Unredacted COVID-19 vaccine contracts between South Africa and several pharmaceutical companies have been made public, leading civil society organizations to accuse the companies of "pharmaceutical bullying", Politico reported on Thursday. 

The vaccine suppliers mainly include Johnson & Johnson (J&J), Pfizer, the Serum Institute of India, and Gavi - the Vaccine Alliance.

The contracts with these suppliers reveal that South Africa paid higher prices for some COVID-19 vaccines compared to the EU.

Notably, the Serum Institute of India charged South Africa $5.35 per dose for the Oxford/AstraZeneca vaccine, while the EU paid just €1.78 (approximately $2.17).

South Africa was, however, able to secure a discount on the price of the BioNTech/Pfizer vaccine, paying $10 per dose compared to the €15.50 (just under $19) reportedly charged to the EU.

But NGOs say this is still more than the cost price of $6.75 that the African Union was reportedly charged.

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Multiple civil society organizations have analyzed the South African contracts and concluded that they reveal "pernicious pharmaceutical bullying and heavy-handedness."

"The terms and conditions in these contracts and agreements are so one-sided, and so in favor of multinational corporations that they beggar belief," Fatima Hassan from the Health Justice Initiative told Politico. 

The contracts also reveal that Johnson & Johnson (J&J) and Pfizer prevented South Africa from imposing export restrictions on vaccines and both prohibited the country from donating or exporting doses without their consent.

Gavi's contract, related to vaccines under COVAX, did not guarantee the number of doses or delivery dates.

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The release of these contracts offers concrete evidence to support these allegations. Globally, there has been a push for greater transparency regarding COVID-19 vaccine deals, as many were marked by secrecy and included strict clauses on indemnity and confidentiality.

In the EU, there has been a call for both unredacted COVID-19 contracts and disclosure of alleged text messages between Commission President Ursula von der Leyen and Pfizer CEO Albert Bourla during contract negotiations.

The publication of these documents should trigger worldwide measures, according to the coalition comprising HealthGAP and Global Justice Now.

These two groups are advocating for the ongoing discussions regarding a pandemic treaty and the review of the International Health Regulations to address the enforcement of equitable terms in potential future agreements related to pandemic-related products.

J&J clarified that the final price paid by South Africa was $7.50 per dose, which matched their global pricing for all customers. J&J highlighted its technology transfer to Aspen Pharmacare in Gqeberha for local production of the Johnson & Johnson COVID-19 vaccine and the subsequent production of Aspen's own COVID-19 vaccine, Aspenovax. The company also noted its advocacy and support for the donation of hundreds of millions of vaccine doses by countries like the US and EU members.

Regarding COVAX, a Gavi spokesperson explained that it was designed to ensure equitable access to COVID-19 vaccines for all countries. While lower-income nations received doses at no cost, South Africa, as an upper-middle-income country, participated in COVAX as a self-financing member. South Africa received over 9 million doses from COVAX, including approximately 8 million dose donations, free of charge.

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