Why Doctors Without Borders is turning down a million free pneumonia vaccines

Streptococcus pneumoniaeCDCStreptococcal pneumoniae

As it turns out, giving away medicine for free won’t be the way to end drug pricing fury.

The director of Medecins Sans Frontieres (otherwise known as Doctors Without Borders), a humanitarian group focused on supplying medical care in emergency situations around the world, penned a blog post Monday detailing the organisation’s reasoning for not accepting free pneumonia vaccines from pharmaceutical company Pfizer.

In theory, it might make sense: Give a set of vaccines away for free, and then they can be used by people who might not otherwise be able to afford them. But, MSF argues, it’d be better if the organisation could just pay for the drug at a discounted rate than deal with the complications and restrictions that come along with donations.

“Free is not always better. Donations often involve numerous conditions and strings attached, including restrictions on which patient populations and what geographic areas are allowed to receive the benefits,” the organisation’s executive director Jason Cone wrote. “This process can delay starting vaccination campaigns, which would be an untenable situation in emergency settings, or grossly limit who you’re able to reach with the vaccine.”

Donations, Cone argued, are also not a sustainable solution, since the donation can be cut off or discontinued at any time.

Pneumonia, which can be caused by a virus, bacteria, or fungus, was responsible for killing 920,000 children in 2015. Pneumococcal vaccines protect against the bacteria Streptococcal pneumoniae. There are two pneumonia vaccines out there that MSF is concerned with: one made by GlaxoSmithKline, one by Pfizer.

For the past two years, Pfizer and GSK have been donating the vaccines to MSF, which Cone noted was a one-time thing. MSF has been pushing both companies to supply the vaccine for $5 a child, and in September GSK agreed to do it for around $9 a child.

A spokeswoman for Pfizer told Business Insider that the company had offered MSF another 1 million vaccine doses, including 100,000 doses right away, which Pfizer said would “build on the significant donation previously provided to MSF.”

When asked if the donations would be the only way Pfizer would provide doses (as opposed to cutting the price), the company said, “We are actively exploring a number of new options to enable greater access to our pneumococcal vaccine, Prevenar 13 (Prevnar 13 in the United States), to aid NGOs facing humanitarian emergency settings.”

Other organisations that provide vaccines to developing countries, such as the GAVI Vaccine Alliance, have policies in place about drug donations. GAVI, for instance, only resorts to donations “under exceptional circumstances.”

“Donations of medical products, such as vaccines and drugs, may appear to be good ‘quick fixes,’ but they are not the answer to increasingly high vaccine prices charged by pharmaceutical giants like Pfizer and GSK,” Cone wrote.

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