The race to inoculate Southasia's populations has been marked with delays, cost constraints, red-tapism and mistrust – shedding light on the severity of global and regional vaccine inequality. A crucial concern throughout the region has been the issue of cost; the prices that governments, and in some cases individuals, are paying for the vaccines.
While the recent news cycle has been inundated with reports of fresh supplies of vaccines, important conversations about the economics of vaccine access and availability remain unclear or misleading, given that public procurement processes for vaccines have been largely opaque, mainly through the use of Non-Disclosure Agreements (NDAs).
Given the paucity of information on the costs of the vaccines across the region, and the value of a cross-country comparison of these figures, we have put together the following infographic. The chart shows reported prices per dose of vaccines procured through various agreements around the region. The numbers were compiled from a range of sources, including news reports and UNICEF's vaccine market dashboard. While this data shows a useful comparison, please note that this is a limited view given that at this stage of the vaccine rollout, it is challenging to gauge costs – with some vaccines being more expensive to produce than others and some vaccine prices remaining undisclosed. At the same time, it should be noted that some proportion of vaccines administered so far were received as grants at no cost.
Meanwhile, any proposal to address the supply constraint by relying on the market appears dubious in light of reports from Pakistan, where many cannot afford vaccines at the given private market prices. The sales of vaccines in private hospitals have ranged from around USD 28 for a CanSino Biologics one-dose shot to USD 80 for two doses of the Sputnik V vaccine (of which the procurement price is nearly half this rate) – almost four times the international market price. In March 2021, the government reversed its decision to exempt private firms from price caps. While the drug regulatory authority wanted Sputnik V to be sold at a lower price – AGP Limited, a private pharmaceutical company, won an interim court order to sell the vaccine until a final price is fixed. However, this price dispute with private importers has not only stalled the commercial administration of vaccines across private hospitals in Karachi, Islamabad and Lahore but delayed further distribution.