- Guillermo D. Olmo @BBCgolmo
- BBC World News
The whole world is vying for a place to receive the coronavirus vaccine, a good that is still too scarce and produced by few pharmaceutical companies.
Governments sign contracts with the companies that have developed these vaccines in record time, yet critical information about those agreements remains hidden from the general public due to strict confidentiality clauses.
How much they cost or how they will be distributed are details that in most cases the public does not know, because this is required by the signed agreements.
In Peru, for example, negotiations between the government and the Pfizer company ran aground for this reason. And in Colombia, the government claims that confidentiality clauses prevent it from still offering a clear vaccination schedule.
In response to a request for information in the European Parliament in mid-November, Health Commissioner Estela Kiriakides stated: “Due to the highly competitive nature of this market, the Commission is legally unable to disclose the information contained in these contracts “.
And the Belgian Budget Minister, Eva de Bleeker, had to withdraw shortly after posting a message on Twitter in which she collected the price list of the laboratories with which the EU had negotiated.
Complaints about non-compliance with commitments made by some vaccine manufacturers are now being joined by voices demanding greater transparency on a vital public health issue.
And the controversy continues to escalate, especially in the European Union (EU), angry after the laboratories Pfizer and AstraZeneca informed them that they will not be in a position to supply the block with the amount of initial doses agreed.
This has led, according to EU sources cited by Reuters, from Brussels to require pharmaceutical companies to make public the terms of the contracts and threaten to control exports of vaccines produced in Europe.
Why so much secrecy?
A common practice
According to Jonathan García, an expert in public health at Harvard University, in the USA, “this is nothing new; it is frequent that confidentiality clauses are included in the contracts between the health systems of the countries and the pharmaceutical companies” .
“The laboratories seek to divide the market to be able to negotiate different prices with different countries,” he adds.
This allows them to negotiate with countries based on their resources, offering lower prices to poor or developing countries and demanding higher amounts from richer ones.
The AstraZeneca company has revealed that the vaccine it has developed in collaboration with the University of Oxford will cost approximately $ 3-4 per dose (two required). But yours is an exceptional case for now.
In addition to prices, information regarding production and logistics, and those known as liability clauses, are often kept secret.
They stipulate limits on the responsibility of laboratories in the event of possible adverse effects of drugs and indicate that if there are differences, they will not be resolved by national courts, but by special international arbitration courts.
Voices calling for greater transparency warn that the urgency of developing a vaccine for a disease that has already claimed more than two million lives worldwide has been able to lead governments to accept even greater limitations of liability.
In the Strategy for the Acquisition of Vaccines published by the European Commission, it was stated that “the responsibility for the development and use of the vaccine, including any specific compensation required, will fall on the Member States that acquire it.”
The case of Peru
A country in Latin America, Peru, has become a prominent example of the problems that this limitation of liability entails for pharmaceutical companies.
The Peruvian government’s negotiations with the Pfizer company for the acquisition of the vaccine did not materialize because, according to the Minister of Health, Pilar Mazzetti, “some clauses were identified that required a more in-depth analysis to determine compatibility with Peruvian laws and scope that the State can assume “.
BBC Mundo tried to contact Pfizer, but got no response.
The lack of an agreement with Pfizer led the Peruvian authorities to look for other options, such as the vaccine from the Chinese manufacturer Sinopharm.
Contrary to what is happening in other countries in the region, such as Argentina or Chile, vaccination has not yet begun in Peru and the authorities have not been able to offer a secure schedule.
In Colombia, the government has come under heavy criticism for not having started vaccinating people yet and having referred to confidentiality clauses to justify why it could not yet offer a date to start doing so.
Confidentiality in contracts, however, has defenders, based, above all, on the so-called “cross subsidies”. By being able to charge more to rich countries, laboratories are in a position to offer affordable prices to countries with fewer resources.
Economist David Bardey points out in conversation with BBC Mundo that if there were transparency in drug prices, “it would be more complicated for laboratories to charge higher prices to richer countries if they can observe lower prices for other countries.”
“If we want the most developed countries to pay more, it is better that the prices are not public,” says the expert, who also warns that the most advanced countries are acquiring many more doses than they need because “their governments have a large pressure from their public opinion and that is pushing them to a kind of health nationalism. ”
The right of companies to make a profit from the large investments they make in research is also often referred to.
And a third factor is intellectual property rights. A Spanish public health expert who preferred not to give his name summarizes the role that, in his opinion, the large Western laboratories are playing: “They are defending their patent to prevent others from manufacturing it in India and selling it to them at a lower cost to poor countries. ”
Jonathan García believes that the arguments in favor of transparency gain value in the context of the pandemic.
“We are talking about a global health emergency, something that happens every 100 years, given which one would expect the system to use much more transparent mechanisms and seek a more cooperative scheme. Instead, we see that a monopoly market is still being sought and maintaining advantages in prices “.
Differences in access to vaccines have led the world to a risk of “catastrophic moral failure”, as defined by the director of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, the fact that the countries most in need go to have to wait years to immunize its population.
The history of epidemics shows that it would not be the first time. It has already happened with poliomyelitis and smallpox, diseases eradicated much earlier in the most advanced countries.
Or with HIV, which still decimates many African populations when patients in the so-called first world have seen their life expectancy significantly extended thanks to the development of antiretroviral treatments.
“The drugs are available; the problem is the costs,” says Garcia.
And middle-income countries, like most of Latin America, cannot afford to negotiate with laboratories the demanding attitude shown by the European Union, a bloc made up of 27 states among the most prosperous in the world.
* With additional information from Martín Riepl in Lima and Carlos Serrano in Miami.
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Eddie is an Australian news reporter with over 9 years in the industry and has published on Forbes and tech crunch.