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vaccine apartheid
Watchdog Warns Mpox Vaccine Maker 'May Be Exploiting the Latest Global Health Crisis'
"We must question why Bavarian Nordic refuses to adjust its unconscionable approach to pricing and access," wrote the director of Public Citizen's Access to Medicines program.
Aug 24, 2024
A U.S.-based watchdog group on Friday called out what it described as the "profiteering approach" taken by one of the only companies in the world with an approved vaccine for mpox, an infectious disease whose rapid spread in the Democratic Republic of Congo prompted the World Health Organization to declare a global emergency earlier this month.
Peter Maybarduk, the director of Public Citizen's Access to Medicines program, wrote a letter to the Danish pharmaceutical giant Bavarian Nordic expressing deep concern that the company "may be exploiting the latest global health crisis, putting profits over people."
A spokesperson for Bavarian Nordic, the maker of the mpox vaccine Jynneos, told STAT in a recent interview that the firm doesn't "tend to talk about price," a lack of transparency that set off alarm bells amid a pressing international crisis. Mpox has spread to the DRC's neighboring countries, and Thailand and Sweden each recently reported a case.
Maybarduk elaborated on his concerns:
In 2022, the Pan American Health Organization (PAHO) resolved to procure mpox vaccines despite Bavarian Nordic’s refusal to provide a single low price for all PAHO Member States. Consequently, the vaccine costs much more than any of the other vaccines available through the Revolving Fund, PAHO's bulk vaccine purchaser. In negotiations with manufacturers, the Revolving Fund usually seeks to obtain a supplier's lowest available price to ensure that all PAHO Member States can access affordable vaccines, regardless of size or level of development.
Given Bavarian Nordic's troubling approach to pricing with PAHO then, we remain concerned about pricing implications now for group procurement by Africa CDC and multilateral purchasers such as Gavi, as well as wider ramifications for the global public health response.
"While many actors have roles to play in ensuring a coordinated international effort to contain the spread of mpox, including how best to make use of vaccines," Maybarduk added, "we must question why Bavarian Nordic refuses to adjust its unconscionable approach to pricing and access."
The WHO's emergency declaration and the lack of vaccine access in the countries most affected by mpox has sparked concerns of a repeat of the vaccine apartheid that undermined the global response to Covid-19, with deadly consequences.
Lawrence Gostin, Sam Halabi, and Alexandra Finch, experts at the O'Neill Institute for National and Global Health Law at Georgetown University, wrote in a New York Times op-ed earlier this week that "we shouldn't discount the pandemic potential of mpox."
"Africa CDC has estimated that it needs 10 million doses to stop the current outbreak. But as was the case with the Covid vaccines, mpox vaccines are in the hands of the world's richest countries and companies," the experts wrote. "An agreement between Africa CDC, the European Union, and Bavarian Nordic has already been reached for the procurement and rapid distribution of about 200,000 doses, but many more are needed. The United States has said it will donate 50,000 doses to Congo from its stockpile. But this still leaves Africa nowhere near the 10 million doses needed."
"Bavarian Nordic says that by the end of this year it could manufacture two million more doses, and then eight million doses next year, if purchase orders are made," they added. "But there is no clear commitment to make these doses affordable for African countries."
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Despite False Claims, an Equitable Pandemic Treaty Would Make Us All Safer
We urgently need global rules and international cooperation to prevent, prepare for, and respond to the next dangerous infectious disease.
May 30, 2024
This week, World Health Organization member states meeting at the World Health Assembly are widely expected to extend negotiations for a new pandemic treaty after talks collapsed last Friday.
The political blowback and disinformation campaign against the treaty have been fierce.
Reps. Jim Jordan (R-Ohio) and Thomas Massie (R-Ky.) claimed the “WHO agreement may contravene the First Amendment.” It doesn’t. Twenty-four governors wrote to President Joe Biden raising constitutional concerns, none of which hold water.
The concentration of global vaccine manufacturing capacity in rich countries drives inequities.
More about disinformation later. What’s most important is that the risk of the next pandemic looms—just witness the spread of H5N1 avian influenza among dairy cattle and farm workers. We urgently need to shore up international rules to prevent, prepare for, and respond to the next pandemic.
The pandemic agreement would, in essence, strike a global social bargain.
The Biden administration wants a transparent exchange of scientific information in real-time, including surveillance data, notification of dangerous outbreaks, and sharing pathogen samples and their genomic sequences. Global rules on scientific exchange can help curb outbreaks at their source and detect dangerous variants. More importantly, these data are the lifeblood needed to develop lifesaving diagnostics, vaccines, and treatments rapidly.
This global social bargain also requires equitable allocation of medical products made possible by scientific sharing. And without equity, the Global South rightly won’t sign on.
We think of equity as a matter of ethics, and it is. But it is also the most effective way to stop the international spread of novel diseases before they become pandemics. Equity is central to rebuilding trust between the West and the Global South, which was shattered during Covid-19.
The concentration of global vaccine manufacturing capacity in rich countries drives inequities. As we saw with Covid-19, high-income countries pre-purchased vaccines from pharmaceutical companies, causing serious international vaccine shortages.
