Being Good

"Vaccine delivery from Pfizer: under negotiation"

The Philippines received 525,60000 doses of AstraZaneca vaccines through the COVAX facility in two shipments last week.  This completes the initial supply provided to the country by the global COVAX facility and follows the receipt of 600,000 doses of the Sinovac vaccine on the last day of February.

Vaccinations are now ongoing across the country for health care workers. As the second week of March rolls in, it is still unclear when, or even whether, the Pfizer doses which were expected in February will arrive. 

In other news, McKinsey is in the midst of searching for a new chief after Kevin Sneader became the first McKinsey global managing partner to not receive a second term. Meanwhile, press, politicians and royal advisers were abuzz Monday after allegations of racism and mishandling of mental health issues surfaced in Oprah’s interview of Prince Harry and Meghan Markle.

Vaccine Roll-out and the Pfizer question

The Pfizer vaccine received emergency use authorization (EUA) in the second week of January and the first delivery was expected mid-February. Even after the local lawmakers passed a law providing liability protection for vaccine makers and the local WHO representative confirmed that the government had complied with the standard indemnity requirements, it became apparent that Pfizer had additional requirements contained in what the WHO representative called a side letter.

On Monday this week, the country’s vaccine czar announced that the government is arranging for delivery of about 20 million doses of the vaccine in the second quarter of 2021. An infographic from the Presidential Communications Operations Office shows a breakdown of sources for the government’s target of enough vaccines for 70 million Filipinos by the end of 2021. Deliveries from two sources are expected to begin in the first quarter: 44M doses from COVAX and 25M doses from SinoVac. Three other sources are expected to begin shipping in the second quarter: NovaVax with 30M doses, AstraZeneca with 17M doses, and Gamaleya with 10-15M doses Another 20M shots are expected from Moderna beginning July of this year. Going with the lower volume for Gamaleya, this is 146 doses, enough for 73M people assuming that all of the COVAX vaccines require two shots. This will cover about 66% of the country’s estimated 111M population. Another 5M doses are expected from J&J beginning October. As the J&J vaccines re single dose, this increases total individuals that can be vaccinated to 78M. 

Three vaccines have received emergency use authorization from the local FDA: Pfizer, AstraZeneca, and SinoVac. EUA’s are presumably in process for the other vaccines and explains their later committed delivery dates. In the Infographic, an entry for Pfizer shows 15M doses starting in August with the annotation:  under negotiation. 

At this point, many people are wondering what is causing the delay with the Pfizer deliveries. After all, the WHO hailed its agreement for 40M doses with Pfizer as paving the way for ensuring that poorer countries would be able to access the vaccine as early as February of 2021.

There is no news concerning what Pfizer has asked the Philippines for. There is, however, some disturbing news from Latin America. Pharmaceutical Technology reports that public officials from Argentina and another country that could not be named owing to a non-disclosure agreement with Pfizer, alleged that Pfizer;s demands went well over the indemnity requirements of other vaccine manufacturers. The article also reports that Pfizer demanded that sovereign assets, including federal bank reserves and military bases, be put up as collateral for potential legal costs. The Philippine law sets up a similar fund but it is for all companies, not just Pfizer. There is a similar fund in the US. More worrying is that the allegations include a demand for liability protection not only from civil claims from citizens who suffer adverse effects after vaccination but also cases brought against Pfizer for its own negligence, fraud, or malice. Documents from Brazil’s Ministry of Health show that similar demands were made of Brazil. In Latin America, neither Brazil nor Argentina signed agreements with Pfizer. Other countries that have signed agreements have been silent but deliveries to those countries were delayed an average of three months, presumably resulting from additional requirements from Pfizer. I have not found a denial of these allegations from Pfizer. 

Looking Good or Being Good

As the fallout from Oprah’s interview with the Duke and Duchess of Sussex continues, the royal family remains silent. 

I watched snippets of the interview and found it particularly painful as Prince Harry painted a painful parallel between the Biritish press treatment of his mother, the late Princess Diana and his wife, Meghan Markle. It was particularly horrifying to hear that Meghan had been told she could not seek professional help when she was experiencing depression and suicidal thoughts as this would be seen as detrimental to the reputation of the royal family. And I am certain my face was just as shocked as Oprah’s when Meghan related how a member of the royal family had raised questions of how dark her baby might be when she was pregnant with her first born.

Harry and Meghan’s stories make it easier to understand why they left the UK. And yes, of course, this is one side of the story. But it should also be clear that this is the first time we are hearing this side of the story. Certainly, the allegations of racism resonated with people of color, especially those in Britain.

But this tale from the British royal family, the story of Pfizer, and the story of McKinsey’s behavior during the opioid crisis have one thing in common: the behavior of people in power.

In a world desperate for a vaccine, is it right for Pfizer to use their power to ensure that they as a company are protected well beyond what other companies are asking for? The facile answer, of course, is that no one is forcing countries to say yes. There are other choices. Unless, of course, you count the reality of vaccine scarcity.

In a world where you can estimate how many people will die unnecessarily from opioid overdoses, is it right for a company to advice pharmaceutical companies to turbocharge their marketing of these drugs?

In this modern century, is it acceptable for people in power to keep silent while condoning racism?

So much of what drives those in power is image and reputation. To that end, they hone their public relations machinery. But power too often creates entitlement. And this sense of entitlement coupled with masterful public relations can create a culture of impunity within these institutions.

The question to us is this: what should we do?

Readers can email Maya at integrations_manila@yahoo.com. Or visit her site at http://integrations.tumblr.com.