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Just a quarter of Pfizer’s COVID-19 treatment orders will go to developing countries

Some nations could be paying ten times the price of Paxlovid’s generic equivalent, as WHO chief calls for treatment access to battle acute and long COVID-19

Rich countries have secured almost three times as many courses of a World Health Organisation (WHO)-recommended COVID-19 medicine, Pfizer’s Paxlovid, according to new analysis from Oxfam and the People’s Vaccine Alliance.

Using new data from Airfinity, they found that just a quarter of orders for the treatment will go to low- and middle-income countries, despite the fact they make up 84 per cent of the world’s population and have a much greater need as far fewer people are vaccinated against COVID, unlike rich nations which are largely protected.

On the eve of crunch talks at the World Trade Organisation (WTO) over intellectual property rules for COVID-19 treatments and tests, the organisations are warning that we are seeing the same worrying trend of inequity that we saw with COVID vaccines.

Pfizer’s monopoly also means that some middle-income countries could be paying ten times more for Paxlovid than a generic equivalent, with reports of them being quoted as much as US$250 per course. This is despite the fact that other lower-income countries will have access to a Clinton Health Initiative (CHAI) deal with Pfizer and undisclosed generic companies, which means they could access the treatment for just US$25 a course. 

Dr. Catherine Kobutungi, Executive Director of the African Population and Health Research Center said: “When vaccines were our main medical tool to fight COVID-19, big pharmaceutical companies prioritized maximizing their profits by selling doses to the richest countries. Millions died while people in low- and middle-income countries were sent to the back of the vaccine queue. And now, we are witnessing a repetition of the same inequity with COVID-19 treatments and tests.”

“Oral antiviral treatments are easy to administer. They reduce hospitalisation and cut deaths. And they may reduce the likelihood of long COVID. Yet, right now, they’re nearly exclusively accessible to people in the richest countries. The fact is that if you are a vulnerable person with COVID-19 in a high-income country, you will probably have access to treatments that can help you survive. If you live in a lower-income country, you probably won’t. It’s grotesque inequality and it kills”, she added.

The WHO recommends using Paxlovid to cut COVID-19 hospitalisation and death rates, and has called for equitable global access to COVID-19 medicines as part of a strategy to combat long COVID. A recent, non-reviewed study suggests that Paxlovid may lower the risk of patients developing long COVID.

There are hundreds of other potential COVID-19 medicines in the development pipeline, including at least 77 in late-stage clinical trials that could be more effective and have a wider scope of use. However, intellectual property rules are giving a small number of companies a monopoly on supply, allocation, and price, meaning low- and middle-income countries are unlikely to have affordable access to these medicines either.

Because far fewer people in low-income countries are vaccinated than in rich countries, they are more vulnerable to hospitalisation and death from COVID-19. These countries have already experienced the highest death toll in the pandemic, a trend that could continue without access to treatments like Paxlovid.

Jennifer Reid, Senior Health and Vaccine Equity Advisor at Oxfam, said: “After the inequity they faced with the vaccine rollout, developing countries are now experiencing access and affordability issues for COVID treatments. It is a disgrace that those who need them the most are receiving the least and that patent laws are handing Pfizer a long monopoly on this lifesaving medicine. 

“Addressing both acute and long COVID is essential – and the WHO has been clear that countries need treatments like Paxlovid to cut deaths and hospitalisations. But the patents minefield is a massive barrier preventing many developing countries from getting the medicines and tests they need now and in the future to save lives.”

In June, after a year and a half of negotiations, the WTO rejected proposals to waive intellectual property rules for all COVID-19 medical technologies, adopting a far more limited text that only covers vaccines. Ahead of talks taking place tomorrow in Geneva, civil society organizations are urging WTO member states to immediately agree to an extension to include treatments and tests, which would allow developing countries to produce for their own populations and export for others in need, ensuring essential tools are accessible and affordable.

Mohga Kamal Yanni, Policy Co-Lead for the People’s Vaccine Alliance, said: “Decades ago, governments allowed pharmaceutical companies to control the price, allocation, and supply of lifesaving HIV medicines – and millions of people died without affordable access. Now, the same thing is happening again with COVID-19 vaccines and medicines. Companies have been allowed to decide who lives and who dies. WTO member states must ensure that public health takes precedence over commercial interest.”

 

Notes to editors

A new briefing note from the People’s Vaccine Alliance on the case for the extension of the WTO ministerial decision to therapeutics and diagnostics is available here.

