Covid vaccine ‘the most expensive in history’ for poorer countries

Exclusive: Analysis shows lower-income countries are paying well beyond the norm for their vaccine doses

A medical worker holds two vials of the Pfizer vaccine at an inoculation centre in Manila, the Philippines (AFP via Getty)

The Covid jab is one of the “most expensive vaccines in history” for poorer countries, analysis shows, raising further the concern that those most in need will continue to struggle to access the life-saving vaccines in the coming year.

Despite international promises that the vaccines would be made available at the cheapest prices to lower-income countries, these nations are paying well above the expected cost.

World Health Organisation (WHO) data analysed by The Independent shows that governments of lower-income countries are paying a median price of $6.88 (£5.12) per dose for Covid vaccines.

Before the pandemic, developing countries paid a median price of $0.80 a dose for non-Covid jabs, WHO figures show.

“The price is high relative to the other vaccines used worldwide and in large quantities,” said Tania Cernuschi, team lead for the WHO’s global access, immunisation, vaccines and biologicals department.

She said comparisons could be drawn with the HPV and pneumonia (PCV) vaccines. WHO figures show that lower-income countries pay $4.50 and $3.08 respectively per dose for these two vaccines, both of which, like the Covid jabs, are relatively expensive and used in all countries.

Cheaper universal vaccines, such as those that protect against tuberculosis, or against measles, mumps and rubella (MMR), cost between $0.11 and $2.85 per dose, the WHO figures show.

A WHO source said: “The Covid vaccine is one of the most expensive vaccines in history for poorer countries.”

Victorine de Milliano, a UK policy adviser for the global health NGO Médecins Sans Frontières, said the figures were “further evidence that the current pandemic response is failing people in low-income countries”.

“Pharmaceutical companies are more interested in making profits than improving public health,” she added. “It is deplorable that in a pandemic, companies are charging historically high prices, especially given the public funding that went into these vaccines.”

Some of the lower-income countries’ supplies have been secured through Covax, the global vaccine-sharing initiative co-led by Gavi and the WHO, which covers procurement costs for poorer countries.

Beyond that, though, these nations have had to pay for their vaccines themselves. Many have been forced into deals with manufacturers, who, in some instances, have charged governments from the global south more than those in the developed world.

At the start of the year, it emerged that South Africa had been forced to buy doses of the Oxford-AstraZeneca vaccine at a price 2.5 times higher than that paid by most European countries. Bangladesh and Uganda have also paid more than the EU for the vaccine.

Colombia, meanwhile, has overpaid by as much as $375m for its doses of the Pfizer and Moderna vaccines, according to separate analysis.

At the same time, higher-income countries have paid below the norm for their Covid vaccine supplies.

The WHO data shows that these richer nations are typically paying $10.45 per dose for a Covid jab. For comparable vaccines – the HPV and PCV jabs – they pay $54.31 and $45.4 per dose, respectively.

“Relative to other vaccines, the high-income countries got a good deal” for their Covid jabs, said the WHO source. “But that same good deal is not there for low-income nations.”

As to why this is the case, officials in the WHO have yet to establish a clear reason. “To be honest, we don’t know why things are as they are,” the source said. Investigations are under way to analyse the data and better understand the price inequities.

Typically, richer nations have been first in the queue to strike larger, more lucrative deals with manufacturers, which have represented value for money. In contrast, poorer countries have been left at the back of the queue and forced to pay more than they usually would for their doses.

Reflecting purchases made up to September 2021, the WHO data is drawn from 180 different public and governmental sources across 73 countries.

The campaign group Global Justice Now said the findings were “yet another sickening example of how pharma companies are determined to cash in on the pandemic”.

“There can be no justification for charging poorer countries such outrageous prices,” it added.

Max Lawson, co-chair of the People’s Vaccine Alliance and head of inequality policy at Oxfam, said: “Poor countries are paying through the nose for Covid vaccines. The only way to stop this is for governments like the UK to break up the monopoly of big pharma and force them to share the vaccine recipes.

“Then producers all over the developing world can mass-produce much cheaper unbranded versions for everyone who needs them. We need a people’s vaccine, not a profit vaccine.”

While countries such as the UK have double-vaccinated more than 80 per cent of their adult population, as of mid-December just 6 per cent of people across the entire African continent had received two doses. Globally, wealthy nations have administered more than 17 times the number of vaccines as poor countries.

Labour’s Nick Thomas-Symonds, the shadow international trade secretary, said: “Labour urged the government back in May to help facilitate the ramping up of production of vaccines and the waiver of patents. Unfortunately, ministers did not heed this advice.

“The current system is tilting towards favouring higher-income countries. It is time for the government to step up and lead. Nobody is safe until everyone is safe.”

A government spokesperson said: “The UK has been a world leader in ensuring developing countries can access vaccines through our investment in Oxford-AstraZeneca, early support to the Covax scheme and commitment to donating vaccines.

“We are on track to meet our goal of donating 30 million doses by the end of this year. The UK has already sent 22.3 million doses to Covax – of which 17.8 million have been delivered to developing countries – and a further 3.1 million will be delivered to Covax direct from AstraZeneca in the coming weeks.”