 Big Pharma companies have made giant profits since the world has been in the grips of the COVID-19 pandemic. Pfizer's revenues jumped by 95% from about $42,000,000 to $81,000,000 and its net income rose by 142% between 2020 and 2021. Moderna, a much younger company established in 2010, also recorded a huge jump in net income. Till 2020, Moderna was recording a negative net income. The COVID-19 pandemic suddenly made the company a big pharma giant with a registered net income of $12,000 million in 2021. Moderna's revenues registered a 2,200% jump. What has made these massive profits possible? The majority of revenue for these pharma giants came from vaccine sales. Excluding Combinati, the Pfizer-BioNTech COVID-19 vaccine, Pfizer's revenue grew by just 7%. Therefore, the company's exponential growth in 2021 relied almost exclusively on the vaccine. This revenue is set to increase as Pfizer is projecting the production of 4 billion vaccines in 2022 compared to 3 billion in 2021. Where these vaccines sales were made was a big factor in determining the profits. Most of the big pharma companies have neglected supplying vaccines to low-income countries. Over 80% of Pfizer's and 70% of Moderna's total production in 2021 went to high-income countries and upper-middle-income countries. Low-income countries accounted for only a 1% share of Moderna's total sales. This difference in sales is reflected in the stark inequality in vaccination rates across different countries. While more than 70% of people are fully vaccinated in high-income and upper-middle-income countries, the rate of vaccination in low-income countries is a shocking 6%. Low and middle-income countries have only 44% fully vaccinated populations. Most big pharma companies have also not fulfilled their commitments to COVAX. The COVAX platform was set up as a collaboration between the WHO and other multilateral agencies to accelerate the development and manufacture of vaccines and ensure their fair and equitable access. The WHO has time and again appealed to rich countries as well as big pharma to contribute to COVAX so that vaccines can be made available to poorer countries at lower prices. However, this graph shows that top pharma companies have failed miserably to contribute to COVAX. For instance, out of 3 billion vaccines produced by Pfizer in 2021, it contributed only 40 million doses to COVAX. Moderna contributed only 50 million doses, while J&J amissly 6 million doses. AstraZeneca, Sinovac, and Sinofarm are the only vaccine manufacturers which have contributed more than 100 million doses each to COVAX. Companies that have made the largest profits during the pandemic such as Moderna and Pfizer have just done lip service by providing too few doses to COVAX. Furthermore, big pharma has also refused to share the technical know-how with manufacturers in low-income countries and low- and middle-income countries. The pharmaceutical giants have been ferociously opposing temporary suspension of patents. They have been consistently lobbying with rich countries to thwart all such efforts at international levels. WHO Director General Tedros Gabriosas pointed out that much of the vaccine inequity has been driven by the fact that globally vaccine production is concentrated in a few mostly high-income countries. Thus, there is an urgent need to increase local production of vaccines, especially in low- and middle-income countries. Now we are seeing that the manufacture of COVID-19 treatment might be going down the same route. On January 24th, US advocacy group Public Citizen wrote a letter to Albert Burla, Pfizer's chairperson-achief executive officer. It asked Pfizer to step up and make its COVID-19 treatment back slowed, widely accessible. The letter expressed concern that going by Pfizer's announcement so far, we can expect that more than half of the world population in need of this treatment won't get it. Almost all the treatment courses are directed towards the populations of rich nations. According to a tracker by US-based organization Knowledge Ecology International, Pfizer has signed contracts exclusively with high-income and upper-middle-income countries, mostly from Europe and North America. No African country figures in the list, although the region has the lowest vaccination rates and is most in need of treatments. Pfizer has indicated that low- and middle-income countries will come on board for Pax-Levit through the medicine-spatting pool, only in 2023. Public health movements are calling for urgent action to be taken to stop the devastation of people's health and profiteering of big pharma for one more year. They have stated that freeriding on people's suffering should be stopped and companies like Pfizer and Moderna should be reined in.