Transparency will be important for affordable access to any covid-19 vaccine and it is the responsibility of governments to ensure both, say Manuel Martin and Isabelle Jani-Friend

Recently, the Financial Times reported that there is an important limitation to pharmaceutical corporation AstraZeneca’s not-for-profit promises on the production of their covid-19 vaccine. With hundreds of other vaccines under development, supported by an exceptional level of public funding, this is a cause for concern.

Pharmaceutical corporations must open their books, make all funding and licensing agreements public, and substantiate any no-profit claims with data. We know that pharma does not tend to share this information willingly, so it is time for governments to take charge, demand transparency, and put their commitments to equitable access of covid-19 vaccines into action. 

As someone working on innovation and access to healthcare issues for Médecins Sans Frontières, an international medical humanitarian organisation, and a person living with cystic fibrosis who is at high risk of severe covid-19, we can see how groundbreaking a safe, effective, and affordable covid-19 vaccine would be in our joint global journey towards normality. 

The covid-19 vaccine being co-developed by Oxford University and AstraZeneca was originally discovered by Oxford’s Jenner Institute and has received more than a billion pounds of public funding. When AstraZeneca and Oxford University signed an agreement with one another, they committed to sell the vaccine at a no-profit price during the pandemic, a possible attempt to ward off criticism around their deal. However, in the terms of the deal reported recently by the Financial Times, AstraZeneca has apparently given itself the power to declare that the pandemic is over by as soon as July 2021, allowing them to decide what price they charge after this date.

AstraZeneca has said in a statement that “We continue to operate in that public spirit [of not treating a vaccine as a commercial opportunity] and we will seek expert guidance, including from global organisations, as to when we can say that the pandemic is behind us.”

Yet the potential implications of the FT’s report are still huge, especially considering that the vaccine, if proven to be safe and effective, would likely be needed long after the first phases of the pandemic, including for potential “booster” shots. If it came to pass, it would mean that, after July 2021, AstraZeneca could charge the NHS and other health systems around the world high prices for a vaccine that has received huge investments of public money. This does not surprise us. Decades of experience has shown us that pharmaceutical corporations often do not resist the opportunity to maximise their profits. 

Médecins Sans Frontières works with patients in over 70 countries around the world, including responding to the pandemic in nearly 60 of these countries. MSF has seen firsthand the effect of high prices and monopolies held by pharmaceutical corporations, hindering the introduction of affordable versions of pneumonia and human papillomavirus vaccines in developing countries. If pharmaceutical corporations continue with “business as usual” tactics and charge exorbitant prices, overwhelmed health systems could be pushed to their breaking point, with dire consequences for the health of people around the world. 

The community of people living with cystic fibrosis in the UK fought for five years to gain access to a life changing medicine to treat the disease after pharmaceutical corporation Vertex launched a drug at a price that the NHS simply could not afford. As we anxiously wait for an effective covid-19 vaccine, we cannot allow history to repeat itself. If future covid-19 vaccines are unaffordable and inaccessible, people around the world at the highest risk of severe covid-19, like people with cystic fibrosis, would again be forced to pick up the fight for access. 

The global community is desperately searching for a way out of this pandemic. Billions of pounds of public money are flowing into the research and development of covid-19 vaccines around the world. And despite the millions of lives hanging in the balance, this money continues to be handed over to the pharmaceutical industry through confidential deals without any transparency. This needs to stop. Transparency is a catalyst for affordable access to all health tools and it is the responsibility of governments to ensure both.

The covid-19 pandemic is an unprecedented situation that demands unprecedented measures. If governments are truly committed to ensuring equitable access to covid-19 vaccines for the world, they must put people first and force pharmaceutical corporations to open their books. During a pandemic, more lives than ever rest on transparency.

Manuel Martin is a medical innovation and access policy adviser for the Médecins Sans Frontières Access Campaign. Twitter @LeaozinhoM

Competing interests: Manuel Martin is an employee of the Doctors Without Borders / Médicines Sans Frontiers Access Campaign. No other competing interests.

Isabelle Jani-Friend is a freelance journalist and a patient leader for Just Treatment. 

Competing interests: Nothing further to declare.