Campaigners warn that 9 out of 10 people in poor countries are set to miss out on COVID-19 vaccine next year

Published: 9th December 2020


Nearly 70 poor countries will only be able to vaccinate one in ten people against COVID-19 next year unless urgent action is taken by governments and the pharmaceutical industry to make sure enough doses are produced, a group of campaigning organisations warned today. 

By contrast, wealthier nations have bought up enough doses to vaccinate their entire populations nearly three times over by the end of 2021 if those currently in clinical trials are all approved for use. Canada tops the chart with enough vaccines to vaccinate each Canadian five times. Updated data shows that rich nations representing just 14 per cent of the world’s population have bought up 53 per cent of all the most promising vaccines so far.

The organizations, including Amnesty International, Frontline AIDS, Global Justice Now and Oxfam, who are part of an alliance calling for a People’s Vaccine, used data collected by science information and analytics company Airfinity to analyze the deals done between countries and the eight leading vaccine candidates. They found that 67 low and lower middle-income countries risk being left behind as rich countries move towards their escape route from this pandemic. Five of the  67 – Kenya, Myanmar, Nigeria, Pakistan and Ukraine - have reported nearly 1.5 million cases between them.

Anna Marriott, Oxfam’s health policy Manager, said:  “No one should be blocked from getting a life-saving vaccine because of the country they live in or the amount of money in their pocket. But unless something changes dramatically, billions of people around the world will not receive a safe and effective vaccine for COVID-19 for years to come.” 

Heidi Chow, from Global Justice Now, said: “All pharmaceutical corporations and research institutions working on a vaccine must share the science, technological know-how, and intellectual property behind their vaccine so enough safe and effective doses can be produced. Governments must also ensure the pharmaceutical industry puts people’s lives before profits.”

The Pfizer/BioNTech vaccine has already received approval in the UK and vaccinations are beginning this week. It is likely to receive approval from other countries including the US within days. Two further potential vaccines, from Moderna and Oxford in partnership with AstraZeneca  are expected to submit or are awaiting regulatory approval. The Russian vaccine, Sputnik, has announced positive trial results and four other candidates are in phase 3 clinical trials.

So far, all of Moderna’s doses and 96 percent of Pfizer/BioNTech’s have been acquired by rich countries. In welcome contrast Oxford/AstraZeneca has pledged to provide 64 percent of their doses to people in developing nations. Yet despite their actions to scale up supply they can still only reach 18 per cent of the world’s population next year at most. Oxford/AstraZeneca deals have also mostly been made with some of the big developing countries like China and India, while the majority of developing countries have not done deals and have to share the COVAX pool of vaccines between them.

This demonstrates that one company alone cannot hope to supply the whole world, and that only open sharing of technology between vaccine producers can make this possible.

The People’s Vaccine Alliance is calling on all pharmaceutical corporations working on COVID-19 vaccines to openly share their technology and  intellectual property through the World Health Organization COVID-19 Technology Access Pool, so that billions more doses can be manufactured and safe and effective vaccines can be available to all who need them. 

The Alliance is also calling on governments to do everything in their power to ensure COVID-19 vaccines are made a global public good—free of charge to the public, fairly distributed and based on need. A first step would be to support South Africa and India’s proposal to the World Trade Organisation Council this week to waive intellectual property rights for COVID-19 vaccines, tests and treatments until everyone is protected.

Steve Cockburn, Amnesty International’s Head of Economic and Social Justice, said: “The hoarding of vaccines actively undermines global efforts to ensure that everyone, everywhere can be protected from COVID-19. Rich countries have clear human rights obligations not only to refrain from actions that could harm access to vaccines elsewhere, but also to cooperate and provide assistance to countries that need it.

“By buying up the vast majority of the world’s vaccine supply, rich countries are in breach of their human rights obligations. Instead, by working with others to share knowledge and scale up supply, they could help bring an end to the global COVID-19 crisis.”

The vaccines developed by AstraZeneca/Oxford, Moderna and Pfizer/BioNTech have received more than $5 billion dollars of public funding, which the alliance said placed a responsibility on them to act in the global public interest.

