There are many reasons I volunteered to take part in the AstraZeneca Covid-19 vaccine trial in Johannesburg. In part, I wanted to live up to my own loud mouth. After tweeting about how the South African trials presented an incredible opportunity to gather local context-specific vaccine data, I was challenged to put my own body on the line if I felt it was so important. I signed up a week later.
More so, I had the (admittedly idealistic) belief that by taking part in the trials, South Africa would be able to get the vaccine at a more affordable rate when it was approved for production. Recent reports, however, appear to indicate that in spite of AstraZeneca’s claim that it wanted to “provide vaccines to the widest population, with as fair access as possible”, the siren song of profit-making has beaten out altruistic intention — a story we’ve heard too many times before.
On Thursday, a senior health official told AFP that the doses of the AstraZeneca vaccine would cost South Africa $5.25 each — which is more than double the $2.16 charged for European Union members. The health department’s deputy director-general, Anban Pillay, has been quoted as saying: “We were advised that [the] Serum Institute of India has applied a tiered pricing system and, given that [SA] is an upper-middle-income country, their price is $5.25. The explanation we are given for why other high-income countries have a lower price is that they have invested in the [research and development], hence the discount on the price.”
As an AstraZeneca trial participant, I find this statement more than a little disconcerting. If our local trials, which I’ve been involved in for more than 150 days now, are not considered a contribution to “research” enough to motivate AstraZeneca to honour its commitment to “fair access”, it begs the question: what is?
The pharmaceutical company has repeatedly promised not to profit from its Covid-19 vaccine “during the pandemic”. This claim came under scrutiny towards the end of last year when documents showed that AstraZeneca had set a target date by which to declare the end of the pandemic (allegedly July 2021), which would presumably allow it to alter its vaccine pricing from the expected $3 a dose thereafter.
Although the company says it approached the “development of the vaccine as a response to a global public health emergency, not a commercial opportunity”, the more-than-doubled fee per dose for South Africa (in spite of research contributions in the form of a trial) inspires concerns that AstraZeneca appears not to have really meant it — at least not when it comes to the African continent and its 1.2-billion inhabitants.
Other reports have indicated that the massive premium on shots purchased directly from the Serum Institute of India, which is manufacturing under licence from AstraZeneca, is the result of South Africa’s failure to place orders timeously. Although the government’s failings in this regard are by no means insignificant or unworthy of criticism, one struggles to sit comfortably with the idea that a delayed order could in any way warrant a doubled price tag.
Throughout the duration of the trial, when asked why I’m taking part, I’ve answered that my participation is as much about being able to do something, anything, in a pandemic that left all of us feeling helpless, as it was about playing a miniscule role in the research that would hopefully help to ensure our nation gained affordable access when the time came.
Yet when it comes down to it, no matter whether trials were held in a country or not; no matter whether a country is considered to have contributed to a vaccine’s research and development; no matter whether those trials are seen as having value enough to warrant recognition by the pharmaceutical companies who conducted them: access to the vaccine should be free and fair to everyone everywhere.
Unequal access will hold back the world’s ability to overcome this crisis because no one is safe until we all are. And when it comes to mounting a “response to a global public health emergency” that isn’t driven by commercial interests, there are simple steps that can be taken to ensure it is actually so: pharmaceutical companies must operate with full transparency, particularly when it comes to knowledge sharing and pricing strategies; intellectual property rights should be waived to enable manufacturers all over the world to ramp up productivity; and surplus vaccine doses purchased by rich countries should be distributed to developing countries to ensure that they reach everyone who needs them — not just those who can afford them.
It is said that history has the tendency to repeat itself. In the 1990s, we saw the devastation caused by unequal access to HIV treatment. In many ways, we still do. In the early days of 2021, we have the capability to ensure that 30 years from now, the lessons we learned can finally be put to good use. The failure to do so could see us accounting for our refusal to learn and make the necessary changes in the unnecessary loss of more human life.
The geographic location in which a person is born or resides should not dictate access to potentially life-saving medical intervention. And neither should a person’s bank balance. The call for a #PeoplesVaccine has been ringing since May. As the human race, we have the know-how and the ability to produce enough vaccines for everyone globally.
It is time AstraZeneca and the other pharmaceutical companies took that call seriously. It is time that they mean what they say when releasing press statements about a “no-profit pledge”. It is time that we, the people, demanded that every human life is finally treated as equal. Because, in the words of Shirley Chisholm, the first African American woman elected to the United States Congress: “Health is a human right, not a privilege to be purchased.”