232 billion High income countries: 1.032 billion doses (84%) Low and middle income countries: 200 million doses (16%)

$10.50 a dose ‘no-profit’ during pandemic29 $2.1 billion from US govt30

Sinovac

Total under contract: 357 million High income countries: 7.5 million (2%) Low and middle income countries: 350million (98%)10

$3031 per doseFinancial backing from the Chinese government32

Sinopharm

Total under contract: 383 million High income countries: NoneLow and middle income countries: 383 million (100%)

One estimate says $3033 a dose

State-owned company34

Gamaleya/Sputnik14

Total under contract: 559 million High income countries: 1.5 million (0.3%) Low and middle income countries: 558 million (99.7%)

Less than $1035 a dose (two dose regimen)

The Gamaleya institute is part of the Ministry of Health in Russia.36

Fighting for a People’s Vaccine I 5

2. The UK government should impose conditions on all public funding

The UK government has already committed £475 million to Covid-19 research and development and should use its influence as a major funder to ensure treatments and vaccines produced from publicly funded research are openly licensed to enable any producer to manufacture them and are affordable for all countries. These stipulations should be formalised as public interest conditions on any new funding committed to further Covid-19 research and development.

3. The UK government should stop opposing the proposal to suspend patent rules

The governments of India and South Africa have put a proposal on the table of the World Trade Organisation to suspend the rules on patents that prop up Big Pharma monopolies. The proposed suspension would cover all Covid-19 health products and last until widespread vaccination is in place. If approved, this would break up Big Pharma monopolies on Covid-19 vaccines and treatments, allowing as many suppliers as possible to maximise global supply. Countries in the Global South are welcoming this proposal, while rich countries, including the UK, oppose it.37

Free the Vaccine CC

BY-NC

-SA

August 2020: Free the Vaccine and its allies held a protest outside Moderna’s headquarters in Cambridge, Massachusetts, to urge the corporation to remove intellectual property rights around their coronavirus vaccine which was paid for with US taxpayer dollars, and to commit to signing the OpenCOVID Pledge.

6 I Fighting for a People’s Vaccine

4. The UK government should override patents to gain access to Covid-19 treatments and vaccines

The government has the ability to override patents on vaccines and treatments to allow other manufacturers to make that product. However the government has not used these powers in decades, in deference to the pharmaceutical industry. These powers have mainly been used by countries in the global south in the past two decades to access HIV treatments but they have often faced threats and bullying from other rich countries and pharmaceutical companies when they have done so. The government should be prepared to use these powers in the UK during this pandemic as well as provide support to countries in the global south who use them too.

Join the campaign for a People’s Vaccine

Leaving Big Pharma monopolies unchallenged will mean continued inequality of vaccine access and will prolong this global pandemic. It’s time to change the rules to save lives. We need a people’s vaccine, not a profit vaccine.

Will Covax help with equitable access to Covid-19 vaccines?The Covid-19 Vaccine Global Access (Covax) Facility is a global vaccine programme to enable countries to purchase vaccines collectively and distribute them equitably. Covax Advance Market Commitment (AMC) funds and delivers Covid-19 vaccines for 92 low-income countries.38

In spite of its aspirations, Covax is fundamentally flawed because it does not challenge Big Pharma monopolies and so will always struggle to purchase enough vaccines.

The programme only aims at providing enough vaccines to vaccinate 20% of each country’s population in 2021 with no plan for how more doses will be acquired. This is problematic as this is nowhere near enough for each country to achieve herd immunity.

The UK government has contributed £548 million39 to help fund the COVAX AMC but at the same time has undermined the scheme by racing ahead to hoard doses. The UK has so far pre-ordered seven different vaccines. With a total of 519 million doses purchased, that is around 7 doses per citizen in the UK.

We are calling on the Covax Facility to:

• Demand ‘at-cost’ prices from pharmaceutical companies. Profits should not be made off the back of this pandemic

• Require all companies that it works with to participate in technology transfer and open licensing to ramp up manufacturing capacity and help improve availability.

• Make public all agreements made with pharmaceutical companies and force all pharmaceutical corporations receiving funding from the Covax Facility to open their books to allow independent verification of costs and prices.

Join the campaign:www.globaljustice.org.uk/pharma

Fighting for a People’s Vaccine I 7

References

1 https://www.globaljustice.org.uk/news/2020/dec/9/campaigners-warn-9-out-10-people-poor-countries-are-set-miss-out-covid-19-vaccine

2 https://www.theguardian.com/world/2020/nov/03/rich-states-covid-deals-may-deprive-poor-of-vaccine-for-years

3 https://www.ft.com/content/f999c4e4-78a2-4f83-9beb-91c15dccd0b8

4 https://www.theguardian.com/world/2021/jan/25/hoarding- covid-vaccines-could-cost-wealthy-countries-45tn

