COVID-19 vaccine supply realities

During the weekend, the first officially available supply of vaccines arrived from China. These were Sinovac vaccines, which according to reports, amount to 600,000 doses. The government immediately began vaccinating the day after delivery.

The news report that the initial supplies were donated by China, for which our President is very thankful to the Chinese president. Presumably, this augurs well for the future contracting of new supplies on commercial basis.

Slow start in vaccination. It should be stated at the outset that the supply that we have at our disposal for immediate use is limited. The government has been behind the curve in getting supplies, unlike other countries under the same economic circumstances.

This is not for want of not trying to undertake supply arrangements. Up to now, there are no contracts of purchase that have been concluded. Why so delayed?

There are presently a number of covid-19 vaccines already approved for emergency use in some countries. The US has the Pfizer and the Moderna vaccines. And only this week the Johnson & Johnson vaccine had been approved, and already the first supplies, destined of course for US destinations, are rolling out.

The Pfizer and Moderna vaccines have now been sent to world markets in limited quantities for those that had ordered ahead of time. The AstraZeneca, the United Kingdom vaccine, is now widely available across countries that had ordered it. The Chinese have several vaccines now in wide use, and so has Russia’s Sputnik’s outside Russia.

Of course, initial supplies are limited. Of course, these go to countries that have already contracted their orders for delivery. The question is why has the government been delayed in finishing any contracts.

All these are rolling out in many countries. Although we are assured by WHO (World Health Organization) of supply from the Covax project facility that is procuring supplies for less developed countries for purchase of the vaccines they need.

Under the Covax facility, the Philippines is reported to have supplies of AstraZeneca committed, but there is no official report from the government of the amount. Unofficial news is that AstraZeneca arrivals are still in the future. There is, therefore, as of now no other vaccine, except the Chinese Sinovac that officially arrived in the country.

The government has resources to acquire vaccine supplies. The budget is buffered by access to multilateral institutions like the ADB and the World Bank, and there is prioritized budget to be spent. But up to now the government cannot report any firm supply contracts for any brand of covid-19 vaccine to the public.

Reported unofficial leakages in supplies that have circulated in the news media have been particularly damaging to the government’s efforts. It shows that dishonest people, including highly placed government officials, have apparently taken advantage of them by having themselves vaccinated ahead of the rest of us.

The problem of vaccination in the country can be broken up into two logistical operations: the procurement of supply for the center and the rollout of the vaccines to the various centers where vaccination is administered, the hospitals, the economic sectors where productive activities have to continue and local governments.

Slow vaccine supply acquisition. The failure to acquire supply of vaccines quickly enough demonstrates the failure of the bureaucracy to adopt quick and focused decision-making concerning this important task.

The command center – the inter-agency task force (IATF) to fight the pandemic – focused most of its efforts on the day-to-day challenges. On many aspects of these problems, the government has undertaken a reasonably impressive effort.

We could give the effort a good pass on overall achievements with respect to taking care of the prevention of deaths and hospitalization through insistence in low tech solutions (such as masks, face shields, lock-down rules). All these measures helped to minimize the burden on healthcare for the nation, considering the presence of difficult challenges in crowded communities, with even more packed housing, difficulties in contract tracing, and so on.

Also, the DOH website provided useful and credible statistical updates. It is also important to commend the spokesperson, the Health Undersecretary (Dr. Maria Rosario Vergeire) who has been a standout in providing daily news briefings that connect well with the general public in simplicity of message as well as sharpness of content.

In general, and given the severe pandemic challenges faced, the government during the one-year of extreme trial has performed sufficiently well in reducing the spread of the disease and in managing the burden on the national health care burden.

But on the problem of vaccine supply, it displayed a very poor performance.

The inter-agency task force could have put together a specialized inter-agency unit to secure the vaccine supply issue. Instead, it acted as if the respective parts of the bureaucracy waited for things to happen, business as usual. Here, Department of Health leadership was surely wanting!

True, there is a vaccine czar appointed. But what is a vaccine czar to do if there is a Secretary of Health, a Justice minister and financial approvals for his act to do. The so-called vaccine czar is not the government.

Not having the wherewithal to produce a vaccine for lack of capacity, wise Health leadership could have pro-actively encouraged participation in trial vaccines of those countries experimenting with them.

That was what some countries, notably Chile, Indonesia, Turkey, India, have done. Those countries positioned their access to early supplies of successful vaccine experiments once these were manufactured and available in scale. Indonesia started its vaccination program with a good supply of Chinese vaccines as early as January this year, for instance. Many countries in Latin America and in Europe have also done this.

The failure of the country to corner the offered contract of supply of the Pfizer vaccine, in spite of efforts made by Philippine Affairs Secretary Locsin and Ambassador to US Romualdez demonstrated the poor work at the home front. An alert task force on the matter could have actively worked to get a decision undertaken quickly. But the DOH passed it to another bureaucrat’s desk where the matter froze. (To be continued)

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