Another shot at vaccine transparency

The world’s reaction to COVID-19 has had a transparency problem from the start.

Now it is vaccines and vaccination programmes that are plagued by obfuscation, chaos and miscommunication. And just like at the beginning of the pandemic, this lack of transparency is costing lives.

This week, an investigation by Public Citizen revealed how Pfizer – which along with Moderna has emerged as one of the most desirable COVID-19 vaccines – used its increasing power in negotiations with governments. Leaked and unredacted vaccine contracts reportedly show that the pharmaceutical giant pushed to “silence governments, throttle supply, shift risk and maximize profits.” All during one of the worst public health emergencies in the world, while risking the lives of billions of people.

There has been little public scrutiny of vaccine development companies like Pfizer, despite the increasingly important role they have been playing in the pandemic. One of the reasons for this is the disturbing lack of transparency in the contracting processes of vaccines.

According to a report by Transparency International Global Health, only 6 per cent of the analysed vaccine contracts between developers and governments were publicly available, and even these had sections crossed out. Just one contract (0.5 per cent) was published without redactions. Most of what is known about vaccine contracts has been gleaned through leaks and investigative exposés.

Such opacity and outsized influence by vaccine developers have consequences for billions around the world, especially for already vulnerable populations living in countries with less negotiating power to begin with. This has thrown COVID-19 vaccination and recovery programmes into a state of disarray and forced us all into depending on actors with opaque motives.

Nowhere is this more obvious than in the case of COVAX, the equitable access to vaccines programme that promised to vaccinate the world.

Eighteen months after its launch, COVAX is responsible for just 5 per cent of vaccinations globally. In the many, mostly low-income, countries depending on the programme for vaccines, 98 per cent of people are yet to receive their first shot. This has led to what many are calling a ‘two-track pandemic’, with high vaccination rates and a lifting of restrictions in economically powerful countries, while the rest of the world continues to battle wave after wave of infections.

Opacity from vaccine developers is just the very deadly cherry on top of an already crumbling cake.

For an effective and equitable recovery from the COVID-19 pandemic, we need companies like Pfizer to make their commitment to global health security transparent and to be held accountable when they push profits over public health. We also need COVAX to deliver on its promise of equitable vaccine access to lower and middle-income countries.

Embedding transparency in both public contracts and distribution programmes for vaccines will bring us one step closer to achieving this.