What happens to our vaccination programme?

Bangladesh administering about 9.9 million doses of vaccine, comparatively fast, may sound impressive. Yet, these doses so far have helped vaccinate less than 2.5% of the country's population, and only about 3.54% received at least one shot. 

After Serum - our only source - stopped sending us vaccines, Bangladesh is now set to receive 110,000 doses from China, and 106,000 doses from Pfizer, courtesy of COVAX, the global vaccine initiative.

As Bangladesh had to stop giving the first dose of vaccine on 26 April and later had to discontinue registration for vaccination altogether, the country is in a precarious position. So, we explored what the public health experts believe caused this predicament and what could be our way forward.

The experts we spoke to mentioned several reasons why our vaccination programme suffered such a blow.  If we summarise them,  it includes putting all eggs in the same basket, not engaging public health experts into the vaccination drive, moving ahead without a proper strategy etc. 

"Vaccinating 160 million people is like a marathon race, but Bangladesh began it like a 100-meter race. It was not the right approach; it needed a certain tempo and a flow. People have to be convinced to take vaccines. It was supposed to be a long-term goal. But we didn't take the long route," said Taufique Joarder, president of Public Health Foundation Bangladesh.

So, what now? How can Bangladesh stand up on its feet again and resume a smooth vaccination drive that ensures our vulnerable population gets the vaccine shots sooner? In this article, we explore the possible routes that can lead us out of the current crisis. 

Securing alternative sources for vaccines

"By deciding to rely only on Serum, we put all our eggs in the same basket. So, it was destined to backfire. It was a predictable textbook case of a failure that could have been avoided as public health experts have been vocal from the beginning," Joarder said. 

However, in the wake of the Serum crisis, the government sought assistance from the US, the UK, China, and Russia. Although the Westerners are quiet to our calls so far, China and Russia have responded positively. 

The government has sanctioned the purchase of the SinoPharm vaccine, authorised the usage of the Russian vaccine, Sputnik-V, and emergency usage of Pfizer vaccines. 

Australia can be another important source as the country has a low infection rate and a surplus of the AstraZeneca vaccine. Besides, Thai pharmaceutical giant Siam Bioscience has upgraded a plant and has built a partnership with AstraZeneca to produce vaccines. 

Bangladesh should seek all the possible sources for vaccines so that all our eggs do not remain in the same basket. 

Try home production? 

Currently, the most discussed issue in global vaccine diplomacy is the waiver of patents for Covid-19 vaccines. Since Joe Biden has thrown his weight behind this, it has gained significant traction. 

But vaccine production is a complicated procedure, and not all countries will be able to produce doses correctly. Russia proposed to produce its vaccines in Bangladesh in collaboration with local pharmaceutical companies, even though this has not materialised yet. 

Even before that, Beximco had proposed to manufacture the AstraZeneca vaccine in our country. The company reached out to AstraZeneca but did not get permission. Also, Renata Limited has offered to produce the Moderna vaccine domestically. 

Firstly, our government needs to be far more vocal and proactive about the waiver of patents. Bangladesh has reasonable credibility in the international community, and it is high time we used it.

Bangladesh has a burgeoning pharmaceutical sector with great potential. But producing vaccines in the country will require a large investment, and companies are not likely to make that if they do not believe it will be profitable. 

The government should try to incentivise or even invest in reducing the risks of investments.  These companies will have to prove that given the authority and right technology, they will be able to produce flawless and high-quality doses. 

Investment and strict supervision from the government can lead the way to build confidence. The aforementioned Thai vaccine plant is an example that these companies are willing to increase their production capacity by entering into partnerships.

Developing the Moderna vaccine is more complicated as it needs to be stored in sub-zero temperature, which is not possible outside of Dhaka. Taking steps to build storage facilities, showing commitment and willingness to go above and beyond to produce vaccines safely from the government end is important. 

Bangladesh has only vaccinated less than 2.5 percent of its population, with approximately 3.54 percent receiving at least one shot. Source: Reuters

Delaying the second jab

Delaying the second jab is now recommended. Bangladesh gave out its second doses of the AstraZeneca vaccine after eight weeks of administering the first dose. 

But the UK is currently administering its second dose at a 12 weeks interval. Researchers from Oxford University have proven that their vaccine can be effective even at a 16-week interval. 

Under the current system, the country will run out of doses in a week. This will give the Bangladeshi government more time to pool doses from other sources and allow them to restructure their distribution process and look into alternative sources. 

Participating in clinical trials

It may seem like the vaccine development process has stopped, but in reality, it is still going on for multiple variants of the Coronavirus, including a Pfizer vaccine tailor-made for children. 

These companies are required to conduct a large-scale trial for their vaccines to get approval. Countries like Qatar, Chile, Brazil and South Africa have hosted clinical trials in their respective countries to get preferential access to vaccines. 

Israel has secured doses from Pfizer by allowing them access to clinical data of their citizens, essentially functioning as a national clinical trial. 

However, Israel has been able to accomplish it due to its digitised health records. Bangladesh does not have such an overarching infrastructure, but it certainly can create one, demonstrated by the successful voter registration process in our country. 

This will entail significant government spending, but it will not only be a mechanism for procuring vaccines, but it will also work in the future as a national health database. 

Diplomatic options 

There has been significant pressure on the West and pharmaceutical companies to ensure equity of access to vaccination across the globe. Bangladesh can be the face of this effort and lead the charge. 

It has not received the 10 million doses promised by COVAX by May. Other countries like Pakistan are also in the same boat and can be potential partners. 

Our country has a record of effective collaboration among the less developed countries. This will raise support for patent waiver and put pressure on Western countries to donate vaccines to the third world. 

Vaccine diplomacy is an intricate and complicated web of geo-political and financial actions. 

While the  West is busy ensuring sufficient doses for their citizens, countries like Russia, China, and even India have used vaccines to demonstrate soft power. But opportunities are still there. Capitalising on them will be crucial to secure vaccination for the nation and initiate a return to normalcy. 

Readus Salehen Jawad is an undergraduate student at the Department of Economics, University of Dhaka.

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.