Dr. Mohga Kamal Yanni, from the People’s Vaccine Alliance, said: “Rich countries have enough doses to vaccinate everyone nearly three times over, whilst poor countries don’t have enough to even reach health workers and people at risk.

“The current system, where pharmaceutical corporations use government funding for research, retain exclusive rights and keep their technology secret to boost profits, could cost many lives.”

Lois Chingandu, Director of Frontline AIDS, said: “This pandemic is a global problem that requires a global solution. The global economy will continue to suffer so long as much of the world does not have access to a vaccine.

“We need to put pharmaceutical industry profit aside during this unprecedented pandemic, both to save humanity and the economy.”

Momentum is mounting for a People’s vaccine, which has already been backed by COVID survivors, health experts, activists, past and present world leaders, faith leaders and economists including: Cyril Ramaphosa, Imran Khan, Ellen Johnson Sirleaf, Gordon Brown, Helen Clark, Mary Robinson, Joseph Stiglitz, John Nkengasong and Thomas Piketty.

Last month in the US, more than 100 high-level leaders from public health, faith-based, racial justice, and labor organizations, joined former members of Congress, economists and artists to sign a public letter calling on President-elect Biden seize on this extraordinary moment and power of the US President to support a People’s Vaccine. 

Concurrently in the EU, a broad coalition of health worker trade unions, NGOs, activist groups, students associations and health experts launched a European Citizens’ Initiative for a people’s vaccine.  The Initiative would allow European citizens to introduce legislative proposals if they collect 1 million signatures.

Notes to editors

All figures are based on the fact 2 doses are required apart from the Johnson & Johnson vaccine which is a single dose vaccine.

The People's Vaccine Alliance is a coalition of global and national organizations and activists united under a common aim of campaigning for a ‘People’s Vaccine’. The call for a People’s Vaccine is backed by past and present world leaders, health experts, faith leaders and economists. For more information visit: https://peoplesvaccine.org

The figures have been calculated by analysing data from Airfinity for November 2020. The statistic ‘9 out of 10 people missing out on vaccines in 67 countries’ is based on the fact that 30 low-income countries and 37 lower-middle income countries currently will only have access to any vaccine through the COVAX Advanced Market Commitment (AMC). The 67 countries do not include middle-income countries such as Brazil, Indonesia and Vietnam, who have also made their own bilateral deals. So far, the COVAX AMC has managed to secure 700 million doses from the leading vaccine candidates, to be distributed between the 92 countries that have signed up.  The figure was reached by dividing 700 million doses by the population of the 92 countries (3.6 billion), then dividing that by two, as two doses are required by the vaccines already secured by COVAX AMC to vaccinate each individual. Details  of the COVAX AMC can be found here: https://www.gavi.org/news/media-room/92-low-middle-income-economies-eligible-access-covid-19-vaccines-gavi-covax-amc

The 67 countries are: Afghanistan, Angola, Algeria, Benin, Bhutan, Burundi, Burkina Faso, Cabo Verde, Cambodia, Cameroon, Central African Republic, Chad, Comoros, Republic of Congo (Brazzaville), Cote d’Ivoire, Democratic Republic of Congo, Djibouti, Eritrea, Ethiopia, Eswatini, Gambia, Ghana, The Guinea, Guinea-Bissau, Haiti, Kenya, Kiribati, Democratic People’s Republic of Korea, Kyrgyz Republic, Lao PDR, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Micronesia, Moldova, Mongolia, Mozambique, Myanmar, Niger, Nigeria, Pakistan, Papua New Guinea, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Solomon Islands, Somalia, South Sudan, Sri Lanka, Sudan, Syria, Tajikistan, Tanzania, Timor Leste, Togo, Tunisia, Uganda, Ukraine, Vanuatu, West Bank and Gaza, Yemen, Zambia, Zimbabwe.

Calculations of proportion of doses for rich and poor nations were based on analysing data on supply deals gathered by Airfinity. We examined the vaccine candidates that are in phase three trials that have done significant supply deals with countries across the world, cross-checking with original sources. There are currently eight of these: Astra Zeneca/Oxford, Novovax, Johnson & Johnson, Sanofi/GSK, Pfizer/BioNTech, Gamaleya/Sputnik, Moderna and Sinovac. 

