In addition to mobile clinics targeting people living in homelessness, in partnership with the city of Rio de Janeiro, MSF conducted health promotion, screening and medical care activities at a low-cost restaurant in Bonsucesso.
Press release |

COVID-19 vaccines: MSF deplores just 2% of Pfizer’s 2021 & 2022 supply going to COVAX Facility

4 min
Photograph by Mariana Abdalla
In addition to mobile clinics targeting people living in homelessness, in partnership with the city of Rio de Janeiro, MSF conducted health promotion, screening and medical care activities at a low-cost restaurant in Bonsucesso. Photograph by Mariana Abdalla

Geneva, 22 January 2021 – Pfizer and BioNTech announced today a deal to supply up to 40 million doses of their COVID-19 vaccine to the COVAX Facility, a global COVID-19 vaccine purchasing mechanism aimed to improve equity of vaccination. While Médecins Sans Frontières/Doctors Without Borders (MSF) welcomes this announcement, this advance purchase agreement lamentably represents only 2% of the doses (40 million of 2 billion*) in the deals struck by Pfizer and BioNTech for 2021 and 2022. MSF calls for transparency and urgency from the two pharmaceutical corporations and Gavi, the Vaccine Alliance around price, supply and distribution.

The majority of Pfizer’s vaccine doses (75%, 1.5 billion of 2 billion*) in these deals has been secured behind closed doors by high-income countries, leaving a very small slice of the doses for developing countries and humanitarian organisations. Of a total of over 27.2 million doses delivered so far, high-income countries have received almost 27 million, but middle-income countries have only received close to 250,000 doses – and low-income countries have received none.*

Rather than continuing to prioritise bilateral deals with high-income countries, Pfizer must make the vaccine doses available to the COVAX Facility as soon as possible. And Gavi must, at a minimum, require that all companies share their technology so that all successful vaccines are produced in adequate quantities to meet the global need, regardless of proprietary issues. 

Development of the Pfizer vaccine was supported by a grant of nearly US$443 million from the German government through its partner BioNTech, and a loan of over $118 million from the European Investment Bank. The World Health Organization (WHO) listed the vaccine for emergency use at the end of December 2020 – the only COVID-19 vaccine to receive this approval to date.

From early on in the pandemic, and in light of this significant public investment, MSF has called for any potential future COVID-19 vaccines to be priced at cost, and urges Pfizer and any other pharmaceutical corporations entering deals with Gavi to price these vaccines at cost. 

The COVAX Facility includes an Advanced Market Commitment (AMC) for 92 developing countries. It is critical that these countries are not left at the back of the queue waiting for vaccines while high-income countries with existing bilateral deals are given privileged access.

Quote from Dana Gill, US Policy Advisor, MSF Access Campaign

“Despite calls from several Heads of State for global solidarity at the beginning of the pandemic, what we see today is a far cry from a picture of equity. So far, wealthier countries have administered nearly 27 million doses of Pfizer and BioNTech’s COVID-19 vaccine, while no doses have been distributed in low-income countries.

While today’s announcement from Pfizer for COVAX is a step forward, the devil is in the details. Pharma is playing business-as-usual: the deal is only 2% of Pfizer and BioNTech’s estimated total doses – a pittance considering their production capacity and the bilateral deals they’ve already struck with high-income countries – and important details around price and delivery are still a secret. If Pfizer is serious about equity and supporting the WHO framework for allocation of COVID-19 vaccines, the bulk of its supply should be offered to the COVAX Facility and priced at cost. 

Transparency across the board is critical to ensure equitable access to COVID-19 vaccines. Full transparency from Pfizer/BioNTech and Gavi on the agreement, on the prices charged for all the countries taking part in COVAX, and specifically when the doses will be delivered to COVAX countries, is absolutely essential. Billions of dollars of public funding have supported the development of COVID-19 vaccines and the COVAX Facility itself. We call on pharmaceutical corporations like Pfizer and its peers to supply the COVAX Facility with the volumes it needs at an at-cost price, and information on this must be made publicly available. If the world is going to emerge from this pandemic, we absolutely must distribute these vaccines equitably, not based upon who can pay the most.”

*Based on data from AirFinity (20 January 2021).