Bill Gates dismisses criticism of high prices for vaccines
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Version 0 of 1. Bill Gates has dismissed criticism by health campaigners of the high prices of some vaccines, warning that it only serves to deter pharmaceutical companies from working on life-saving products for poor countries. In an interview with the Guardian from a major international vaccine-funding conference in Berlin, which on Tuesday announced that $7.5bn had been pledged for immunisation of children in poor countries, Gates denied that the cost of the new vaccine against pneumococcal disease was too high. “Pneumococcus vaccine saves lives for about $1,000 per life saved,” said Gates. “So if you are going to do any helping at all, ever build a hospital, ever pay a doctor, you would [be willing to] pay for pneumococcus vaccine.” The humanitarian aid organisation Médecins sans Frontières (MSF) last week called publicly for the two big pharma companies making the vaccine to drop the price to $5 per child. Each child needs three doses of the vaccine. At the pledging meeting for Gavi, the global vaccines alliance, hosted by German chancellor Angela Merkel, MSF organised a stunt featuring supporters dressed as Merkel, David Cameron, Barack Obama and others spinning “Pharma’s wheel of fortune”, claiming that whichever way the wheel was spun, the drug companies always won. Related: Help us crowdsource vaccine prices around the world However, immunisation, Gates said, “is the cheapest thing ever done in health. This general thing where organisations come out and say, ‘hey, why don’t vaccines cost zero?’ – all that does is that you have some pharma companies that choose never to do medicines for poor countries because they know that this always just becomes a source of criticism. So they don’t do any R&D [research and development] on any product that would help poor countries. Then they’re not criticised at all because they don’t have anything that these people are saying they should price at zero.” Only two pharmaceutical companies, GlaxoSmithKline and Pfizer, currently manufacture the pneumococcus vaccine, which is being made available across the developing world with help from Gavi. On Monday, Pfizer offered to cut the price from $3.30 a dose to $3.10. The $7.5bn will help fund the vaccination effort in poor countries over the next five years. Gates and the UK government put in the largest sums, at about $1.5bn each. Gates praised pharmaceutical companies that were willing to invest in vaccine research and development for poor countries. These companies charge different prices according to countries’ ability to pay, he said. “We get a great price for these things, which is tiered pricing, which in all cases would be about a 50th of what the US price for these things would be. And that’s how we manage to cut childhood death in half, not by saying to pharma companies, ‘hey, you better not do poor world medicines because we’ll come and attack you’.” Although he did not name MSF, Gates made clear his opposition to the organisation’s views, as well as his admiration for its other work: “I think there is an organisation that’s wonderful in every other respect, but every time we raise money to save poor children’s lives, they put out a press release that says the price of these things should be zero. Every five years when we are raising billions – that is the most effective foreign aid ever given, that saves millions of lives. “In fact, there is a legitimate element to it, which is that we have to make sure we understand the cost structure of making those vaccines. In the case of pneumococcus, believe me – the amount we’ve studied it and gone to the factories – this thing is super, super complicated. The quality you want for these things to be made is really pretty mind-blowing. To focus on ‘why isn’t everything free’ is a misdirection that has to do with the fact that they don’t actually know anything about the costs.” Gavi says that half a billion children have been immunised through its suport in the 15 years since it was founded and 7 million lives saved. It hopes to immunise 300 million more children between 2016 and 2020. Crucial to that will be improved immunisation systems in poor countries, says Gates. Some low-income countries, such as Ghana, Ethiopia and Rwanda, do very well. If their practices could be extended to much bigger and richer countries, such as Nigeria, Pakistan and India, the extra 300 million children would be reached very quickly. “The primary healthcare system in northern India, northern Nigeria and Pakistan are not well run, so whether it is immunisations or getting antibiotics, there needs to be effort putting in international help to get those things up to be very high quality,” Gates said. Pilot projects in Bihar, which has a population of more than 80 million, had increased the vaccination rate from 35% to over 80%. Often the supply chain is the limiting factor, Gates said. Improving supply, which means a cold chain in the case of vaccines, transport over difficult terrain and information about what is missing and what is available, also takes a burden away from primary healthcare providers. It is important also to ensure families keep coming to have their children vaccinated. “When a mother brings her kids from a distance and gets to primary healthcare and [they] are told the stuff isn’t there, that breaks down the demand model,” Gates said. |