Humanosphere

Owen Barder

Owen Barder, a development expert at the Center for Global Development, asks “Should we pay less for vaccines?”

Barder’s post was prompted by the critical response some advocacy groups, like Oxfam and Médecins Sans Frontières (aka Doctors Without Borders) made after the successful fund-raising effort on June 13 by the Global Alliance for Vaccines and Immunization, a massive project getting vaccines out to poor kids.

As I noted at the time, these organizations and others were glad to see GAVI receive $4.3 billion in new funding but they felt the alliance was a bit too friendly to the drug industry and too willing to accept industry pricing.

This issue, of what constitutes fair vaccine pricing for poor countries, came up repeatedly this week at Seattle’s Pacific Health Summit. I intend to write about that in a separate post later.

For now, I urge you to read Barder’s excellent take on the critics of GAVI and the vaccine manufacturers.

A few excerpts:

A minority of NGOs have criticized GAVI on the grounds that is too cozy with pharmaceutical companies. But we should be encouraging more, not less, engagement by pharmaceutical companies in the health needs of developing countries. Perhaps pharmaceutical companies have done more for the world’s poor than the aid industry?

Well, I don’t know about that last one. I agree,as Barder writes, that Merck’s Maurice Hilleman, a prolific vaccine scientist, may have saved more lives than any other scientist. I agree that vaccines are perhaps the single most effective health tool at our disposal.

And I’d have to agree that since vaccines are made by drug companies and drug companies have to make money, setting prices needs to strike the right balance between achieving the public health good and rewarding the private sector. Barder makes an excellent case for this.

The trick here is to make sure the drug industry price is fair. Barder appears to be making the industry’s argument but then does note:

There is plenty of reason to maintain a healthy suspicion of pharmaceutical companies. There are plausible allegations of unethical clinical trials, misrepresentation of data, irresponsible marketing and corruption. I find the industry’s obsessive secrecy sinister.

I don’t like the industry’s zealous protection of intellectual property rights, which inhibits the spread of ideas and society’s technological progress. I share the widespread suspicion of companies that are too big, too rich and too powerful. I’m sure that many pharmaceutical companies would be happy to gouge the market if they were given the opportunity to do so.

Nonetheless, it is a shame that an industry which has done so much good for humanity – including in developing countries – is so widely vilified.

So, yes, the industry as a whole should not be vilified. Sounds like we can vilify some of them, however.

But all this is why these “public-private partnerships” — often so glibly described as a win-win solution where profit-making and social good converge — are actually quite difficult and rare.

It requires those trying to help the poor to accept that industry needs to make money, and for some in industry to accept making less money when the goal is about helping the poor (rather than maximizing shareholder value). Not an easy balance to strike.