Most of Moderna’s doses going to wealthy countries
In January 2020, a nonprofit with a mission to develop and equitably distribute vaccines invested $900,000 in a promising but untested bit of technology: Moderna’s coronavirus vaccine.
Announcing the grant, the Coalition for Epidemic Preparedness Innovations touted an alignment of values, namely a shared commitment to global public health. Documents suggest U.S.-based Moderna agreed to uphold the group’s “equitable access principles” — the idea that vaccines should be distributed according to need and at affordable prices.
But more than year later, with the pandemic still raging, Moderna’s successful vaccine is anything but accessible. The company has sold most of the early doses to rich countries. Poorer countries have been almost entirely shut out.
Moderna “seems to have refused to allocate or sell any of their supply beyond the wealthiest countries, the most profitable markets,” said Suerie Moon, co-director of the Global Health Center at the Graduate Institute of International and Development Studies in Geneva.
Asked about the $900,000 grant, equitable access provisions and calls to make the Moderna vaccine widely available, company spokeswoman Colleen Hussey referred The Washington Post to a more than 3-month-old news release about thirdquarter financial results, which noted that discussions with Covax — an initiative to equitably distribute vaccines around the world — were “ongoing.”
Moderna is certainly not the only coronavirus vaccine maker to enter into deals with rich countries. Just 16% of the world’s population has snapped up 60% of doses, according to an estimate from researchers at Duke University.
Moderna’s record stands out because none of its doses are yet earmarked for what the World Bank classifies as low-income nations.
Most of its competitors — Pfizer, AstraZeneca, Sanofi and Johnson & Johnson — have already made commitments to Covax, an effort coled by its early backer, CEPI, as well as the World Health Organization and Gavi, the Vaccine Alliance.
CEPI said it is still in talks with Moderna about supplying Covax but did not provide details on where things stand. The WHO, which coleads Covax and advocates for vaccine access, referred The Post to Gavi, which referred The Post to CEPI.
Moderna, meanwhile, is selling the vast majority of its early doses to high-income buyers, including the United States, the European Union and Canada, where immunization campaigns are already underway.
It is also working with the Philippines, a lower-middleincome country, and with upper-middle-income countries such as Colombia and potentially Mexico, according to tracking by researchers at Duke University and Airfinity, a research firm. But because those countries are further back in line, it may take time for their doses to arrive.
Advocates for global health are frustrated by the disparities.
“It is being rolled out in rich countries even though an institution committed to equitable access funded it — It’s outrageous. It’s tragic,” said Zain Rizvi, an expert on access to medicine at Public Citizen, a watchdog group.
Part of the issue is supply. Wealthy countries could afford to take risks and cut early deals on unproven technology. Only some of their vaccine bets have paid off. But as a result, they have secured a disproportionate share of projected 2021 supply — leaving the rest of the world to wait.
Then there is the problem of price. Along with PfizerBioNTech’s offering, Moderna’s vaccine is among the most expensive of the multiple vaccines purchased by the U.S. and by the E.U. But Pfizer, which has a similar vaccine on offer, agreed last month to supply Covax with up to 40 million doses at a “not-for-profit” rate.
Moderna — whose surging stock price has generated wealth for executives and investors — has yet to announce a similar plan, despite the role CEPI played in its development.
CEPI’s investment in Moderna came at a critical moment. The deal was announced Jan. 23, 2020, less than two weeks after Chinese researchers first posted the novel coronavirus’s genetic sequence to an online database and a week before the WHO declared a public health emergency of international concern.
Announcing the deal, Moderna’s chief executive, Stephane Bancel, thanked both CEPI and the National Institutes of Health, which played an important role in the vaccine’s development.
“Advances in global public health require the collective effort of public-private partnerships,” he said, according to a news release. “No organization can act alone.”
Rachel Grant, a spokeswoman for CEPI, which is headquartered in Oslo, said the foundation’s “early stage catalytic funding of Moderna was crucial to get the project off the ground.”
But CEPI and Moderna did not reach an agreement for second-stage funding. The relationship did not go further, Ms. Grant said, because the company’s funding needs were met by what would become the Trump administration’s Operation Warp Speed.
Moderna got multiple infusions from the U.S. government. By December, it had received $4.1 billion for vaccine development, clinical trials and manufacturing, according to the Department of Health and Human Services. On Thursday, President Joe Biden announced he would exercise an option to buy 100 million more doses of Moderna vaccine.
Unlike China and Russia, which have tried to use potential vaccines to bolster their soft power abroad, the Trump White House was solely focused on domestic supply. President Donald Trump opted out of Covax, citing his feud with WHO.
The Biden administration has tried to patch things up with the Geneva-based organization, and Secretary of State Antony Blinken has talked about helping “make sure that others around the world who want [a vaccine] have access to it.” Still, the United States remains focused on vaccinating Americans and has not announced plans to share, whether bilaterally or through Covax.
Public health experts have tried to sound the alarm. Scientists warn that leaving low-income countries waiting for adequate vaccine supply will prolong the pandemic. Economists caution that “vaccine nationalism” could cost the world more than a $1 trillion a year in GDP.
A coalition called the People’s Vaccine Campaign of South Africa recently called on the U.S. government to push Moderna, specifically, to make its coronavirus vaccine more accessible outside the United States.
“The U.S. government helped research and pay for the development of the NIHModerna vaccine, yet, as things stand, the company Moderna has unilaterally decided that very few nations will benefit from it,” they said in a release.
“We therefore implore you — enforce your rights in this instance and ensure that Moderna and other companies supported by the U.S. government abide by its obligations. Your actions will undoubtedly help to save millions of lives in our country and elsewhere in the global South.”
Even while public health organizations call for an end to vaccine nationalism, some seem wary of pushing the companies controlling vaccine supply. Advocates wonder why those tasked with promoting global public health have not called more forcefully for drug companies to disclose the terms of their vaccine contracts, for instance, or urged vaccine makers to transfer know-how to parts of the world in desperate need of vaccine.
Covax “remains in active discussions with Moderna regarding the procurement of the vaccine for global allocation,” Ms. Grant said, “And we hope that they will commit to support our mission to ensure global equitable access to COVID-19 vaccines along with the other manufacturers in the Covax portfolio.”