According to data from Johns Hopkins, Kenya, Myanmar, Nigeria, Pakistan and Ukraine have had over 1.46m cases between them: https://coronavirus.jhu.edu/map.html

Breakdown of 8 leading vaccine candidates in Phase 3 that have done substantial deals with countries worldwide is available on request. 

Vaccine Candidate Distribution of doses b/w rich and poorer countries (by end 2021) Approx. Price Public money received Commitment to open sharing/ patents
Pfizer/ BioNTech

Total under contract: 1.128 billion doses

Rich countries:1.082 billion (96%)

Poorer  countries:
54 million (4%)

$19.50 a dose in US, two dose regimen. Represents up to 80% profit margin.  Yes- $546 million to BioNTech from EU and German govt.  $2 billion contract with US government.  BioNTech is the holder of the IP and neither BioNTech or Pfizer has made any commitment to sharing IP or joining the WHO C-TAP
Moderna

Total under contract: 777 million
Rich countries: 100%

Poorer countries: 0%

$12 to $32 a dose, two dose regimen. Considered to be ‘pandemic price only’  Yes- $2.48 billion from US government, if certain milestones are met. Yes, but limited. Will not enforce patents during the pandemic and willing to license IP post pandemic. No commitment to open sharing or WHO C-TAP.
Astra Zeneca/ Oxford

Total under contract: 2.731billion 

Rich countries:
983 million (36%)

Poorer countries:
1.747billion (64%)

$3-$5 a dose from the licensed Indian  Serum Institute  two dose regimen and no profit during pandemic. No profit to low income countries in perpetuity.

Yes – over $1.9 billion from US and UK governments, CEPI AND GAVI. IP owned by Oxford University. AZ has an exclusive license to develop and manufacture globally, including tech transfer, to contract manufacturing organisations and sublicencees but contracts are not transparent. 
AZ CEO openly opposed to any public sharing of technology and IP .
No commitment to open sharing or joining WHO C-TAP.
Novavax

Total under contract: 1.376 billion 

Rich countries:
376 million (27%)


Poorer countries
1 billion (73%)

$16 a dose $1.6 billion in US government funding Potential Tech transfer between Novavax and Indian Serum company  but not transparent. 
No commitment to open sharing of technology or IP or of joining WHO C-TAP.
Johnson and Johnson

Total under contract: 1.268 billion 

Rich countries:
768 million (61%) 

Poorer countries
500 million (39%)

$10 a dose, ‘non-profit’- one dose regimen $1.5 billion from US govt No commitment to open sharing of technology or IP or of joining WHO C-TAP
Sanofi/ GSK

Total under contract: 1.232 billion 

Rich countries:
1.032 billion doses (84%)

Poorer countries: 200 million doses
(16%)

$10.50 a dose ‘no-profit’ during pandemic. $2.1 billion from US govt  Loose commitment to ‘sharing their technology’ but no firm position on sharing IP and technology, and no commitment to joining WHO C-TAP
Sinovac

Total under contract: 229 million 

Rich countries (0%)

Developing  countries 
(100%)  

$13.50-$30 per dose Sinovac 40% owned by Chinese Govt. Also has benefited from loans from Chinese govt. Sinovac have shared technology with Indonesian and Brazilian producers but no commitment to WHO C-TAP. Xi Jinping has committed that all Chinese vaccines will be a ‘global public good’ 
Gamaleya/
Sputnik

Total under contract: 587 million
 
Rich countries (0.3%)

Poorer countries (99.7%)

$10 a dose Gamaleya institute that is developing the vaccine is publicly owned and operates under the Ministry of Health.  Some commitment to share technology according to some news reports but nothing concrete and no commitment to joining the WHO C-TAP. 

Contact information

Contact information

Sarah Dransfield: SDransfield@oxfam.org.uk, Mob: +44 (0)7884 114825

Laura Rusu: Laura.Rusu@Oxfam.org, M: +1 (202) 459-3739

For updates please follow @Oxfam.

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