5 https://www.ft.com/content/7961437d-33cd-4f47-b190-2be3b571c8e5

6 https://www.worldometers.info/coronavirus/coronavirus-death-toll/

7 https://www.bbc.co.uk/news/world-55709428 8 https://www.who.int/emergencies/diseases/novel-

coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/covid-19-technology-access-pool

9 https://twitter.com/PIH/status/1349155249911713792 10 https://www.ft.com/content/b964cfb2-5f2e-4cb7-b9ad-

535481495eaa 11 https://healthpolicy-watch.news/81038-2/ 12 All supply figures from Airfinity13 https://www.reuters.com/article/us-health-coronavirus-

eu-vaccine-prices-idUSKBN28V0Y6 14 https://www.fiercepharma.com/pharma/pfizer-ceo-

says-it-s-radical-to-suggest-pharma-should-forgo-profits-covid-19-vaccine-report

15 https://www.globenewswire.com/news-release/2020/09/ 15/2093535/0/en/BioNTech-to-Receive-up-to-375M-in-Funding-from-German-Federal-Ministry-of-Education-and-Research-to-Support-COVID-19-Vaccine-Program-BNT162.html

16 https://ec.europa.eu/commission/presscorner/detail/en/ip_20_1034

17 https://www.reuters.com/article/us-health-coronavirus-usa-pfizer-idUSKBN28X1GC

18 https://www.biopharma-reporter.com/Article/2020/08/ 13/Moderna-lands-US-COVID-19-vaccine-contract-worth-up-to-8bn

19 https://www.ft.com/content/405c0d07-d15a-4f5b-8a77-3c2fbd5d4c1c

20 https://www.fiercepharma.com/pharma/after-nearly-1b-research-funding-moderna-takes-1-5b-coronavirus-vaccine-order-from-u-s

21 https://www.ft.com/content/c474f9e1-8807-4e57-9c79-6f4af145b686

22 https://www.theguardian.com/global-development/ 2020/nov/23/oxford-astrazeneca-results-covid-vaccine-developing-countries

23 https://www.theguardian.com/world/2021/jan/22/south-africa-paying-more-than-double-eu-price-for-oxford-astrazeneca-vaccine

24 https://msf.org.uk/article/governments-must-demand-pharma-make-all-covid-19-vaccine-licensing-deals-public

25 https://www.statnews.com/2020/07/31/operation-warp-speed-sanofi-gsk-covid19-vaccine/

26 https://msf.org.uk/article/governments-must-demand-pharma-make-all-covid-19-vaccine-licensing-deals-public

27 https://www.forbes.com/sites/greatspeculations/2021/ 01/26/johnson--johnsons-vaccine-updates-when-will-the-shot-be-available-for-use/?sh=4e3aeb6861ff

28 https://www.hhs.gov/coronavirus/explaining-operation-warp-speed/index.html

29 https://www.barrons.com/articles/glaxo-and-sanofi-will-sell-100-million-covid-19-vaccine-doses-to-the-u-s-51596193212

30 https://www.gsk.com/en-gb/media/press-releases/sanofi-and-gsk-selected-for-operation-warp-speed-to-supply-united-states-government-with-100-million-doses-of-covid-19-vaccine/

31 https://www.ft.com/content/80f20d71-d7eb-4386-b0f2-0b19e4aed94d

32 https://www.fiercepharma.com/manufacturing/china-s-sinovac-will-tackle-covid-19-shot-new-facility-backed-by-chinese-government

33 https://asia.nikkei.com/Spotlight/Coronavirus/China-forges-on-with-vaccine-diplomacy-amid-Pfizer-fanfare

34 https://www.bbc.co.uk/news/world-asia-china-55212787 35 https://sputnikvaccine.com/newsroom/pressreleases/

the-cost-of-one-dose-will-be-less-than-10-for-international-markets/

36 https://www.nytimes.com/interactive/2021/health/gamaleya-covid-19-vaccine.html

37 https://healthpolicy-watch.news/moderna-and-pfizer-vaccine-trial-results-are-milestones-distribution-poses-new-challenges/

38 https://www.gavi.org/news/media-room/92-low-middle-income-economies-eligible-access-covid-19-vaccines-gavi-covax-amc

39 https://www.gov.uk/government/news/uk-raises-1bn-so-vulnerable-countries-can-get-vaccine

Take action

Global Justice Now campaigns for a world where resources are controlled by the many, not the few. With thousands of members around the UK, we work in solidarity with global social movements to fight inequality and injustice.Global Justice Now, 66 Offley Road, London SW9 0LS+44 20 7820 4900 • offleyroad@globaljustice.org.uk • globaljustice.org.uk

To find out how you can help tackle corporate power and become part of a movement for real change visit globaljustice.org.uk

Global Justice Now is a member of the People’s Vaccine Alliance – a global coalition of organisations and activists united under a common aim of campaigning for a ‘People’s Vaccine’ for Covid-19. The alliance’s members include: Amnesty International, Oxfam, SumOfUs and UNAIDS. The call for a People’s Vaccine is backed by past and present world leaders, health experts, faith leaders and economists. peoplesvaccine.org