Data from Airfinity shows that the richest countries who account for just 16 per cent of the world’s population will receive 74 per cent of all courses ordered of Paxlovid. Low- and middle-income countries who make up 84 per cent of the world’s population will receive just 26 per cent. Despite being first authorised in December 2021, reports suggest that few doses are available to people in low and middle-income countries.

While there is little data available on how many doses of Pfizer’s antiviral treatment have actually been delivered to low and middle-income countries, they have been waiting for months to receive doses through Paxlovid supply agreements from global initiatives like UNICEF and the Global Fund. Pfizer has allegedly insisted that the prices in these agreements remain secret, and the initiatives have not revealed the prices Pfizer charges for courses through their agreements.

Allocation to high-income vs low- and middle-income countries

Proportion of agreed allocation to high-income vs low- and middle-income countries

Source: Airfinity, a life sciences analytics company

 

High-income countries (%)

Low- and middle-income countries (%)

Pfizer: Ritonavir-Boosted Nirmatrelvir (Paxlovid)

31,828,000

 

(74%)

11,221,666

 

(26%)

 

Data note: These figures reflect deals agreed with Pfizer. There are a number of generic manufacturers expected to produce Paxlovid that have signed agreements through the Medicines Patent Pool. However, these agreements are not expected to be producing/exporting finished drug products at scale until early 2023.

According to the World Intellectual Property Organization (WIPO), there are at least 1,465 patents on treatments and 417 on vaccines for COVID-19: https://www.wipo.int/edocs/pubdocs/en/wipo-pub-1075-en-covid-19-related-vaccines-and-therapeutics.pdf

Loss and damage fund at COP27 a monumental win, if properly funded

Responding to the final communiqué of the COP27 climate talks in Sharm El-Sheikh, Gabriela Bucher, Oxfam International’s Executive Director, said:

“The establishment of a loss and damage fund is a monumental achievement for vulnerable developing countries and communities at the frontlines of the climate crisis. They have been calling for funding to cope with the devastating impacts of climate change for over 30 years.

“Given the urgency on the ground, the fund must be operationalised as soon as possible. Rich countries largely responsible for warming our planet should immediately mobilise substantial new and additional resources to pay for climate-related damage in vulnerable countries.

“In East Africa, nearly 40 million people are experiencing climate-induced hunger. Recent catastrophic floods in Pakistan have inflicted more than US$30 billion in damages and economic losses and left 10 to 12 percent of the country’s land area under water, affecting more than 33 million people. The list of extreme weather events and disasters is growing, as are the devastating impacts on communities.

“While we applaud the establishment of the loss and damage fund, we remain deeply concerned about countries’ failure to agree on an equitable and urgent phase-out of all fossil fuels. The world is on track for a catastrophic 2.8°C of warming.

“Rich countries, especially the US and those in the EU, have failed to use their power and resources to meet their fair share of responsibility and their moral and legal obligations. Rich countries and many middle-income countries that have the ability to do so are not transitioning away from fossil fuels fast enough to keep warming below 1.5°C, leading to more losses, damages and suffering. Rich countries are not providing the necessary finance to support developing countries to leapfrog to renewable energy.

“Rich countries have broken their US$100 billion climate finance promise and successfully blocked language at COP27 that would have required them to compensate for earlier shortfalls through increased climate finance in subsequent years. Climate finance is needed in the trillions for adaptation and mitigation. Given their responsibility for the climate crisis, rich countries at least could have provided a clear roadmap on how to deliver the US$600 billion they had promised between 2020 and 2025.

“We are also dismayed by the discussions to enhance the Gender Action Plan, which was at the heart of the UNFCCC processes for gender-responsive climate action. Gender was only marginally mentioned, if at all, in the climate talks’ decisions.

“The climate crisis is about inequality and injustice. Communities at the frontlines of the climate crisis are bearing the heaviest brunt of climate-induced disasters, in addition to multiple crises including conflict, loss of livelihoods, and economic shocks. World leaders must push political differences aside and put the needs of these communities first.”

Popular NZ fashion brands get 5 star rating from Oxfam

Today Oxfam Aotearoa launched the world-famous campaign, What She Makes. The campaign is about asking fashion brands to pay the women overseas who make our clothes a living wage.

Oxfam Aotearoa engaged with four New Zealand founded brands, Glassons, Hallenstein Bros, Kathmandu and Macpac, and two international brands H&M and Lululemon. Today Oxfam released the results of the first step in the process: a credible commitment towards paying workers in their supply chain a living wage.

