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Corporate Influence Clouds Vaccine Pledging Conference

Milfred Perkins

WASHINGTON, Jun 13 2011 (IPS) - Between 2011 and 2012, 6.4 million children could die of preventable diseases, a number greater than the total population of Denmark or Norway.

According to a June 2011 report by Save the Children, a child in the poorest fifth percent of the world’s population is three times less likely than a child in the richest fifth to be immunised, and twice as likely to die before the age of five.

And while vaccination rates are at their highest point in history – with an average of four out of five children receiving the DPT3 immunisation against diphtheria, pertussis and tetanus – one-fifth or 24 million of the world’s children are not receiving even the most basic life-saving vaccines.

According to “The Priceless Payoff“, a study commissioned by the Johns Hopkins Bloomberg School of Public Health that appeared earlier this month in Health Affairs, the leading public health policy journal, these lost lives also represent lost productivity amounting to well over 231 billion dollars.

‘Human generosity at its finest’

As the pledging conference of the landmark public-private initiative known as the Global Alliance for Vaccines and Immunisation (GAVI) drew to a close in London on Monday, the question of whether donors and governments had fully grasped the enormity of deaths and dollars at stake in the vaccine “debate” seemed finally to be answered.

The conference was more successful than even sceptics had hoped, sailing past the targeted 3.7 billion dollars with a one-billion- dollar contribution from GAVI-founder and Microsoft founder Bill Gates, who called the event “human generosity at its finest”.

Conference host and British Prime Minister David Cameron announced funds to the tune of 1.3 billion dollars, making good on his vow to allocate 0.7 percent of the British Gross Domestic Product for international aid by 2013.

United States Agency for International Development (USAID) administrator Rajiv Shah also promised to pump 450 million dollars into the pool, though the donation still awaits congressional approval.

With five million saved lives already under its belt, GAVI is convinced that, armed with its new budget, it can acquire 250 million new doses of vaccines for children in low-income countries by 2015.

However, research shows that even the contributions made in London today might fall short of stemming the flow of preventable mortality – one death every 20 seconds – altogether.

“I definitely think the estimate of 231 billion dollars in lost economic productivity could be much higher,” Orin Levine, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health and co-author of the “Priceless Payoff” report, told IPS.

“In the U.S., the government will spend up to six billion dollars to rework a dangerous curve on a highway if it saves just one life,” he added. “When we did this study, we valued the cost of a life in poor countries after adjusting for lower income levels and the likelihood that people would take more risks because they’re poor to begin with.”

“Therefore I think this is a moderate estimate and, based on the fact that all lives are equal, a conservative analysis,” Levine told IPS.

Corporate interests raise questions

While GAVI’s efforts have been praised the world over, some observers of systemic and cyclical inequality offer a different, more holistic picture of the problem of preventable deaths, and offer alternative solutions beyond a ramping up of financial donations.

Several weeks ago, the Financial Times reported a quiet shuffling of GAVI stakeholders, as the Dutch pharmaceutical manufacturer Crucell made plans to swap seats with GlaxoSmithKline as the new industrial representative on GAVI’s board of directors.

A recent acquisition of the Johnson and Johnson industries, Crucell last year channeled 875 million dollars’ worth of GAVI funds into vaccination programmes in low-income countries, while receiving 60 percent of its 2010 revenues – 888 million dollars – from sales to GAVI of its Quinvaxem paediatric vaccine, designed to immunise children against diphtheria, pertussis, tetanus, Hib disease and hepatitis.

By 2012, Crucell expects to have earned 1.1 billion dollars through sales to GAVI.

“We think some conflicts are too big to manage,” Daniel Berman, deputy director of the Campaign for Access to Essential Medicines for Doctors Without Borders (MSF), said in an interview last month. “If you look at the agenda of the board meetings at GAVI, almost all issues impact Crucell’s bottom line.”

Transparency and competition

Last month, in an attempt to improve transparency and encourage price-reducing competition to expand the flow of vaccines to poor countries, the United Nations children’s agency UNICEF – GAVI’s primary vaccine purchasers – published a full price list of all products procured from pharmaceutical manufacturers.

Highlighting why Crucell and GSK have hitherto so fiercely resisted making this data available in the public sphere, the price list shows that some manufacturers have been selling vaccines at surcharges of up to 180 percent, according to a recent report by MSF.

The report said that GSK and Pfizer have sold the pneumococcal vaccine, designed to prevent life-threatening pneumonia, to GAVI through the Advance Market Commitment (AMC), a scheme that GSK’s chief executive Andrew Witty refers to as an “innovative financing mechanism”.

“We would describe it as corporate welfare that is scandalously expensive to donors and taxpayers,” Berman wrote last week.

Both Oxfam International and MSF have pressured GAVI to practice complete transparency regarding purchasing and prices; act forcefully to promote price-reducing competition; and request pharmaceutical companies to step down from the Board to avoid a conflict of interest.