Frequently Asked Questions

What is the campaign about?
Why is MSF launching a petition?
Do you think a petition will make a difference?
Which vaccines are too expensive?
What are you asking people to do now?
What needs to change to get more kids the vaccines they need?
What kind of immunization work does MSF do?
Why is your campaign called A FAIR SHOT?
Why is this campaign needed now?
Why are vaccines so expensive?
Why is more information on vaccine prices key to making vaccines cheaper?
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 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. Affordable vaccine pricing isn't the only answer, but it's certainly a prerequisite to vaccinate more kids.


Why is MSF launching a petition?

After years of unsuccessful negotiations with Pfizer and GSK to reduce the price of the pneumonia vaccine, we think it’s time to ramp up the pressure on the companies. We have no choice now but to mobilize public support to put pressure on both companies to reduce the price of the pneumonia vaccine and give all children a fair shot.


Do you think a petition will make a difference?

After years of unsuccessful negotiations with Pfizer and GlaxoSmithKline (GSK) to reduce the price of the pneumonia vaccine, we think that when 400,000 people come together to say no to high vaccine prices, it can indeed make a difference. We hope that the board and shareholders of both companies will finally decide to put children’s health before profit. Pfizer and GSK have already racked up more than US$30 billion in sales of the pneumonia vaccine and can afford to make the vaccine affordable and accessible for the most vulnerable children.


Which vaccines are too expensive?

Right now we're focused on lowering the price of the pneumococcal conjugate vaccine, which protects against pneumonia and other respiratory diseases. Pneumonia is the top childhood killer - killing almost one million children each year, mostly in developing countries. But the vaccine to prevent it is unaffordable in many parts of the world.

Incidentally, the pneumonia vaccine was the world's best-selling vaccine in 2014 and Pfizer and GlaxoSmithKline (GSK), the only two companies that make the pneumococcal vaccine, have reported more than $28 billion in sales in just five years.


What are you asking people to do now?

Now that more than 370,000 people have signed the petition asking Pfizer and GSK to reduce the price of the vaccine to US$5 per child in all developing countries, we are asking everyone to spread the word and increase the pressure on the companies to reduce the price – this campaign doesn’t stop at the petition hand over – we will continue to push for an affordable price – stay tuned for more actions!


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 is your campaign called A FAIR SHOT?

We want all kids to have 'a fair shot' at getting the pneumonia vaccine which means that countries must have 'a fair shot' at negotiating affordable vaccine prices.


Why is this campaign needed now?

MSF, like governments and health professionals, has faced a huge increase in vaccine prices over the past 14 years. Even at the lowest subsidized prices only available to the poorest countries, the price to fully vaccinate a child now is 68 times more than it was just over a decade ago. The high price of the pneumonia vaccine is one of the main culprits, taking up 45% of the cost to vaccinate a child today. Steep price hikes are a significant barrier to getting the most vulnerable children protected against some of the deadliest diseases, including the top childhood killer, pneumonia. After years of fruitless negotiations with Pfizer and GSK for an affordable price, we have decided to take our call public, to ask for your help to bring vaccines prices down.


Why are vaccines so expensive?

High vaccine prices persist because of a lack of competition for the newer vaccines. When only two manufacturers (a duopoly) make a vaccine, pricing strategies can be exploitative, because manufacturers are protected from price-lowering competition. Promoting healthy market competition and sharing information on production and manufacturing costs can help drive prices down significantly.

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.


Why is more information on vaccine prices key to making vaccines cheaper?

Increasing information on vaccine prices is essential to allowing countries to compare prices and ultimately negotiate better deals to vaccinate their children. It's difficult to buy a product and expect to get a fair price if you have no idea what the price should be. The World Health Organization (WHO) also recommends pricing data to be made public. Pharmaceutical companies won't share their cost structures unless governments and people put tremendous pressure on them to do so – which is why we are urging people to sign our petition and #AskPharma to reveal the prices they charge.


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 that neither receive Gavi support nor have access to its price cannot afford to introduce the pneumonia vaccine.

Both companies combined have already accumulated more than $28 billion in pneumonia vaccine sales. The price for developing countries should be as close to the production cost as possible.


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.