Vaccine Surpluses Drive Acrimonious European Debates

At the end of 2022, a formal meeting in Brussels brought some sparks of life—if not very much light—into European discussions of medicines policy. Twice a year, the health ministers of the 27 member states of the European Union (EU) get together for a meeting of what is known as the EU health council—and at its most recent meeting, in December, the health council was the unusual scene of some trenchant remarks.

The agenda was—as is usually the case—stacked with routine reports and information points on aspects of EU health policy, and the customary tone can be judged by closing comments of the EU’s top health official, Stella Kyriakides. “Today’s very rich council is a testimony to the unprecedented work that has been ongoing in the area of health over the past years, including during this presidency,” she said in her congratulations to the Czech government, which had been in charge of the council for the last six months in the EU’s system of a rotating presidency. This came after ministers had spent a day wading through updates of the rules on blood transfusion, medical devices, and cancer screening. And her remarks delicately sidestepped the reality that ministers had not been able to debate promised substantial changes to the EU’s pharmaceutical rules because officials had not completed their work on legislative proposals in time. “I want to thank the Czech health minister for a successful Czech presidency and for having advanced the work on many of our key health files,” said Kyriakides. Diplomacy tends to triumph over business at these meetings.

However, one item in particular did generate some more incisive language—and amounted to an unusual baring of ministerial teeth toward the medicines industry. It came in the context of yet another anodyne and largely self-congratulatory statement on the vaccines strategy that the EU developed over the last two years to counter the COVID-19 pandemic. The formal report of the meeting notes that: “EU ministers of health approved council conclusions on vaccination as one of the most effective tools for preventing disease and improving public health.” The EU strategy “represents a major step forward in ensuring the development, procurement, purchase, and distribution of medical countermeasures at EU level, such as of vaccines and therapeutics,” state the conclusions.

Rather more pointed exchanges took place during the meeting itself because the success of the vaccine strategy—centered on establishing contracts with a handful of manufacturers for reliable supplies—has now become an embarrassment. Over the last two years, the EU reached a series of agreements—with Pfizer/BioNTech, Moderna, AstraZeneca, Johnson and Johnson, Novovax, Valneva, and Sanofi/GSK—for the supply of more than two billion doses of COVID vaccines running through to 2024. Changes in demand means the member states don’t need them—or don’t need them now. So, the EU and its member states want to get off the hook. The companies are unsurprisingly reluctant to rip up these contracts, and behind the scenes some tough talking has been underway over the last few months.

The demure proceedings of the December health council were disrupted by an outbreak of member state resentment about the burden they now find themselves saddled with, which found voice in a series of less diplomatic interventions. Germany and France called for a single EU voice to exert pressure on companies, with a “firm message” to Pfizer. Lithuania said it now has a surplus six times its requirements and attacked the obstinacy of suppliers over contractual terms as “mere commercial interest.” “Destruction of vaccines is not something that we can accept” was the refrain. Denmark said that prices should be lower to reflect the lower degree of investment risk in what is now a well-established technology. And with a view to the future that could prove ominous for drug firms, the Netherlands and Belgium both warned that the EU should no longer leave itself dependent on one dominant supplier.

Circumstances have changed, repeated minister after minister during the meeting, invoking not only progress in countering the pandemic, but also the context of the energy crisis, the war in Ukraine, and rising inflation. Above all else, what emerged from the discussions was a determination to act in concert to persuade reluctant manufacturers to give way. Kyriakides urged coordination of the EU position to “move forward together in litigation.” “Companies must show greater flexibility,” she said. And from the chair, Vlastimil Vále, Czech deputy prime minister and minister of health, underlined the need for firm action. “We have all agreed that it is indispensable that vaccine supplies be suspended until the contract is amended,” Vále concluded.

Reflector is Pharmaceutical Executive’s correspondent in Brussels.