Don’t Price Poor Countries Out of the Market For COVID-19 Vaccines & Treatments
As scientists scramble to develop effective diagnostics, treatments, and vaccines for COVID-19, we must make sure that everyone around the world has access to lifesaving medicines, no matter where they live.
The COVID-19 pandemic has been slow to reach the continent of Africa, but the rate of infection has grown 43% just this week. While countries with well-developed health care systems such as Italy, Spain, and the United States have struggled to cope with COVID-19 — with devastating consequences — the pandemic is about to explode in countries that are least equipped to handle it.
In his 2019 State of the Union Address, President Trump said, “[i]t is unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place. This is wrong, this is unfair.”
This line of thinking is dangerous. Asking the world’s wealthiest countries to offset the financial burden of medicines to the world’s poorest patients is as fundamental to the global social contract as asking wealthy Americans to pay more of their income in taxes than less affluent Americans. Insisting that fairness demands that Mozambique pay the same prices for COVID-19 vaccines and treatments as Norway would mean more hardship and illness throughout the world — as well as less innovation.
Progressive pricing, not populist nationalism, is essential to ensuring that everyone has access to medicines. Nearly every country in the world taxes its residents on a sliding scale, with the rich paying a higher percentage. Progressive pricing of medicines works the same way, with rich countries paying more than poor countries for the same treatment. Along with charitable support from affluent countries, intergovernmental organizations, charities, and philanthropists, these “tiered pricing” policies help patients in poor countries obtain access to medicines they would not have if everyone in the world paid the same price.
Even in wealthy countries, many patients struggle to afford drugs and vaccines. In our work with the Global Access in Action project at Harvard’s Berkman Klein Center for Internet & Society, we have explored some of the ways that innovative strategies to charge poorer patients less for essentially the same drugs even within the same countries have shown promise for increasing access, for example in fighting malaria.
In September 2000, 189 countries signed the Millennium Development Goals to improve the lives of the world’s poorest people. While many challenges remain, this commitment has produced remarkable results. For example, the rate of deaths of children under five fell by half between 1990 and 2013, and new HIV/AIDS infections declined by 38% between 2001 and 2013.
Progressive pricing played a critical role in meeting these goals. Medicines to battle HIV/AIDS cost around $35,000 to $40,000 per patient per year in the United States, but only $75 in Africa. Without access to inexpensive anti-retroviral drugs through progressive pricing, the world would suffer 3.8 million new HIV infections annually by 2030, instead of 1.3 million. Between 1995 and 2015, the global economic benefits of the drugs, which prevented 9.5 million deaths, totaled $3 trillion, outweighing costs by more than three to one.
Today, however, a kind of populist nationalism is on the rise and the global social contract is in jeopardy. Development assistance by members of the OECD, the organization of richest countries, has fallen; trade wars have erupted; and the world’s foreign direct investment has dropped three years in a row.
“Those who suffer or who benefit least deserve help from those who benefit most,” said a United Nations declaration when the Millennium Goals were set 20 years ago.
Throughout our history, America has embraced a leadership role in the world. As the world struggles to confront the devastation of the worst pandemic in more than a century, we must not turn our backs on the world’s poor in a time of desperate need.