Building manufacturing capacity in low- and middle-income countries like Brazil, India, and South Africa would remove bottlenecks in global supply. But this will require sharing intellectual property, dedicated financing, and transferring technology from powerful multinational pharmaceutical companies.
The pandemic treaty would also address the “upstream drivers” of pandemics. Biodiversity loss, climate change, and chemical pollution all contribute to the emergence of novel diseases. Up to 75% of new or emerging infectious diseases result from “spillovers” from animals to humans. Zoonotic spillovers have caused most global health emergencies, like SARS, Ebola, mpox, and most likely Covid-19.
A “one health” approach ensures that governments take action at the interfaces between human, animal, and environmental health. This could mean global rules on deforestation, intense farming of animals, overuse of antibiotics, and the trade in wild animals, including wet markets.
But all these global public goods are at risk from a worldwide disinformation campaign aimed at derailing the treaty. False claims include the loss of U.S. sovereignty to craft public health policies. Yet, the draft treaty expressly affirms national sovereignty. Also, the WHO director-general does not have the power to require lockdowns or issue mandates for masks or vaccinations.
This year, more than 64 countries are holding elections. Elections in the United States pose a particularly virulent risk to the success of diplomatic negotiations. Recall that then President Donald Trump withdrew the U.S. from WHO, only to be reversed by Biden. There’s little doubt that a future Trump administration would torpedo WHO negotiations.
The next pandemic is percolating somewhere—whether in dairy cows here in the United States, in a cave in southern China replete with bats, or through the work of nefarious actors using novel technologies like synthetic biology to recreate or enhance dangerous viruses like smallpox.
More than 1 million Americans lost their lives to Covid-19. The next pandemic could be much worse. We urgently need global rules and international cooperation to prevent, prepare for, and respond to the next dangerous infectious disease.
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'Appalling': EU Nations Destroy €4 Billion Worth of Covid Vaccines After Hoarding Doses
"Handing exclusive rights to publicly-funded vaccines and medicines to just a few companies simply does not work—for rich countries or poorer ones," said an adviser to the People's Vaccine Alliance.
Dec 18, 2023
Vaccine equity campaigners on Monday condemned European Union nations for hoarding Covid-19 vaccine doses at the expense of low-income countries after a new Politico analysis estimated that the bloc's members have thrown out at least €4 billion—roughly $4.4 billion—worth of the lifesaving shots.
That equates to around 215 million coronavirus vaccine doses—very likely an undercount, given that Politico wasn't able to obtain waste numbers from every E.U. member country.
"Calculations based on available data show that E.U. countries have discarded an average of 0.7 jabs for every member of their population," the outlet reported. "Top of the scale is Estonia, which binned more than one dose per inhabitant, followed closely by Germany, which also threw away the largest raw volume of jabs."
Piotr Kolczyński, E.U. health policy adviser at the People's Vaccine Alliance and Oxfam International, said in a statement that the new analysis is "further proof that the E.U. wasted millions of its Covid-19 vaccines, hoarded early in the pandemic, as it locked poorer countries out of access."
"The appalling waste in the world's pandemic response was disastrous," said Kolczyński. "Handing exclusive rights to publicly-funded vaccines and medicines to just a few companies simply does not work—for rich countries or poorer ones."
Politico attributed much of the waste to the E.U.'s massive 2021 deal with Pfizer and BioNTech, which agreed to sell 1.1 billion doses of their mRNA jab to members of the bloc as low-income countries struggled to obtain shots for their populations.
"Despite considering a significant reform to reign in pharmaceutical waste and profiteering within its borders, the EU fails to support similar efforts on the global stage."
E.U. members—Germany in particular—pushed back aggressively against the India and South Africa-led call for a Covid-19 vaccine patent waiver, which proponents said would have lifted key barriers to expanding vaccine manufacturing and access. Germany alone has wasted 83 million vaccine doses, according to Politico.
The pharmaceutical industry, for its part, lobbied aggressively to preserve its monopoly control over vaccine recipes and production, focusing significant attention on the European Commission.
With the global health emergency formally over, countries are currently negotiating the terms of a pandemic agreement that would govern how the international community responds to the next global crisis.
Reuters reported in September that "governments remain divided, failing to agree on some of the basics needed to strengthen health systems worldwide."
"Those basics, all issues that hindered a coordinated global response to the Covid-19 outbreak, include the sharing of information, costs, and vaccines," Reuters added. "The divisions arose anew in June, when the European Union negotiated new agreements with pharmaceutical companies to reserve vaccines for future pandemics. The agreements led critics to accuse the bloc of 'vaccine apartheid.'"
Last month, 18 members of the European Parliament wrote to the Council of the European Union and the European Commission expressing "concerns about the E.U.'s negotiating position."
"It proposes to continue relying solely on voluntary measures in the deployment of key public health interventions, such as the transfer of technology, know-how and 'trade secrets,' or the removal of intellectual property barriers," the lawmakers wrote. "In the meantime, the E.U. avoids specific commitments for equitable access to pandemic products."
As the People's Vaccine Alliance noted Monday, the E.U.'s latest proposed text "suggests removing transparency and equity measures."
"Despite considering a significant reform to reign in pharmaceutical waste and profiteering within its borders, the E.U. fails to support similar efforts on the global stage," said Kolczyński. "It is one rule for the E.U. and another for everyone else."
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