The supply of vaccines depends on how much countries pay for doses

It had never occurred to me that different countries would be paying different prices for the same COVID-19 vaccines.

The only reason we really know anything about that is due to a tweet from from a Belgian budget official. The tweet was hastily deleted, but not before the price the European Union is paying for the Pfizer/BioNTech vaccine ($14.76 per dose) was compared to the price the USA is paying ($19.50). Now, it is possible that some of that difference is due to the subsidies the EU provided towards the vaccine's development. The total number of doses ordered may also play into it, as may the speed of delivery. But it seems like few other people had thought about how much different countries were paying for the vaccines either, and countries were not going to be widely broadcasting that information.

There are significant differences in the relative prices of other vaccines too (all courtesy of that same unfortunate tweet): the EU will pay about 45% less than the USA for the AstraZeneca vaccine, and 20% more for the Moderna vaccine. Again, this may (or may not) be a function of the relative investments made by these countries to the development of the vaccines. AstraZeneca's response to requests for information was that, "The price per dose varies depending on the supply chain. We are unable to comment on specific agreements". Which is not very helpful.

It is not clear how much Israel has paid in order to obtain such large quantities so quickly. (Israel is streets ahead of any other country in the proportion if its population already inoculated.) Did they just pay lots of dosh to get preferential treatment? Is this fair? One leaked report suggests that Israel may have paid as much as $30 per dose to get such a large early supply, two to three times the reported market price per dose. This is how the "Israeli miracle" was achieved. Added to this, Palestinians under Israel occupation are not getting vaccinated, while Israelis illegally squatting on Palestinian territory are, but that is, as they say, a whole other issue. If you are cynical, you might say that the fact that Benjamin Netanyahu is due to contest yet another general election in March may also have had something to do with the strong push for early vaccinations, cost be damned.

The whole issue is quite opaque and clearly very sensitive. The Canadian government is not releasing any information about how much Canada is paying for the vaccines it has ordered, and this is becoming much more of a concern as our supply of the vaccines seems to be drying up (or at least progressing much more slowly than promised), and the provinces are complaining that they urgently need more doses. They have huge unused vaccinating capacity as a result, they say, of lack of supply from the federal procurement system.

It has also come to light that Ottawa has offered to pay more in order to expedite supplies of the vaccines, which seems like an embarrassing public admission, and reflects poorly on the whole process. And where does this leave poor countries, many of which are faring much worse than we are?

All of this shouldn't come as a surprise to me. Drug companies are commercial enterprises, out to make a buck. I just naively thought that such considerations might have taken a back seat during such a global crisis.