Glassons, Hallenstein Bros, and Macpac came out on top with a 5 star rating. H&M received 4 stars, Lululemon received 3 stars and New Zealand brand Kathmandu received 2.5 stars.

Oxfam Aotearoa’s What She Makes Lead Tracy Decena said:

“We want to create a race to the top between fashion brands – starting with a real, credible public commitment towards paying the women overseas who make their clothes a living wage. It’s encouraging to see New Zealand founded brands leading the race. Even though some brands did better than others, we want to acknowledge that every brand made some progress. Yet, there is much more to be done, and you can bet we’ll be there supporting and pushing these brands towards the end goal.

“The women making our clothes often work up to 12 hours a day and then extra overtime, but because they make as little as 65 cents an hour, they don’t have enough money for decent housing, food or healthcare – let alone any savings. We are working to change this.

“We encourage our supporters, fashion lovers, and anyone who believes poverty can be a thing of the past to join us by signing the pledge and demanding fashion brands to do better.”

 

The What She Makes Brand Tracker

For rating and rationale head to https://www.oxfam.org.nz/what-she-makes-brand-tracker/

Our ask of New Zealanders

Oxfam Aotearoa will be asking Kiwis to let brands know they want them to do better, and to stand with the women who make their clothes. They can start by joining the campaign and signing the pledge through: https://www.oxfam.org.nz/what-she-makes-sign-the-pledge/.

Our ask of the brands

The What She Makes campaign calls on clothing brands that sell clothes here in Aotearoa New Zealand to make sure the garment workers in their supply chains are paid a living wage. Oxfam Aotearoa will work with six brands: Glassons, Hallenstein Brothers, H&M, Kathmandu, Lululemon, and Macpac. We asked them to take the first step of their living wage journeys: commit to paying workers in their supply chain a living wage. We’ll work with the brands to get them to there, and publish their progress (or lack of progress) regularly.

Oxfam reaction: NZ wins Fossil of the Day award at COP27

Fossil of the Day award


Climate Action Network International has awarded the New Zealand government the Fossil of the Day award at COP27 for opposing an agreement to establish a loss and damage finance facility this year. 

This comes less than a week after the Government repurposed $20 million of its existing climate finance for adaptation and mitigation, for loss and damage. 

Oxfam Aotearoa’s climate justice lead Nick Henry said: 

“This is one award not to be proud of. Our government blocking urgently needed action on loss and damage is frankly not what we expect from a government that says it’s at the leading edge of loss and damage funding.  

“Our government should be standing with Pacific nations at COP27 who are calling for a global fund to address the loss and damage they are experiencing due to climate change. This is a global problem that communities on the frontlines are experiencing right now. A decision is needed now, not in a year.”  

Oxfam in the Pacific’s project coordinator in Vanuatu George Koran says that it is indigenous communities who suffer from rich governments’ inaction: 

“We see the impacts of climate destruction across the Pacific, in Vanuatu and now even in Aotearoa. People in the most vulnerable situations, those who do not have the capacity to adapt, suffer the consequences. The New Zealand Government say they understand the urgent need for loss and damage funds, and yet, we are not seeing any real action. It’s like robbing Peter to pay Paul – we need new and additional funding from our neighbours to fight this crisis.” 

Henry said: “We call on the New Zealand Government to back-up their acknowledgement that loss and damage needs funding by supporting a new loss and damage finance facility. This will help ensure that finance to address loss and damage is accessible and sustained and is delivered in accordance with the principles of climate justice. New Zealand can pledge our $20 million allocation to the new facility.” 

ENDS

 

 

G20 must tackle the “cost of profit” crisis causing chaos worldwide, says Oxfam

G20 countries are receiving US$136 million every day in debt repayments from the world’s poorest countries at a time when up to 828 million people are facing hunger.

The “cost of living” crisis is more accurately a “cost of profit” crisis – of rising billionaire wealth and corporate mega-profits – that is driving up poverty, hunger, indebtedness and deprivation around the world, Oxfam says, as the G20 Summit begins in Bali.

“If the G20 are serious about tackling this looming global economic catastrophe they need to put their own houses in order. That’s where the real cause of this crisis lies,” said Oxfam’s G20 Lead Joern Kalinski.

