Covid-19 Vaccine Embargo
Vaccination is indeed an important effort to tackle the pandemic. However, the health protocols to prevent the virus transmission through 3M and its control through 3T must also go hand in hand.
The Covid-19 vaccine embargo is reported to be slowing down the vaccination rollout in our country.
Four ways are available for a country to obtain vaccines. First, the country purchases it in the global market, directly from the vaccine-producing countries.
Second, vaccines can be accessed through bilateral cooperation with one of the producers. The third option is through a multilateral partnership, involving Covax Facility, which is the global pooled vaccine procurement mechanism jointly formed by World Health Organization (WHO), GAVI the Vaccine Alliance, Coalition for Epidemic Preparedness Innovations (CEPI) and UNICEF.
The fourth is to produce vaccine by itself at home.
Embargo and Other Causes
The embargo has been triggered by India\'s decision to allocate the production AstraZeneca vaccine for its domestic needs because of a surge of positive cases.
During mid-2020, the number of new Covid-19 cases in India reached nearly 100,000 people a day for a few months. The figure could be curbed down to a few thousands early 2021 before resurging sharply in a few weeks to above 100,000 people a day.
Also read: Herd Immunity and Covid-19 Metamorphosis
In the face of the sharp escalation, the government of India has decided to fully focus on improving the number of vaccinated people further from the current speed of more than three million people per day.
The planned extensive coverage of vaccination has prompted India to embargo the produced vaccines previously set aside for export to the world, including the AstraZeneca vaccine, one among several Covid-19 vaccines the country produces.
Also read: Intensifying Covid-19 Genomic Surveillance
The measures certainly have a wide impact on the world, including Indonesia. We were committed to procuring the AstraZeneca vaccine though Covax to the amount of 11.7 million doses. The first stage of shipment saw 1.1 million delivered on 8 March 2021. The rest was scheduled to be shipped in two stages, this month and the following month, before being suspended by the embargo policy. This has resulted in less number of jabs in Indonesia than expected.
The embargo has added to the problem of global stock shortage. The producers have not been able to meet the world’s vaccination needs because either a vaccine has just passed through the initial phase-3 clinical test or the population in each country is just too large to cater to.
In January 2021, the European Union complained about the late delivery of vaccines from Pfizer and AstraZeneca, which it claimed was against the agreement. It testified to the existing problem in the vaccine production process. We have also learned Italy once suspended the delivery of vaccines to Australia.
On the other hand, “vaccine nationalism”, a reluctance by a country to share vaccines with others, has also become a concern. WHO’s director general has issued a statement, saying “vaccine nationalism harms everyone and protects no one.”
Also read: An Evaluation of the Covid-19 Situation
The statement carries a message that it is impossible for the pandemic can be overcome if vaccination is only for people from certain countries while those in other countries do not get the vaccines.
World Bank leaders have said all countries must get vaccines to end the pandemic.
World leaders, including G-20 and President Jokowi, have called for equal distribution of vaccines in the world, though in fact it has not materialized yet because the limited availability of vaccines in the world, and consequently in Indonesia.
Such a condition has been apparent from the outset and should have since been anticipated.
Options
In the face of vaccine shortage, five options are available for consideration, some of them of course having been pursued.
First, keep improving global health diplomacy through bilateral and multilateral frameworks involving international agencies.
We know that several countries have donated vaccines to other countries as part of bilateral relations.
India, for example, gave vaccines as grants in January 2021 to six neighboring countries -- Bhutan, Maldives, Bangladesh, Nepal, Myanmar and Seychelles, as well as some others including Latin America countries.
In early February 2021, the Chinese government delivered Sinopharm vaccines to Pakistan and 13 other countries, including Cambodia, Nepal, Sierra Leone and Zimbabwe. Russia did the same with its Sputnik vaccine. All have been initiated within the framework of "vaccine diplomacy".
Also read: Vaccine Diplomacy amid the Pandemic
The second option is to strengthen negotiations with various vaccine manufacturers, the number of which is now increasing. Indonesia has so resolved to use seven brands of vaccines, but the choices are subject to changes, adjustable to the ongoing development.
Up to April 2021, four brands of vaccines were obtained through the Emergency Use of Listing (EUL) permit from WHO, namely Pfizer, AstraZeneca produced by India\'s Serum Institute, AstraZeneca (South Korea’s SK Bio), which is being used in Indonesia, and the one-jab Johnson & Johnson vaccine.
Besides those two options, the following three (third to fifth) options are what can be done domestically.
The third thing that can be done is to prioritize vaccination for those who are at high risk of contracting the disease, namely the elderly and those who have comorbidities.
The vaccination of the elderly has indeed been carried out, but as we know from the media news, the jab coverage is not satisfactory yet. It needs to be pushed further. People with comorbidities are more susceptible to illness and prone to becoming severe and even fatal.
Also read: Battling Covid-19, One Year On
Some countries classify citizens over 40 or 45 of age with comorbidities into one group with the elderly.
The fourth option is that vaccination is prioritized in the areas found to be showing a high risk of transmission. It is crucial to do in order to stem the spread of disease in the community.
Domestic Vaccines
The potential emergence of new mutations and variants must also be anticipated as early as possible.
The fifth option is, of course, is making vaccines at home. It must be acknowledged that this is no simple task as it requires financial support and supporting public policies.
Our experts have ample competence to process the manufacturing of vaccine, and Bio Farma is experienced and known internationally as a trusted vaccine manufacturer. Of course, the vaccine manufacturing processes must comply with scientific principles so that the product is truly safe and reliable.
TJANDRA YOGA ADITAMA
Vaccination is indeed an important effort to tackle the pandemic. However, the health protocols to prevent the virus transmission through 3M and its control through 3T must also go hand in hand. We cannot just rely on vaccination. On the other hand, the potential emergence of new mutations and variants must also be anticipated as early as possible.
Tjandra Yoga Aditama, Director of Postgraduate, Yarsi University, Professor at Indonesia University Medical School, Former Director of Infectious Diseases, WHO Southeast Asia
This article was translated by Musthofid.
