Frequently Asked Questions

What is the problem with pneumonia vaccine prices?
What is this campaign about?
Why are you asking individual investors to take action? What is their power?
What do I need to know to use this tool? Where can I find this information?
Do you think this will make a difference?
What is the source of your data?
What needs to change to get more kids the vaccines they need?
What kind of immunization work does MSF do?
Why are vaccines so expensive?
How did you come up with $5 as the target price?
Pfizer and GSK say that they are already doing their best to reduce the price of the pneumonia vaccine. Is this true?
How much does the pneumonia vaccine cost now?
Why has MSF accepted in-kind donations of the pneumonia vaccine from Pfizer and GSK?


What is the problem with pneumonia vaccine prices?

Pneumonia is the leading cause of child mortality worldwide, killing nearly one million children every year. There is a vaccine which could prevent many of these deaths but one third of the world’s countries have not been able to introduce it because Pfizer and GlaxoSmithKline (GSK) – the only two manufacturers – have kept the price artificially high. Millions of children living in countries such as Jordan, Thailand, and the Philippines are left out.


What is this campaign about?

Doctors Without Borders/Médecins Sans Frontières (MSF) is campaigning for lower vaccine prices. The cost to vaccinate a child has skyrocketed in recent years: many countries struggle to absorb the rising costs, while others can't afford to introduce certain vaccines. In 2016 after years of efforts and public campaigning GlaxoSmithKline (GSK) and Pfizer – the only manufacturers of the pneumonia vaccine- finally announced that they were reducing the price of the vaccine to slightly more 9 dollars per child for humanitarian organizations like MSF. This was definitely a step into the right discussion but that still leaves millions of children unvaccinated in countries where their parents or governments can’t afford the vaccine.


Why are you asking individual investors to take action? What is their power?

We know that companies are accountable to their shareholders. We also know that many people are not aware that they have investments in Pfizer and GSK through their mutual funds or retirement plan. This is why are have developed a tool to make it easy for people to discover if they hold investments in these two companies and give them the power to demand lower pneumonia vaccine prices.


What do I need to know to use this tool? Where can I find this information?

You need to know the name (or ticker symbol) of your mutual funds. If you don’t know it you can contact the human resource department or your financial advisor to get the name.


Do you think this will make a difference?

We know that companies are accountable to their shareholders. If only one shareholder voices concern about high vaccine prices in developing countries, this will be only a drop in the ocean. If a large number of shareholders do the same, eventually companies will have to listen and adjust their policies.


What is the source of your data?

The investment information is made publicly available through the U.S. Securities and Exchange Commission’s EDGAR database https://www.sec.gov/edgar/searchedgar/webusers.htm. Data represented here is pulled from each fund’s schedule of investments as reported in their quarterly N-Q forms filed between September 30, 2016 to April 18, 2017.


What needs to change to get more kids the vaccines they need?

We know that high vaccine prices are a key barrier to introducing new vaccines. There are a lot of additional challenges such as lack of staff or refrigeration capacity in remote areas of developing countries. But when a high price prohibits a country from even being able to use a vaccine, these additional points are less relevant. We need to all use our voices to amplify our call on Pfizer and GSK to reduce the price of the pneumonia vaccine.


What kind of immunization work does MSF do?

Each year, MSF teams vaccinate millions of people, largely as outbreak response to diseases such as measles, meningitis, yellow fever and cholera. MSF also supports routine immunisation activities in projects where we provide healthcare to mothers and children. In 2014 alone, MSF delivered more than 3.9 million doses of vaccines and immunological products. MSF has purchased the pneumonia vaccine (also called the pneumococcal conjugate vaccine, or PCV) in the past for use in its emergency operations. In 2013, MSF vaccinated with PCV treatment and pentavalent vaccine in Yida refugee camp, South Sudan. In 2014 and 2015, similiar vaccination activities with the PCV vaccine were conducted for refugees in Uganda and Ethiopia.