“In reality we are facing a ‘cost of profit’ crisis. The richest are getting richer, while ordinary families and the poorest countries are being squeezed dry,” said Kalinski.

Since the start of the pandemic, poor countries have had to shell out US$113 billion to their rich G20 country creditors, during a time that four times more people died of Covid in poorer nations than in rich ones.

In 2021, on average, poor countries were forced to spend 27.5 percent of their budgets on debt repayment – four times more than on health and 12 times more than on social protection. Even the public climate finance they are getting from rich nations, including many in the G20, are 71 percent loans.

Meanwhile the G20’s biggest corporations are making record profits. BP made £7.1 billion, their biggest profits in 14 years, and BNP Paribas € 2.76 billion in just the past three months. Nine out of ten of the biggest fossil fuel companies are headquartered in G20 countries. US corporations are seeing their biggest profit margins since 1950 and have been accused of ‘greedflation’; driving higher inflation through price hikes.

The G20 is home now to 89 percent of all the billionaire wealth in the world – at around US$10 trillion. This has grown by US$1.88 trillion, creating 287 newly-minted pandemic billionaires, since 2020. Energy and food billionaires are currently getting richer by a half-a-billion dollars a day.

Oxfam urges the G20 to acknowledge the consequences that this shocking inequality is visiting on ordinary citizens the world over in the form of mass hunger, death and worsening poverty.

In Somalia, Ethiopia and Kenya historic levels of drought mean that one person will likely die of hunger every 36 seconds between now and the end of the year as the worst-hit areas hurtle towards famine. Women and girls, who are often the main food producers, primary caregivers, and stewards of household nutrition, are at higher risk of hunger.

The Ukraine war is an additional layer to existing problems. While 828 million people face hunger, the world’s main food traders made record profits and food and agribusiness billionaires increased their collective wealth by US$382 billion (45 percent) over the past two years. The United Nations has appealed for US$17.1 billion in humanitarian food security assistance for 2022 but so far donors have only given US$7 billion.

Globally progress in fighting poverty has halted, according to the World Bank, with poverty increasing during COVID-19 for the first time in decades. Inequality has grown too; with the poorest seeing their incomes decline twice as much as the richest.

“Austerity is the exact wrong reaction – a textbook blunder – that is ripping away social safety nets and beating people down into poverty,” Kalinski said.

Recent Oxfam research on inequality shows that despite the worst health crisis in a century, half of all poor countries have cut their share of health spending. Almost half of all countries cut their budget share going to social protection, 70 percent cut their share going to education and two-thirds failed to raise their minimum wage in line with economic growth. Over the next five years, three-quarters of all countries globally are planning further cuts totaling US$7.8 trillion dollars.

143 of 161 countries Oxfam surveyed froze tax rates on their richest citizens, and 11 countries even lowered them. Corporate tax dodging also continues on an industrial scale with an estimated one trillion dollars of corporate profits shifted to tax havens in 2019.

The G20 must tackle the root causes of hunger: extreme inequality and poverty, human rights violations, conflict, climate change and food and energy price inflation. Oxfam says the G20 must develop an economic and social rescue plan that protects the rights of the poorest people and tackles extreme inequality. This means:

  • Championing systematic strategies to tackle inequality and monitoring progress by rejecting austerity, boosting inequality-busting public spending, making tax more progressive, and increasing workers’ rights and pay
  • Widescale debt relief and significant debt cancellation for the poorest countries
  • Increasing taxes on windfall profits, wealth and corporations
  • Issuing more Special Drawing Rights, and allocating more to the poorest countries
  • Boosting inequality-busting aid
  • Delivering on climate finance, especially for the most vulnerable countries
  • Committing to enhancing pandemic preparedness and building more resilient systems.

To halt the worsening hunger crises the G20 must:

  • Urgently mobilise financial resources into humanitarian emergencies
  • Address the root causes of hunger crises including climate change, conflict, poverty and inequality, human rights violations and food price inflation
  • Ensure that blockades, economic sanctions and military activities in all countries do not hinder the free, safe and reliable transport of food and agricultural supplies, especially in conflict-affected areas
  • Rebalance the power in food supply chains to create a more sustainable and just food system.

