As dozens of local and international groups write to Jacinda Ardern demanding a tougher stance on trade agreements with the countries sustaining vaccine apartheid, Edward Miller suggests the refusal to act will have significant financial implications for NZ and the world.

Vaccine apartheid describes the stark inequalities in access to Covid vaccines between rich countries and the rest of the world. It is sustained by a handful of rich countries whose populations now have broad access to vaccines, but are refusing to support a temporary relaxation of WTO intellectual property rules on covid vaccines and technologies (the so-called “TRIPS Waiver”) that would extend that access to poorer countries.

The emergence of Omicron has meant the postponement of the WTO Ministerial meeting, in which developing countries were planning to advance negotiations on the TRIPS Waiver.

On Monday, 33 local and international groups wrote to Prime Minister Jacinda Ardern, calling on the New Zealand Government to make support for a TRIPS Waiver a pre-requisite of its bilateral trade negotiations with the United Kingdom and European Union.

That letter highlights the fact that the UK requires New Zealand support to join the Comprehensive and Progressive Trans-Pacific Partnership, and therefore can make support for the TRIPS Waiver part of the overall negotiating package for concluding the NZ-UK FTA.

Omicron’s emergence has also spurred a flurry of new research and commentary, suggesting that countries’ health budgets – including in Aotearoa New Zealand – could be hit with hundreds of millions more to cover the cost of additional boosters.

Emerging information on vaccine resistance

Many questions remain around the Omicron variant, and most of the research is based on sequenced modelling.

One (relatively-small and not yet peer-reviewed) real world study suggests the variant is 20 to 40 times as resistant to vaccines as the original variant.

Lab studies from Pfizer-BioNTech appear to support these findings, suggesting that an initial two-dose vaccine may be insufficient to prevent infection.

While Pfizer CEO Albert Bourla stressed that more real world data is necessary to understand how well third doses fare against the Omicron variant, he also suggested that, “we will need a fourth dose.”

Costing a fourth dose

For New Zealand, which is only just beginning to roll out booster shots for vulnerable populations and healthcare workers, the possibility of a second round of boosters is not totally unforeseen but suggests that these costs may become a faster, more regular occurrence.

The Government has consistently refused to reveal the price it pays for the Pfizer vaccine, arguing that revealing the figures would affect the country’s vaccine supplying. An investigation by the Bureau of Investigative Journalism suggested that Pfizer had even demanded Argentina and Brazil put up sovereign assets – including federal bank reserves, embassy buildings or military bases – as collateral in negotiations.

Budget 2021 set aside $964.3 million to cover the cost of vaccines over a two year period (including advance purchase agreements for other vaccines), which we understand will cover the cost of all 21 million doses New Zealand has under contract.

A simple average would suggest that we’re looking at around $45 per dose, however it’s not unreasonable to presume that the vaccines with higher efficacy rates would command a higher price. Pricing data from the US (which has ordered hundreds of millions of Pfizer doses) suggests they were able to negotiate a US$19.50 (NZ$29) price tag.

Supposing therefore that a single Pfizer dose cost the New Zealand Government somewhere around $30-$50, then shelling out for a fourth booster for the almost-four million people that have so far received a first dose could bring with it a $120-200 million price tag, sheeted back to New Zealand taxpayers.

Booster apartheid?

Talk of a second round of boosters is much more difficult to imagine for countries in the Global South, where primary vaccination rates remain low. First dose rates in lower middle income countries have now reached 45.8 percent, while in low-income countries that figure is only 7.1 percent.

In November, WHO Director General Tedros Adhanom Ghebreyesus decried the fact that six times as many booster shots are being administered daily around the world than primary doses in low-income countries.

Analysis by the Financial Times suggests that rich countries have administered almost twice as many boosters in the previous four months than poor countries had administered in total doses all year.

Covid vaccine profits have minted at least nine new billionaires since the pandemic began, and the vaccine manufacturers know implicitly that rich countries have deeper pockets than low-income countries.

This is a surefire approach to prolong the pandemic, as well as raising costs for New Zealand taxpayers. Now it is Omicron, but unless the rates of primary vaccinations are lifted in low-income countries the cycle of mutation will continue. Pharmaceutical shareholders can rejoice as rich countries tally the cost of another round of boosters, but we all end up less safe as a result.

All of this points to the desperate need for Aotearoa New Zealand to use the political leverage it has through its bilateral trade negotiations with two of the key outliers – the UK and the EU – and make a TRIPS waiver a precondition of concluding those negotiations. A soft approach on this issue will cost New Zealand taxpayers hundreds of millions of dollars.

Edward Miller is spokesperson for It’s Our Future, which coordinated groups signing on to the open letter.

Leave a comment