Why are vaccines so expensive?

The pneumonia vaccine market is a duopoly, and there aren't any additional manufacturers expected for another several years. The data we've been able to find by digging around the secretive vaccine market clearly show that pneumonia vaccine pricing today is opportunistic and irrational. For example, on the retail market, people in Morocco and Lebanon each pay more for the pneumonia vaccine than those in France.


How did you come up with $5 as the target price?

Although data is limited, we looked at all the information publicly available regarding the cost to make the vaccine to determine an affordable and viable price point. MSF doesn't believe life-saving vaccines should be sold for large profits in developing countries. Companies must do their part to reduce vaccine prices and lower the overall cost to immunise a child. The vaccine manufacturer Serum Institute of India has publicly stated that it will sell the pneumonia vaccine for $6 per child (for all three doses) when it brings its version of the vaccine to market in several years' time. The lowest subsidized price available today for the pneumonia vaccine is roughly $10 per child (for the three doses), but is only available to the world's poorest countries through Gavi, the Vaccine Alliance. In 2013, Gavi released an evaluation that concluded the price it pays for the pneumonia vaccine is likely well above the cost to make the vaccine. In the meantime, Pfizer and GSK have already reaped more than $28 billion in sales for this vaccine over the past five years, with the majority from sales in wealthy countries.


Pfizer and GSK say that they are already doing their best to reduce the price of the pneumonia vaccine. Is this true?

We are faced with an artificial system that maintains unreasonably high prices for most countries, while still reaping profits off the back of the poorest countries. At the current lowest global price (for Gavi), GSK claims that they make little profit off of the pneumonia vaccine, and Pfizer claims they sell it at a loss. But they won't share any data to prove it, while other data shows that current prices are well above the cost of manufacture. What we do know is that many developing countries like Jordan, Thailand or the Philippines that neither receive Gavi support nor have access to its price cannot afford to introduce the pneumonia vaccine.


How much does the pneumonia vaccine cost now?

The lowest price available today for the pneumonia vaccine - $9.15 per child (for three doses) - is highly subsidized by taxpayers and, before the GSK & Pfizer price reductions for humanitarian organizations in late 2016, had only been available to Gavi, the Vaccine Alliance, which provides the vaccine to the world's poorest countries – a subset of all developing countries. More than 30% of Gavi-supported countries are currently losing Gavi funding, and will be required to pay the full $9.15 per child themselves, which will be unaffordable for many. These countries will also eventually lose access to Gavi's $9.15/child price; at that time, it is forecasted that they could have to pay as much as 6 times more for the pneumonia vaccine. But other developing countries, including middle-income countries and others not eligible for Gavi financial support, pay much higher prices already. For example, a country like Tunisia has not been able to afford the high price of the vaccine and individuals who want their children vaccinated must pay more than $190 per child in the private market if they wish to protect their children.


Why has MSF accepted in-kind donations of the pneumonia vaccine from Pfizer and GSK?

For many reasons, private donations of drugs and vaccines are not a sustainable way for MSF to operate medical humanitarian projects in more than 70 countries. Donation programmes rely on the will of private companies whose priorities will always be paying customers; donations typically come with a large number of constraints, risks and uncertainties that hinder our ability to respond to medical emergencies. Instead, as a professional organization, MSF prefers to negotiate directly with vendors for sustainable, affordable supplies of medical products. MSF conducted negotiations with Pfizer and GSK for approximately five years to try to access a fair and sustainable price for the pneumonia vaccine. Our efforts failed, but the medical needs persist, so MSF had no choice but to accept donations from both companies. The agreements are a notable exception to MSF's policy not to accept donations from corporations whose income come from the production and/or sale of tobacco, alcohol, arms, pharmaceuticals, and mineral, oil, gas or other extractive industries. While MSF is grateful for the donations of pneumonia vaccine that help us protect vulnerable children from pneumonia in some of our emergency operations, donations are not MSF's preferred solution for meeting its medical operational needs.