I think pharma NDAs r unethical, collectively LMICs should push back & demand transparency to public.

This is better for governance & also so that we don’t fall to the pressures of pharmas in negotiation. Unfortunately, they hold the cards now.

But the comparison to the Belgian prices r inaccurate. EU countries get their prices thru negotiation under the EC, which made an initial EUR2.7b for development of vaccines in exchange for early purchase agreements at specific prices.

Similar to the US, under Op Warp Speed, they funded Western pharmas to get first dibs. Not a strategy I like but it did expedite at least 2 vaccines on the market now, Pfizer’s and Moderna’s.

As for why Pfizer (since it’s not the cheapest), so far Pfizer & Moderna having the best efficacy. Not sure about everyone else, but I prefer to get a vaccine with high efficacy for higher price, as our caseload is so high & threatening our public hosp capacity.

(Apart from Chinese & Russian vaccines) AZ is the cheapest so far because the pharma pledged to sell at cost to some countries. Also, some issues with vaccine trial design & results. I’m sure they can work it out, but not my first choice for now.

If we don’t secure an agreement early & wait for all vaccines to be on the market, we will be left out. Definitely won’t reach our shores by early 2021.

It’s a calculated risk. Prefer if we spend now & get some instead of waiting. Demand will be sky high soon.

But what we should have done is, have a joint alliance with ASEAN countries and negotiate with pharmas under a bloc.

As a bloc, we will have better negotiating powers & resources. And maybe push to kill off the NDA.

U get a better deal & instil confidence in the public.

Global health is messy & fraught with politics.

It’s naive to think all countries can get vaccine at the same (best) prices & availability. That is why COVAX was formed (but having their own problems too, showing how hard it is to ensure equitable distribution)

An ASEAN bloc has so much potential. Most of our countries have manufacturing capacity & manpower. High tech labs (and big brains) not short as well. And our ace in the sleeve, we are basically a hub for transport/distribution to anywhere in the world.

I’ve mentioned at the start of the pandemic, most decisions are nation-centric. After 1 year, we didn’t learn much & still making the same mistakes.

The vaccine procurement & distribution is our last shot at ‘equalising’ the situation.

Shameless plug https://medium.com/@Yoongkhean/covid-19-the-great-equalizer-or-inequality-amplifier-52bf38217a15