The worrying trend of poor transparency in the development and procurement of COVID-19 vaccines
By Natalie Rhodes, Policy Officer
Our analysis reveals that the development of, and contracting for the supply of COVID-19 vaccines has also been accompanied by a disturbing lack of transparency. The urgency of the COVID-19 pandemic has demanded rapid disbursements of public funds, quick decision-making, and unprecedented public health interventions. In a time where clinical development and procurement processes have become the most important of our lifetime, it is concerning to see transparency being accorded so little importance.
The case for transparency in vaccine development and contracts is clear: the huge global demand, the vast sums of public money already and still to be invested and spent, and the need to build public confidence in vaccines as the best way to bring the pandemic under control.
For Whose Benefit? assesses the transparency of two key stages of the vaccine development – the clinical trials and subsequent procurement of vaccines.
In looking at clinical trial transparency we discovered an incoherent global policy landscape. Required levels of data sharing and publication vary substantially depending on the location of clinical trials, where the vaccines are to be manufactured and the country applied to for approval. Clear guidance on how clinical trial data should be shared during a health emergency such as COVID-19 is lacking globally. This has enabled a growing trend of ‘science by press release’ and the frequent use of media to announce clinical trial results without the accompanying publication of the associated data analysis or sharing of clinical trial protocols. This facilitates potentially dangerous misinformation and misunderstanding.
In looking at contract transparency we found an extremely low publication rate of COVID-19 vaccine contracts worldwide with just 6% of contracts being published. In contracts published there are major redactions that hide key details of public interest and may play a part in explaining why many countries lost out in the initial race for vaccines. Based on the limited information available, we also found that there is notable variability in the pricing of vaccines, with some buyers are paying more than we would expect when compared to GDP per capita. Further, the inclusion of extensive indemnification clauses in the available contracts suggest that contracts are pushing financial risks onto national governments, and away from the developer.
Overall, our analysis of the global COVID-19 vaccination process indicates a lack of good quality governance in the areas of clinical trials and contracting in health emergencies. Poor guidance and weak and inconsistent global policy mean that key information has only been shared because of the voluntary actions of certain vaccine developers, governments, and vaccine buyers. There is a pressing need for global policy reform to improve the current standards of openness to embed transparency into development and contracting processes. Whilst initial steps can be taken to immediately improve this, it is vital that governments work together to create a regulatory framework that removes the opportunity for the degradation of standards of openness.
We make recommendations that will help increase monitoring and transparency in the rollout of COVID-19 vaccines, and in the long-term increase transparency, access to information, and accountability in the pharmaceutical industry, and pandemic-related research and development and public contracting.