美国国家公共电台 NPR Merck Pulls Out Of Agreement To Supply Life-Saving Vaccine To Millions Of Kids（在线收听）

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The pharmaceutical giant Merck is pulling out of an agreement to sell a lifesaving vaccine to poor countries at a reduced cost. At the same time, the company has just started sending the vaccine to China, where it will likely be sold for a much higher price. As NPR's Michaeleen Doucleff explains, the pullout may leave millions of babies at risk for rotavirus. A warning - this story does contain graphic details.

MICHAELEEN DOUCLEFF, BYLINE: For the past 50 years, Dr. Mathuram Santosham has been treating babies around the world for infectious diseases. He says there's one baby he'll never forget.

MATHURAM SANTOSHAM: I was in a rural hospital in Nigeria, and a young woman running to me with her baby.

DOUCLEFF: Santosham couldn't understand what she was saying

SANTOSHAM: But I knew just from her body language what she wanted. She wanted me to save her baby.

DOUCLEFF: The little girl had an infection called rotavirus, which causes a high fever, seizures, explosive diarrhea. The little girl was dying.

SANTOSHAM: And I touched the baby, and the baby had just lost her pulse. The baby had just died.

DOUCLEFF: Santosham tried to resuscitate the baby, but he couldn't do anything.

SANTOSHAM: Just a few minutes ago, the baby was alive. I mean, that's how fast things can go. And it just broke my heart.

DOUCLEFF: Santosham is a pediatrician at Johns Hopkins University. He says rotavirus is one of the most contagious diseases on earth.

SANTOSHAM: Before the age of 5, every child, whether you live in the U.S. or you live in a developing country, is infected with this disease.

DOUCLEFF: Here in the U.S., before there was a vaccine, rotavirus hospitalized about 50,000 children each year. But it was rarely fatal because children could be easily treated. That's not true in poor countries. There, rotavirus can quickly become life-threatening. For this reason, Santosham says, the vaccine is critical. But the vaccine is also very expensive.

Here in the U.S., it costs about $200 a course. So back in 2011, the two companies that manufacture the vaccine, Merck and GlaxoSmithKline, agreed to reduce the price for poor countries to about $10 a course. Merck committed to supplying the vaccine to four countries in West Africa. This agreement fits well with one of Merck's corporate missions of increasing access to medicines around the world. Merck emphasized this in a promotional video.

(SOUNDBITE OF ARCHIVED RECORDING)

GEORGE W. MERCK: We try never to forget that medicine is for the people. It is not only for the profit. The profits follow. And if we have remembered that, they have never failed to appear.

DOUCLEFF: For the past six years, Merck has stuck to its commitment. It has delivered more than 30 million doses to the West African nations of Burkina Faso, Ivory Coast, Mali and Sao Tome and Principe. Now Merck is withdrawing from that agreement. A spokesperson for Gavi, a charity that negotiates vaccine prices for poor countries, says that Merck will not be able to deliver all the doses it promised this year and next. In 2020, it will stop delivering the vaccine altogether to West Africa. GSK says it will not make up for Merck's shortfall. In an email to NPR, a Merck spokesperson wrote that the company can't continue to sell the vaccine to West Africa because of, quote, "supply constraints," such as "unanticipated manufacturing issues and packaging challenges."

At the same time, Merck has started to sell the vaccine in China, where a local vaccine company will likely charge more than 10 times what poor countries pay. When asked if there was a connection between the pullout from West Africa and the launch in China, a Merck spokesperson did not answer the question directly but wrote that it's sending the vaccine to China to fulfill a binding contract there. Christopher Pace analyzes the vaccine market for the company GlobalData. He says launching in the Chinese market has big potential to boost Merck sales of the vaccine.

CHRISTOPHER PACE: China's vaccine market is quite large due to the large population. And we're expecting it to continue to grow moving forward into the future.

DOUCLEFF: Merck's agent in China is banking on a strong uptake. It's planning to purchase millions of doses of the vaccine from Merck in the next few years with a price tag of more than $450 million. A pair of new vaccines were just given the stamp of approval by the World Health Organization this year. Both are manufactured in India. But PATH, the nonprofit that helped develop these vaccines, says they won't be ready in time to fill the gap left by Merck's pullout from West Africa. In the meantime, millions of babies there will be at risk for this disease.

Michaeleen Doucleff, NPR News.