AstraZeneca vaccine price pledge omits some poor countries, contract shows

AstraZeneca can charge a higher price for its Covid-19 vaccine in dozens of poor countries once the pharmaceutical company decides the pandemic has ended, according to a copy of its contract with Oxford University seen by the Guardian.

The British-Swedish drug firm has promised to provide the vaccine at a not-for-profit price to the developing world in perpetuity, but a review of a redacted version of its contract with Oxford University, obtained by the student advocacy group Universities Allied for Essential Medicines (UAEM), found that the promise excludes many low-income and lower-middle-income countries.

Among those left off the list are 34 countries classified by Unicef and the WHO as being in need of vaccine support, including Sri Lanka, Angola, Timor-Leste, Honduras, Zimbabwe and the Philippines, which could all be charged a higher price once AstraZeneca declares the Covid-19 pandemic has ended.

In contrast to its pharmaceutical competitors, AstraZeneca has forgone billions of dollars in revenue by providing its vaccine at cost price, a promise that was key to securing its partnership with Oxford’s Jenner Institute, where the formulation was developed.

Critics say that though AstraZeneca is doing more to ensure global vaccine access than any other company, estimates that 97% of the funding for development of the Oxford vaccine came from taxpayer and charitable sources mean it should be considered a public commodity.

Other vaccines, such as Moderna’s mRNA formulation, were also heavily subsidised by the public but are already making billions of dollars in profit for their shareholders.

The Oxford/AstraZeneca contract names 58 developing countries as eligible for the cheap price in perpetuity, sourced from a 2019 list of nations that required vaccine aid produced by the international public-health group Gavi.

But under Covax, a global agreement to distribute vaccines equitably, the list of countries in need of help buying vaccines was subsequently extended to 92.

The contract has not been revised to reflect this longer list, creating a remainder of countries that may struggle to fund their own vaccines but which are not contractually guaranteed a not-for-profit price once AstraZeneca says the pandemic is over. Among them are countries such as Mongolia, Egypt and Indonesia, as well as the Palestinian territories.

Another contract signed between AstraZeneca and a Brazilian manufacturer, the contents of which were first reported by the Financial Times, indicates that AstraZeneca reserves the right to declare when the pandemic is over and set a provisional end date of 1 July this year, though with caseloads still surging in many parts of the world and the UK yet to exit total lockdown, this date will almost certainly be put back.

AstraZeneca indicated it was too early to say in which countries it would ultimately seek to make a profit. “We are still in the midst of a pandemic and therefore our current focus is on supplying the vaccine to vulnerable communities across the world as quickly as possible,” it said.

“From the start of the pandemic our core purpose has been to provide the vaccine globally, at no profit, to countries regardless of income level. We were the first to sign up to Covax and our vaccine accounts for over 90% of supply to date, with 77m doses delivered to 127 countries, the majority being low- and middle-income countries.”

It is likely to continue providing vaccines at cost price to Covax in the long term, but under its current contract it would have the option of charging some developing and lower-income nations a higher price if they seek to buy the vaccine directly from the company.

AstraZeneca’s promise not to generate a profit from the vaccine during the pandemic has been held up by the UK government as evidence that more forceful measures to improve access, such as waiving patents on all Covid-19 vaccines and treatments, are not warranted.

“The contract between Oxford and AstraZeneca highlights that we need a more inclusive approach to knowledge sharing and equitable technology transfer, rather than one company having the sole right to manufacture it,” said Florence Rodgers, UAEM’s UK national coordinator. “We call on Oxford and AstraZeneca to share the vaccine with the WHO’s Covid-19 technology access pool to allow for truly global vaccine access.”

Heidi Chow, a senior policy and campaigns manager at Global Justice Now, said the loophole in the Oxford contract was proof that the “AstraZeneca model” would not alleviate vaccine inequality. “Covax is not capable of vaccinating anywhere near enough people to end this pandemic,” she said. “Even if fully funded, the programme only aims to vaccinate 30% of participating nations’ populations – and it has been lagging far behind targets.”