The European Union, Canada and other developed countries have signed deals to get hundreds of millions of doses of Covid-19 vaccines and boosters over the next two years, furthering a divide between rich and poor countries.
Under the recent deals, Pfizer Inc. and BioNTech SE agreed to supply the European Union up to 1.8 billion doses of their vaccine through 2023, while agreeing to supply Canada up to 125 million doses.
Australia, Switzerland and Israel, meanwhile, are set to get Moderna Inc.'s shot through next year, and Switzerland has options for doses in 2023.
The agreements will ensure the countries, including some that failed to lock up sufficient supplies of the mRNA vaccines earlier this year, have enough supplies to inoculate residents and protect them against potentially elusive variants, while providing a sales windfall to the manufacturers.
Yet the deals once again leave out developing countries, many of which have fallen behind in vaccinating residents and struggled to contain the spread of the virus.
Moderna sees Covax, the global-health initiative intended to get doses to low-income countries, as its primary means to supply lower- and middle-income countries, a spokesman said. The company said last month it would deliver 34 million doses in the fourth quarter of 2021 to Covax, which has an option to purchase another 466 million doses next year.
Pfizer has pledged to provide 2 billion doses to low- and middle-income countries over the next 18 months, a company spokeswoman said. It also has agreed to provide 40 million doses to Covax this year for distribution, which have begun to reach more than a dozen countries, she said. Pfizer's commitment to ensure access to the vaccine "has never wavered," and it is talking with countries and stakeholders about improving access, she added.
About 6 billion doses have been purchased by more than two dozen rich nations and the European Union, according to the latest figures from the Duke University's Global Health Innovation Center, which tracks vaccine purchases. By comparison, the rest of the world has combined to purchase more than 3 billion doses.
Neither the countries nor the companies disclosed the terms of the recent deals.
Covid-19 vaccine sales are forecast to total $70 billion through next year for Pfizer and more than $27 billion for Moderna, according to Bernstein Research.
Bernstein estimates Pfizer and BioNTech charge between $18 and $19.50 a dose in developed markets, compared with $7.50 in developing markets. Moderna charges between $17 and $20 a dose, compared with $8 in developing markets, according to Bernstein.
The Pfizer-BioNTech vaccine's sales would make it among the top-selling pharmaceuticals of all time. AbbVie Inc.'s anti-inflammatory drug Humira has been the recent top seller, notching nearly $20 billion in 2018 sales.
The U.S. hasn't signed new supply deals, but its agreements with Pfizer and Moderna provide the option for future purchases. In the U.S., each company is slated to deliver 300 million doses by the end of July.
The EU deal would help the bloc resolve the vaccine procurement problems that hurt its vaccination efforts earlier this year.
EU residents and public-health experts criticized the bloc as ordering vaccines too slowly, partly because they didn't want to pay as much as Pfizer and Moderna sought, and favoring older vaccine technologies over new ones.
Limited supplies of the mRNA vaccines hit especially hard after some countries restricted use of shots from AstraZeneca PLC and Johnson & Johnson over safety concerns.
The recent deals suggest the two-dose vaccines from Pfizer and Moderna have become the vaccines of choice in developed nations. They also mean most of the developed world should have enough Covid-19 vaccine supplies for the next couple of years to protect all their residents.
The new EU deal builds on 600 million doses Pfizer agreed to deliver this year. Under the deal, Pfizer agreed to send an initial 900 million doses starting in December, and the EU has the option to buy another 900 million doses.
The new supply will be enough for the bloc's 450 million citizens to get four Pfizer-BioNTech doses, according to Bernstein.
Australia, which has about 25 million residents and recently stopped administering AstraZeneca's shot to people under age 50, said last month that Moderna would provide 10 million doses this year and 15 million booster shot doses next year. Earlier, the country had placed orders for 40 million doses for delivery this year.
Pfizer has said it expects to produce 3 billion doses this year, and at least 4 billion next year. Moderna said it is targeting manufacturing up to 3 billion doses next year.
Some developing nations have reached deals with mRNA vaccine makers for doses, though supplies probably aren't enough to vaccinate all their populations.
Paraguay, which counts more than 7 million residents, said last month it signed a supply deal for 1 million doses of the Pfizer-BioNTech vaccine. Botswana said in April that Moderna is providing the African country, which has more than two million people, 500,000 doses of its shot.
Of the approximate 50 supply deals that Pfizer and BioNTech have with countries and groups like Covax, about half are with low- and middle-income countries, according to Duke's Global Health Innovation Center.
Pfizer has said it would discount its vaccine to middle-income countries, while providing it at cost to poorer countries.
Six of the 19 Moderna deals are for low- and middle-income countries, according to the Duke center. Moderna has said it would price its vaccine in low-income countries at its lowest-tier price.
Many developing nations are still negotiating with Pfizer and Moderna, according to the companies. They also are waiting on doses from Covax and appealing to the U.S. government to provide excess doses.
Covax has been beset by manufacturing and delivery delays.
To access more doses, some developing countries have asked the World Trade Organization to waive patent protection for Covid-19 vaccines. The U.S. said it supports the move, though Germany and some other developed countries have opposed it. The drug industry is lobbying against the proposal, saying waiving patent protection wouldn't provide relief any time soon while straining raw material supplies.
Public-health and vaccine experts say developing countries need more supplies to vaccinate residents to contain the spread of the virus and protect against dangerous new variants that emerge.
Developed countries won't be able to fully reopen, the specialists added, unless developing nations are able to immunize a sufficient number of residents.
With developed countries securing more doses for the next few years, low- and middle-income countries will probably find themselves dependent on rich countries to share or reallocate doses, said Prashant Yadav, a senior fellow at the Center for Global Development who studies supply chains.
He said that, if the divergence persists, more countries will likely sign supply deals with China and Russia, which have been eagerly providing doses made by their manufacturers.
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