If there’s one group that meets with as much approbation as one can in our modern world, it is Medecins Sans Frontieres. They recently turned down a million doses of a pneumonia vaccine from Pfizer, the big pharma giant. The head of MSF explained why. Pfizer’s was a one time donation. Sure many children would benefit and many lives would be saved. But that would not solve the problem. The problem is how unaffordable the vaccine PCV13 sold as Prevnar 13, is. A course of treatment is 3 to 4 doses, and one doze in Morocco costs $63.70, $67.30 in Tunisia (who is about as far from Morocco as Norther California is from Southern). It is $58.40 in France but in the US it is about $137. One of the problems is how difficult it is to obtain data about costs, sales, profits, variation in prices. Not surprisingly Pfizer is secretive. It holds several patents on the drug, including some for how the drug is made. A South Korea company came close to duplicating PCV13 but Pfizer sued and the idea had to be discontinued. The vaccine can reduce death from strep pneumonia in children by 88%. Still no matter how difficult the decision was, MSF turned down the donation. Donations of a million doses would have helped treat the children under the current care of MSF, but the problem would still exist. MSF does not want to be at the mercy of drug companies which serve their interest first. For MSF this would spell an uncertain future not only for the needed vaccines in years to come, but also for other high priced drugs. Given the shortage of data about drugs and prices, making it even more difficult for groups like MSF to bargain, WHO along with UNICEF and MSF began a database where all can input what they know. Meanwhile the action of MSF is to be hailed. How many of us would have the foresight and the moral courage to do what they did. Perhaps they can set an example and inspire us should we be in a position to do something similar with the drugs we take or the issues we support.