 Notes

  •  “G20 countries are receiving US$136 million every day in debt repayments from the world’s poorest countries”: Oxfam calculations based on World Bank International Debt Statistics database: Principal repayments plus interests paid by low and lower-middle income countries to G20 countries in 2022 divided by 365 days.
  • “Since the start of the pandemic, poor countries have had to shell out US$113 billion to their rich G20 country creditors”: Oxfam calculations based on World Bank International Debt Statistics database: Sum of principal repayments plus interests paid by low and lower-middle income countries to G20 countries in 2020, 2021 and 2022.
  • “The G20 is home now to 89 percent of all the billionaire wealth in the world – at around US$10 trillion. This has grown by US$1.88 trillion, creating 287 newly-minted pandemic billionaires, since 2020”: Oxfam calculations based on Forbes billionaire list from 18 March 2020 and 31 October 2022.

Investigation reveals big pharma’s lobbying against COVID-19 intellectual property waiver

An investigation by Politico and The Bureau for Investigative Journalism has revealed that:

  • Pharmaceutical companies threatened to withdraw investment from countries including Indonesia, Colombia and Belgium if they supported an intellectual property waiver for COVID-19 vaccines, tests, and treatments. Colombian officials in Geneva were told by their government that supporting the waiver might disrupt vaccine negotiations with Pfizer and others.
  • Top pharmaceutical industry executives enjoyed direct access to senior officials within the EU, which was opposed to a waiver, and encouraged potentially rogue member countries, including Italy and France, to fall into line.
  • The German government pressured fellow EU governments to oppose the TRIPS waiver, and when concerns were raised about how the EU waiver opposition looked to the rest of the world, Germany proposed that this could be managed with “smart communication on the topic” that “underlines the proactive role of the EU in providing vaccines globally.”
  • When it became clear to the US business lobby that they could not affect the US position in support of an intellectual property waiver, the industry looked to Europe and the UK, which they saw as more receptive. As negotiations ramped up, the US Chamber of Commerce and US pharmaceutical lobbyists including the Pharmaceutical Research and Manufacturers of America (PhRMA) and the Biotechnology Innovation Organization (BIO) met the European Commission to lobby against the waiver. The UK’s biotech lobby met with George Freeman, a science minister, “to discuss intellectual property and the life sciences sector.”
  • Between January 2020 and September 2022, 13 pharmaceutical lobby groups and companies held nearly 100 meetings with the most senior European Commission officials. In the U.K., there were more than 360 meetings between January 2020 and March 2022 — equivalent to nearly one every two days. Boris Johnson personally attended 11 of them.
  • In the EU during 2021, COVID vaccine and treatment developers including Pfizer and Moderna and the largest pharma lobbying groups, including the EFPIA, spent at least €15 million on lobbying. The year before, the companies spent more than €15.7 million. In 2019, their lobbying costs were €13.9 million, according to data analyzed from LobbyFacts.
  • Major industry players also paid at least 31 private consultancies to lobby the Commission on their behalf. AstraZeneca and Johnson & Johnson each paid around €700,000 in 2021 for consultancies working on topics such as the EU vaccines policy and the bloc’s strategy for COVID-19.

Responding, Max Lawson, Co-Chair of the People’s Vaccine Alliance and Head of Inequality Policy at Oxfam, said:

“These shocking allegations are a testament to the huge unaccountable power of big business in global politics. Pharmaceutical companies were seemingly granted unfettered access to the European Commission and the British and German governments, while countries that supported measures to improve vaccine access faced threats from the industry. When US lobbyists couldn’t influence the US government, they turned to the EU and UK. This is not how life and death decisions should be made.

“Millions died without access to vaccines while pharmaceutical companies gouged extraordinary profits from the pandemic. Rich countries expressed warm words and pledged donations, but to Germany, the UK, Switzerland, and the European Commission, it was apparently just a PR exercise. In the end, global solidarity was snuffed out by the wealthy pharmaceutical lobby, which is not how a healthy democracy should function.

“There is, however, a glimmer of hope amid these revelations. The narrow outcome of TRIPS negotiations set an important precedent, recognising that intellectual property rules are a barrier to accessing medical tools. World Trade Organisation members are now deciding whether to extend the decision to cover tests and treatments. That could ensure that everyone, everywhere has access to lifesaving medical tools that reduce COVID-19 hospitalisations and death. While big pharma will once again use all of its lobbying might to protect its medical monopolies, governments must ensure this time that they put people’s lives before profits.”

Copyright © 2024 Oxfam Aotearoa.

Oxfam is a worldwide development organisation that mobilises the power of people against injustice. Oxfam Aotearoa is a registered charity with the New Zealand Charities Register (registration CC24641). Donations are tax refundable.

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