Hard-Hit Countries Face Big Vaccine Bills

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Hard-hit countries face big vaccine bills

Colombia has already paid a steep price in the pandemic with more than 61,000 deaths from Covid-19. Now the South American nation faces another cost: about $850 million to immunize its population.

With an annual health budget of just $10 billion for about 50 million residents, Colombia is one of many countries struggling to afford immunizations. Health-care advocates have said that drugmakers hold the upper hand in negotiations with governments that have limited cash and aren’t eligible for free doses.

Colombia has reported 2.3 million Covid cases, or about two out of every 100 worldwide. Tougher restrictions in major cities, fueled by rising infections at the start of the year, hampered recovery from its deepest economic contraction in history, and the government is planning tax increases and spending cuts.

Countries like Colombia “are against the wall,” said Carolina Gomez, co-founder of an advocacy group at Universidad Nacional de Colombia that works to ensure access to medicines and health technology. “They have no choice but to submit to what the drugmakers say.”

Covax, a program backed by the World Health Organization and other groups that aims to deploy shots equitably to every corner of the globe, is helping many poor countries access immunizations by providing doses funded by donors. But it can’t cover the costs for countries like Colombia or supply enough to protect most of a country’s population.

So Colombia has done direct deals for doses needed to supplement its purchases via Covax. The country agreed to buy 10 million doses from partners Pfizer and BioNTech at $12 each, regulatory filings show.

It’s paying about $295 million for 10 million Moderna doses, according to Finance Ministry documents pointed out by researchers from Universidad Javeriana in Bogota. That’s equivalent to almost $30 a dose, although it may include logistics expenses. The cost of 20 million doses through Covax comes to roughly $225 million. The figures take into account some transport costs. Officials declined to provide more details.

High- and middle-income countries will pay more than low-income nations for Pfizer’s shot, but at a significant discount from “normal benchmarks” during the pandemic, the company said. Pfizer said it won’t profit off supplies to poorer countries. Moderna didn’t respond to requests for comment.

South Africa, which budgeted as much as 19.3 billion rand ($1.3 billion) to vaccinate two-thirds of its population, confronted a similar dilemma. After a small study indicated AstraZeneca’s shot offered minimal protection against mild to moderate illness caused by a new variant, it had to change course.

The government agreed to buy doses of both Johnson & Johnson’s single-shot vaccine as well as the Pfizer-BioNTech product at $10 each, according to its health department. It committed $5.25 a dose for AstraZeneca’s vaccine made by the Serum Institute of India. Moderna offered vaccines at between $30 and $42 per dose, but South Africa hasn’t announced any orders.

Such payments are spread out across the globe. In another example, Malaysia has estimated its vaccine costs at about 3 billion ringgit ($730 million). The healthy ministry’s 2021 budget is less than $8 billion for its population of about 33 million.

The expenses for these countries may not seem like a huge price to pay compared with the size of their economies and the overall cost of the pandemic, but they’re adding to the pain for those governments.

“Up until now the landscape has been defined by availability,” said Safura Abdool Karim, a public health lawyer and researcher at the Wits School of Public Health in Johannesburg. “It will increasingly be defined by affordability.”—James Paton and Andrea Jaramillo

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