Global South should learn from Big Pharma’s bullying of South Africa

In August, a Supreme Court ruling forced South Africa’s government to make public the secretive vaccine supply contracts it struck with big pharmaceutical companies at the height of the COVID-19 pandemic.

The documents confirmed what many have long suspected: When selling its COVID vaccines to Global South countries, Big Pharma’s priority was not to help them bring a deadly pandemic under control, but to maximise its bottom line.

Every single contract – there were a total of four that were revealed, with Johnson & Johnson (J&J), Pfizer, the Global Alliance for Vaccines and Immunization (Gavi), and the Serum Institute of India – turned out to overwhelmingly favour Big Pharma and demand South Africa pay much more than its more powerful counterparts to protect its citizens from the worst of COVID.

An analysis of the contracts by the Health Justice Initiative (HJI), the South African health equality nonprofit that launched the legal bid to get the contracts released, revealed that J&J charged South Africa 15 percent more per dose of its COVID vaccine than it charged the European Union, while Pfizer-BioNTech charged the country nearly 33 percent more than it reportedly charged the African Union. The biggest apparent markup paid by South Africa was to the Serum Institute of India, maker of the Oxford AstraZeneca vaccine. South Africa paid $5.35 a dose, compared with the EU’s price of $2.15.

What we found in these contracts was shocking – in fact, infuriating – but not at all surprising. Anybody paying a little attention to the global pharmaceutical market already knows that Big Pharma companies have been pressurising countries across the Global South to buy their essential medicines and vaccines for extortionate prices and under exploitative conditions since long before the beginning of the COVID-19 pandemic.

Nevertheless, getting to read these contracts in their entirety was still a big win for health equality advocates in Africa and beyond. All Big Pharma companies employ large teams of top-quality lawyers to keep their unethical and unfair contracts secret, and the governments bullied into signing those contracts also try their best to keep them hidden from the public. So while we have always known that Big Pharma is exploiting Global South governments, we did not know to what extent until we saw the shameful contracts signed by South Africa.

Furthermore, the revelation that the Serum Institute, a vaccine manufacturer based in the Global South, and, Gavi, which was supposedly formed to improve equitable access to vaccines across the globe, joined in the bullying of COVID-stricken South Africa into signing unfavourable contracts. According to the contract made public, Gavi gave no guarantees to South Africa about the number of doses it would receive, or the delivery date, but South Africa remained liable to pay for everything it ordered, making it obvious that smaller Global South nations cannot depend on anyone other than themselves when it comes to delivering lifesaving vaccines and medicines to their citizens in a timely manner.

Now that we know the severity of the problem, we need to take action. We need to treat what we learned about South Africa’s treatment by Big Pharma as a wakeup call and make sure no Global South government finds itself in a similarly helpless situation when the next pandemic inevitably knocks on our door.

What needs to be done is clear: Global South nations should make pharmaceutical research and development a priority, build reliable supply chains for core materials, expand their manufacturing capabilities, and work towards truly freeing themselves from Big Pharma’s clutches. This is an especially urgent necessity in Africa, where, the International Finance Corporation says 70 to 90 percent of all medicines prescribed are imported from abroad.

Many African nations already have the basic infrastructure in place to free themselves from the clutches of Big Pharma – if not immediately today, in the not-too-distant future.

South Africa, for example, is home to Biovac- a part state-owned vaccine manufacturer that is ready and eager to help the country begin its journey towards pharmaceutical sovereignty.

Global South governments should focus on investing as much as possible in such initiatives and make pharmaceutical localisation one of their long-term priorities.

Regrettably, not all Global South governments seem to have clocked the many future advantages of localised medicine and vaccine production.

In South Africa, for example, a recent tender for pneumococcal vaccinations, which Biovac manufactures locally, was awarded to a supplier in India that offered to provide a cheaper alternative. Such moves – clearly made with short-term budgetary concerns in mind – gravely hinder efforts for pharmaceutical independence in these countries.

“India is a great supplier of vaccines to the global community in general and to Africa in particular,” Biovac chief executive Morena Makhoana told me. “The COVID19 pandemic, however, has proven that concentrated vaccine manufacture can be a risk – we witnessed India closing its borders and restricting the export of its COVID-19 vaccines.”

It is, therefore, important for Global South governments to refrain from taking contracts away from local manufacturers and awarding them to bigger players abroad for short-term savings.

“It is important that Africa becomes [pharmaceutically] self-sufficient”, Makhoana said. “This can only be achieved if companies [like Biovac] are supported by their governments.”

South Africa’s COVID vaccine contracts offer undeniable proof that Big Pharma is harming the people of the Global South by prioritising profit over lives. It is high time Global South governments take a stance against Big Pharma’s abuse and free themselves from the clutches of these predators.

Pharmaceutical independence, which requires immense financial and human investment, would not come overnight. However, governments can put their countries on the path to freedom simply by supporting the local manufacturing efforts of companies like Biovac. (Ray Mwareya is a fellow of the World Ethical Data Foundation and a technology journalist.)