When Free Is Not Good Enough

Did you know that the leading cause of child mortality worldwide is pneumonia? And though a pneumococcal vaccine has been available for a number of years, it’s still out of reach for many of those who need it most. Pharma manufacturers are aware of the problem and often donate vaccines to redress the balance. On the surface, it seems like an altruistic act, but Doctors Without Borders/Médecins Sans Frontières (MSF) argues that free isn’t good enough. In October 2016, MSF rejected a donation of one million free pneumonia vaccines from Pfizer in protest of the company’s high prices.

Is it a foolish decision? After all, surely one million donated vaccines are better than no vaccines at all?

“No. Free is not always better,” Jason Cone, Executive Director of MSF in the US, wrote in a blog post (1). “Donations often involve numerous conditions and strings attached, including restrictions on which patient populations and what geographic areas are allowed to receive the benefits. This process can delay starting vaccination campaigns, which would be an untenable situation in emergency settings, or grossly limit who you’re able to reach with the vaccine.”

Cone cites a number of other reasons for the rejection. For example, new manufacturers may not wish to enter a market that seems saturated by a donation arrangement; companies may use donations to justify high prices elsewhere; and, crucially, donation offers can disappear. Being able to pay for their own vaccines would give governments greater control.

The only other producer of a pneumonia vaccine is GlaxoSmithKline – MSF has been negotiating with both companies on price for seven years. In September 2016, GSK finally agreed to lower their prices for humanitarian organizations – MSF is now urging Pfizer to do the same.

According to Cone, the World Health Organization (WHO), UNICEF and Gavi, the Vaccine Alliance, all have clear recommendations against donation offers from pharma companies. MSF’s rejection is likely to draw attention to a problem in the industry that many of us may not have considered in depth. I’ll finish with a thought-provoking quote from Cone:

“Doctors Without Borders does not believe that our medical work, nor the work of other humanitarian organizations or governments trying to serve their people, should be at mercy of the voluntary ‘goodwill’ of pharmaceutical corporations.”

Stephanie Sutton
Editor