No to ‘vaccine apartheid’

The government should set up a committee of eminent individuals to act as an oversight body for the purchase of Covid vaccines

GERD ALTMANN/PIXABAY

The rich countries have booked many more doses of Covid vaccines than they need for their population – five times more for Canada, two times more for the US, 3.6 times more for the UK and 2.7 times more for the EU.

Meanwhile, the 85 poorest countries in the world have hardly any access to Covid vaccines. The World Health Organization (WHO) has launched the Covax initiative, targeting the delivery of two billion doses of the vaccines in 2021.

But the Covax scheme has not yet received a significant portion of the contributions pledged by the richer countries. It distributed only 70 million doses of Covid vaccines by 27 May 2021 (3.5% of the targeted amount). Health and human rights activists have criticised this imbalance in access to the vaccines, terming it “vaccine apartheid”.

This massive imbalance in the allocation of a scarce resource is due entirely to money. The richest countries in the world contributed millions of dollars to the various pharmaceutical companies working on Covid vaccines with the understanding (crystallised in binding contracts) that these countries would get the first option to buy ‘x’ million doses of that vaccine if it came to the market.

Middle-income countries like Malaysia did not enter such forward contracts because of the financial risk involved – if the vaccine wasn’t effective or if it had too many side effects, the money invested would have had to be written off. That was part of the deal.

So middle-income countries like Malaysia opted to wait to see if the vaccines were suitable for nationwide use before placing orders. So, we are in the second tier of buyers, competing for a limited resource with other middle-income countries that followed a similar strategy.

This is why the Socialist Party of Malaysia (PSM) is firmly against the fragmentation of the Covid vaccination programme in the nation that is being advocated by several political leaders. If we allow richer states to acquire the vaccine on their own, what about the poorer states in the federation? Are the lives of the people of poorer states less valuable than those of the residents of Selangor, Penang and Sarawak?

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And if we allow the large factories to buy vaccines for their staff, what about those in small and medium-sized enterprises, the daily paid workers and the smallholders? Is their protection not as high a priority? Isn’t this similar to the vaccine apartheid, practised by the rich countries, that we are critical about?

PSM’s stand has always been that we need to tackle this pandemic on the basis of solidarity. Kita jaga kita (We’ve got each other’s back)!

The fragmentation of the vaccination programme, if allowed, will lead to rising vaccine prices as different states and other parties will offer higher bids to buy the scarce resource (and perhaps score some political points). Remember how Andrew Cuomo, the Governor of New York City, complained bitterly (in his televised chats with the public) about how the prices of PPE and ventilators had rocketed because of the fragmented nature of procurement in the US then.

PSM is all for the involvement of private hospitals and GPs in the rollout of the national vaccination programme, but it must be a unified national programme coordinated by the Ministry of Health, based on need (vulnerability to infection) and not the capacity to pay. There can be no compromise on this principle. The Covid vaccine should be given free to people based on their risk profile.

To facilitate whole-of-society cooperation in the battle against Covid, it would be helpful if the government could clear the air about certain outstanding issues regarding vaccine procurement that threatens to undermine the government’s credibility.

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Pasir Salak MP Tajuddin Rahman brought up one of these issues in Parliament. He interrupted the finance minister to ask who would get the RM500m commission for the purchase of Covid vaccines. A video that made the rounds showed the minister bemused, at a loss how to respond to this ‘friendly fire’.

As many Malaysians are suspicious about possible hanky-panky in vaccine procurement, the government should clear the air.

From Khairy Jamaluddin’s statements, we understand that the major pharmaceutical companies insisted on non-disclosure clauses in the contract agreements, and given the tight supply situation, countries like Malaysia were not in a strong position to refuse.

But there is nothing stopping the government from setting up a committee of eminent individuals to act as an oversight body for the purchase of Covid vaccines. This committee, which has to be sworn to secrecy, could comprise a couple of MPs from the opposition, a former Bar Council president, a Suhakam commissioner and a retired judge. Give the committee the mandate to ask for and review all relevant documents and provide them with a dedicated secretariat. This would create an effective process of checks and balances while keeping to the terms of the government’s agreement with Big Pharma.

This oversight committee should also review the allegation that Pharmaniaga mishandled a big batch of Sinovac vaccine material resulting in losses amounting to tens of millions of ringgit. This is a serious allegation that the committee should look into.

Pharmaniaga ‘inherited’ the staff and the technical capacity of the then-Government Medical Store, the procurement arm of the Ministry of Health before that function was privatised as Remedi Pharmaceuticals in 1993. Remedi later morphed into Pharmaniaga, which for the past 20 years routinely bottles vaccines that are used by the ministry, so they should have considerable expertise in this.

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Is it possible that Pharmaniaga fumbled on this assignment with Sinovac? The oversight committee should look into this.

Obviously, the oversight committee has to honour the non-disclosure terms of Malaysia’s contracts with the pharmaceutical companies. But that should not be a barrier to it giving a summary of its findings to the public. If the committee uncovers serious malpractices, then it should forward those to the Attorney General’s Chambers for action.

The government should also address the legitimate questions and public anxieties over the vaccines by holding virtual town hall sessions on topics. These sessions could cover topics such as how the National Pharmaceutical Regulatory Agency decides which vaccines are suitable for Malaysia, the difficulties that middle-income countries like ours face in bidding for these vaccines, the steps being taken to rope in the private sector in the delivery of the vaccines to the public, and the strategy of the government to allay vaccine hesitancy.

We have a smart and articulate minister in charge of vaccine procurement. He would be able to handle these town hall sessions. Put up the answers to the participants’ questions on a website so that more people get to understand the process better.

We are in a difficult situation. Lives are being lost and livelihoods destroyed. We are at war with the virus, and right now we are on the receiving end!

We need a whole-of-society approach to get through this challenging period. The government needs to do its part to clear swirling doubts. The people need to be more vigilant to separate fact from fiction. Let’s work together to get everyone safely through this crisis.    

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