More Pain, More Gain! The Delivery of COVID-19 Vaccines and the Pharmaceutical Industry’s Role in Widening the Access Gap

Abstract

Background: An effective response to the COVID-19 pandemic entails a comprehensive strategy that ensures equitable access to all COVID-19-fighting technologies. To achieve this goal, the international community has acknowledged immunization as a public good. However, a trend of grossly unequal dose distribution emerged, owing, among other factors, to pharmaceutical companies' profit-driven actions, jeopardizing the mechanisms built to increase vaccine access. The contradiction between public health interests and corporate discretion in determining vaccine dose distribution poses critical concerns about the health risks associated with lengthening the duration of the pandemic and the eventual liability of companies for violations of human rights. Methods: To evaluate the risks posed to the COVID-19 immunization program, data on vaccine allocation and delivery, vaccine dose application, immunized populations, and the volume of Advanced Purchase Agreements (APAs) between countries and pharmaceutical companies were compiled and assessed. A descriptive analysis was then conducted to analyze the role of pharmaceutical companies in providing equitable access to COVID-19 vaccines. Results: When the data is broken down by income (as of June 2021), it shows that high-income countries have already crossed the COVAX 20% immunization threshold. However, countries of all other income levels have yet to achieve this mark for fully vaccinated people. Upper-middle-income countries have approximately 3%, low-and-middle-income countries have approximately 2% and low-income countries have less than 0.1% of fully vaccinated people per hundred. The supply shortage is expected to last until the second half of 2021. Conclusion: As a result of the COVAX failure, a health gap emerged with countries living in a pre-immunization period for an extended time. The existing conflict between the international response to tackle COVID-19 and corporate profit-driven behavior contributed to prolonging pandemic, especially in Africa. Accordingly, there is a need to approve an international treaty that targets the activities of all actors, including the pharmaceutical companies, in protecting human rights and the right to health realms.

Ethical and Practical Considerations for an Agreement to Ensure Equitable Vaccine Access Comment on "More Pain, More Gain! The Delivery of COVID-19 Vaccines and the Pharmaceutical Industry’s Role in Widening the Access Gap"

“…Borges et al 5 want that an unequal distribution such as the one witnessed during the COVID-19 pandemic does not happen again. They claim that “there is a need to approve an international treaty that targets the activities of all actors, including the pharmaceutical companies, in protecting human rights and the right to health realms.” 4 Such a treaty should not only involve pharmaceutical companies, but also governments, international organizations, and civil society.…”

Profits First, Health Second: The Pharmaceutical Industry and the Global South Comment on "More Pain, More Gain! The Delivery of COVID-19 Vaccines and the Pharmaceutical Industry’s Role in Widening the Access Gap"

“…The article by Borges and colleagues 1 about the inequitable access to COVID-19 vaccines between the Global North and the Global South is a stark reminder that pharmaceutical companies are primarily motivated by profits with the alleviation of suffering and the promotion of health a secondary concern. Borges et al focus on access, but the profit motivation also determines the choice of conditions that companies undertake research and development (R&D) for.…”