A petition launched by the humanitarian charity Médecins Sans Frontières/Doctors Without Borders and delivered at the headquarters of Pfizer and GSK, has urged the companies to “lower the price of pneumonia vaccine” on April 27th, 2016. It was signed by 400,000 people.

The humanitarian charity – Médecins Sans Frontières (MSF)/Doctors Without Borders – it seems, will not back away from its demand unless the top pharmaceutical companies – Pfizer and GlaxoSmithKline (GSK) – lower the prices of the vaccine.

In an attention-grabbing bid to pressurize the pharmaceutical giants, the charity has opted a new technique. This time the petition, signed by almost 400,000 people from 170 countries, was delivered anonymously in the form of large syringes – all filled with the signed copies of the petition.

“Cut down the prices”, demanded each petition, “they are too high for each child.”

The petition, signed “MSF’s A Fair Shot”, was delivered on April 27th, 2016, to the headquarters of Pfizer in New York and GSK in London by an undercover person carrying large suitcases filled with oversized syringes. The timing was immaculate as well; the petition arrived precisely on the eve of Pfizer’s annual shareholder meeting.

The petition demanded that the companies cut down the price of pneumonia vaccine in developing countries and for humanitarian organizations to $5 per child.

Dr Greg Elder, Medical Coordinator at MSF’s Access Campaign, believes the unbelievably high prices of the vaccination are the main obstacle in vaccinating many children from around the world.

“Millions of babies and young kids around the world are left unprotected against pneumonia because Pfizer and GSK charge such high prices for the pneumonia vaccine that many governments and humanitarian organizations can’t afford to vaccinate children,” said Dr Greg and went on to say that both Pfizer and GSK earn more than $30 billion from the sale of pneumonia vaccine alone. It’s pretty safe, the doctor believes, to assume that the companies can afford to cut the prices so that the vaccine becomes affordable and accessible to each and every child in the world.

And Dr Greg is right in his demand. Why should a child die of pneumonia when its vaccine is available?

This was exactly what the pharmaceutical companies were reminded of during the recent stunt. Dozens of people placed flowers at the main door of Pfizer’s headquarter where each flower symbolized the child who lost his life to pneumonia.

While MSF’s brand new stunt is grabbing plenty of attention in the world’s media, it has not been the charity’s first. Last November, the charity launched a worldwide campaign requesting both companies to reduce the prices of pneumonia vaccine on world pneumonia day.

The charity also released a report last year highlighting the perpetual increase in the cost of the vaccine. The stats showed that the cost of fully immunizing a child increased tremendously over the course of thirteen years (from 2001 to 2014) i.e., 68 times. During this time, the number of childhood vaccines grew from six to 12.

In 2001, the World Health Organization (WHO) included six vaccinations in its immunization schedule. These included: poliomyelitis, pertussis, tetanus, diphtheria, measles, and tuberculosis. The minimum cost of these vaccines were $0.67 (£0.44; €0.58). Further six vaccines were included in the mandatory list of scheduled vaccinations by 2014 i.e., rubella, rotavirus, pneumococcal diseases, haemophilus influenzae type b, hepatitis B and human papillomavirus in adolescent girls. The new addition escalated the prices of complete child’s immunization schedule from $32.09 to $45.59.

The ever-growing price of the pneumonia vaccine has made it impossible for many countries to afford it. These include Egypt, Algeria, Tunisia, Jordan, Thailand, Indonesia and Bosnia. The report found that drug companies’ ‘tiered pricing policies’, which settle the pricing matter of the drugs according to the economic status of the country, lack this straightforward economic rationale. The middle income countries are denied support by the global alliance on vaccine and immunization, GAVI, as per rules it only extends support to the lower income countries. The middle income countries are bound to miss out the lower priced child’s complete pneumonia vaccine program offered by GAVI.

Middle income countries that are not currently immunizing their children include Sryia, Lebanon, Jordan, Iraq and Indonesia.

In 2016 Honduras will be graduating from the GAVI support which may lead to $5.1 million/year, an estimated cost for two vaccines — rotavirus and pneumonia vaccine. Honduras is expecting a leverage from GSK to supply the both vaccines on the same old price of 1.09$, which would increase up to $25 per child, after becoming a non-GAVI member.

MSF blames the high price of life-saving vaccines on the monopoly of the two companies. Manica Balasegaram, who is an executive director of MSF’s Access campaign, said, “GSK and Pfizer charge such high prices for the pneumonia vaccine that many governments and humanitarian organizations aren’t able to vaccinate children.” She further added that pneumonia vaccine is a globe’s bestseller, as far as vaccines are concerned, and in 2014 Pfizer made $4.4bn from it.

The charity is not alone in highlighting the rising inequality of the vaccine prices. Last year, 193 governments of the world unanimously passed a resolution in the World Health Assembly to make vaccines universally available at an affordable rate. The governments of more than 50 countries underlined the financial burden of the increasing cost of vaccines thwarting them to either introduce or maintain the routine immunization programs in their countries.

According to MSF, the cheapest price for all three doses of pneumonia vaccine is around $10.

Pneumonia Vaccine – Pfizer and GSK Perspective

In a statement released by Pfizer, the company management attempts to rationalize the whole high-price game. Pfizer, the statement said, opts a tiered price policy that lets the company reduce the vaccine price in the poor countries while compensating for it by charging more from economically stable countries.

“The prices are set according to the country’s ability to pay.”

The MSF, on the other hand, believes the GAVI mechanism – Advance Market Commitment (AMC) — for funding the pneumonia vaccine is not being followed by the two companies. AMC is a mechanism through which the donor countries provide funds to the vaccine manufacturers, and in return, get a price guarantee from these companies. Penumococcal vaccine is AMC funded; and is expected to reach low-income countries within 10-15 years after its introduction in high-income countries. Currently, AMC-funded pneumonia vaccine is available in 50 GAVI-eligible countries.

GSK has set a five-year price freeze on pneumonia vaccine, which MSF believes is not enough. MSF demands a permanent price freeze. Pfizer, on the other hand, has made no such commitments despite the conclusion of GAVI mechanism.

About Pneumonia

Pneumonia, known as a killer disease, is the main but preventable cause of death in children across the globe. Each year, it accounts for 15% of all deaths of children under the age of five. According to the WHO, pneumonia killed 922,000 children in 2015. Vaccination remains the mainstay of infection prevention.