Why Has Malaysia Decided To Opt-Out Of The COVAX Initiative?

The decision to opt-out of COVAX undermines the careful and strong reputation for health care excellence that Malaysia has prided itself with. It has the potential to erode confidence in participating and investing in our economy.

It is 18 September and the deadline for enrolment and commitments to the international COVAX project is here.

For some reason not explained or shared publicly, up to the time of this writing, Malaysia has still not chosen to join the 172 countries which have signed on to the COVID-19 Vaccine Global Access (COVAX) Facility, a global partnership that aims to support the development of a vaccine against the coronavirus and share access to it.

In a time when global solidarity and cooperation are most needed, the government has, it seems, decided to take a wait-and-see approach, and has stated that it is not in a hurry to join the international coalition.

It is a baffling and stunning decision, which will have consequences not only in the public health space, but also across international relations, economic markets, and our reputation as leaders in global and regional health. It could even undermine our access to an eventual vaccine.

If Malaysia were to participate, besides being guaranteed access to the largest portfolio of vaccines, we will also be negotiating as part of a global consortium, bringing down prices through economies of scale and pool procurement, and working to ensure fair and equitable access for others who can’t afford the vaccine. Through this approach, countries will also stand the best chance at protecting the most vulnerable members of their populations. This is what the COVAX initiative is all about.

We are all anxiously waiting for a safe and effective vaccine for Covid-19. But it is sometimes difficult to predict which vaccines will be successful. The human body can be baffling. Even when a candidate vaccine produces a positive response in some people, it may result in adverse reactions in others, causing it to fail. In fact, many of the more than 160 candidates will fail.

The best chance of success for any country is to participate in an endeavour which diversifies and broadens access to a broad portfolio of possible vaccine candidates. A form of “insurance”, spreading risk and pooling resources. Something that countries would not necessarily have through multiple bilateral agreements with individual manufacturers.

There is no guarantee that going it alone and making separate bilateral deals will produce better results, in fact it might be a disadvantage. Instead of benefiting from being part of a collective, we might instead be left out altogether and be among the last to get the vaccine.

Going it alone may be possible for larger countries such as the US and China with economies that are able to fund, develop and produce their own vaccines for their own population. It is not a realistic possibility for Malaysia to address our acute needs, regardless of the positive news and spin coming from those pharmaceutical concerns which are expected to benefit.

It would be dangerous for Malaysia to step out of the COVAX umbrella, into an environment where it would be every country for itself.

Make no mistake. National solutions will not and cannot defeat a pandemic of this scale. We need everyone and every country to get onboard and work together. Only then can we ensure that populations can be protected, and borders restrictions lifted so that economies can reopen and rebuild, movement between countries safely resume, families reunited, and life going back to what it was before the outbreak.

The reality is that with a population of 33 million, a limited market size, and a pharmaceutical industry largely catering to the domestic market, Malaysia has neither the political clout nor the economic strength or leverage to carve out a better deal for itself.

Instead, this decision to opt-out will leave this country and its people at a serious disadvantage and with limited options, be at the mercy of a small number of vaccine manufacturers, and lack the advantage of economies of scale to get the best possible price. The deal we end up will unlikely be fair and equitable.

Most of the world’s nations have already joined COVAX, which is co-led by the World Health Organisation, the Coalition for Epidemic Preparedness Innovations, and Gavi, the Vaccine Alliance. The initiative aims to make available three safe and effective vaccines. The 92 lower-income countries would receive enough doses to cover their health workers, and the remaining most vulnerable 20 percent of their population. The other 80 countries, which are high-income and upper middle-income countries, would receive doses based on their financial contributions.

Of course, as an upper-middle income country, if Malaysia participates in the COVAX initiative, it will be expected to make proportionate funding commitments. It is also part of being a responsible member of the international community.

Being involved in COVAX is more than just about the vaccine. It is about being part of a global effort to put into place a transparent, accountable, and predictable framework which is working towards ensuring equitable access to an eventual vaccine. It is also about building confidence in the economies participating in and benefiting from the initiative.

Even Iraq has signed on to not only be a part of this global effort, but to also contribute its share to the funds needed. So why is Malaysia opting to exclude itself from this international effort?

It would be dangerous and self-defeating for Malaysia to flirt with “vaccine nationalism” as an extension of the #kitajagakita approach. We could find ourselves at the back of the line for doses.

This is not to say that we should drop our interests and priorities, but the best result in this public health emergency is for each country in the group to do what is best for itself as well as a collective.

Undoubtedly there are various aspects of COVAX that need to be improved. But that is better done by being in the room and at the table, rather than outside looking through windows.

The response to the Covid-19 public health emergency has repeatedly been described as a marathon, where a long and steady pace and strong and sustained political commitment are needed to get to the finishing line. But this cannot be a race where there are only a few winners.

The decision to opt-out of COVAX undermines the careful and strong reputation for health care excellence that Malaysia has prided itself with. It has the potential to erode confidence in participating and investing in our economy. By denying the benefits that all countries participating in COVAX will possibly receive, the decision poses a direct health and economic threat to Malaysians.

The Covid-19 pandemic is a public health emergency that requires collective solidarity, empathy and cooperation, beyond our borders.

No one is safe until we are all safe.

Azrul Mohd Khalib, is head of the Galen Centre for Health & Social Policy

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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