Nepal | January 23, 2021

Vaccine politics: Fair, equitable distribution at stake

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At a time when there is a rat race for the procurement of vaccines, just depending on the COVAX facility or India may not be adequate. The distribution of vaccines through the COVAX facility is still in the womb. So Nepal should approach other pharmaceutical companies for the procurement of vaccines that suit it

It is a matter of satisfaction that many countries have developed vaccines against COVID-19 in a short span of time. Some vaccines have been rolled out, and vaccination programmes have also started in some countries, while other are being developed or in various trial phases.

On the other hand, the WHO is aiming at fair and equitable distribution of vaccines through the CO- VAX facility, which was established in April 2020.

Although following the health protocol is an effective measure against catching, or preventing the transmission of, COVID-19, vaccination will enable the immune system to recognise and stop the coronavirus from entering the bodily system. Vaccines will save lives, bring health systems back on track and help the world economy recover from the effects of the pandemic. That is why, many rich countries are falling over themselves to procure vaccines enough for their populations.

As many as 42 countries – 36 high-income and six middle-income countries– are rolling out vaccines for their people. Further, many rich countries have booked vaccines in large quantities.

This means that low-income and many middle-income countries may be at the receiving end; it is not certain whether they will receive the required vaccines or not.

This being the situation, it is highly likely that vaccine politics will take centre stage when it comes to procuring vaccines. The most dangerous aspect of vaccine politics is that prices of vaccines may be jacked up, and poor countries may be left out in the cold, while rich countries will be walloping in vaccination programmes.

This is where the WHO has expressed its concern.

The WHO, which has been pulling out all the stops since COVID-19 emerged in China in late December 2019, has emphasised the fair and equitable distribution of vaccines through the COVAX facility and urged all countries to contribute to the facility. A few countries controlling the supply of vaccines at the expense of other countries cannot be justified on humanitarian grounds as COVID-19 is a global pandemic and has affected all countries, rich or poor.

It is disappointing that even high- and middle-income countries which are part of the COVAX facility are making bilateral deals for the procurement of vaccines.

It looks difficult to ensure the fair and equitable distribution of vaccines to all countries as envisaged by the WHO.

What is Nepal doing on the vaccine acquisition front? India has approved the Oxford-AstraZeneca vaccine, the vaccine developed by the Serum Institute of India (Covashield) and the vaccine developed by Bharat Biotech (Covaxin).

The country is going to initiate massive vaccination programmes soon.

Bangladesh has approved the vaccine developed by the Serum Institute of India for emergency use and inked an agreement with the manufacturing company for the procurement of 30 million doses. The vaccines are expected to reach Dhaka in early February. But there is a dilemma in Nepal as to when and from where the vaccines will arrive.

Nepal is weak in health systems. The country lacks cold chains suitable for vaccines that require storing at ultra-cold temperatures.

The Pfizer-BioNTech vaccine needs to be stored at minus 70 degrees Celsius, whereas the Moderna vaccine requires a temperature of minus 20 degrees Celsius for storage. So vaccines like the Oxford-Astra- Zeneca vaccine that can be stored at refrigerator temperatures (2 to 8 degrees Celsius) are suitable for the country. Even so, additional cold storage facilities need to be constructed in all seven provinces.

Nepal is depending on the COVAX facility for the acquisition of vaccines.

Vaccines enough for 20 percent of the population are expected to be received from the facility. The country has also requested India to provide vaccines enough for 20 percent of its population in the latter’s purchase deals. The country has also approached the Serum Institute of India about procuring vaccines.

The vaccines to be distributed under the COVAX facility are not available right now. The WHO has made contracts with various pharmaceutical companies for the acquisition of two billion doses. However, the intended vaccines are in trial phases. Nepal has been assured that the vaccines will arrive in the country by the end of March after their quality, safety and efficacy have been assessed by the WHO.

Vaccines developed for people in the West may not be suitable for Asians due to the high rate of malnutrition, comorbidities, infections and poor health.

Viewed thus, the vaccines developed in India and China seem to be suitable for Nepal.

Nepal has planned to inoculate 72 percent of its population, excluding children up to 14 years of age.

The priority list includes healthcare workers, social workers, the elderly above 55 years of age, people with underlying medical conditions and those working in sectors where social distancing is hard to maintain.

In the first phase, three percent of the population that includes healthcare workers and social workers will be inoculated. Thereafter, up to 20 percent of the population, including the elderly, will be inoculated.

For this, data of priority groups of people are being collected.

The government says it is clapping its eyes on the vaccines being rolled out or developed across the world. At a time when there is a rat race for the procurement of vaccines, just depending on the COVAX facility or India may not be adequate. The distribution of vaccines through the COVAX facility is still in the womb. So Nepal should approach other pharmaceutical companies for the procurement of vaccines that suit it.

At the same time, preparations should also be made for the storage, transportation, distribution and use of vaccines before it is too late.



A version of this article appears in print on January 12, 2021 of The Himalayan Times.

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