KUALA LUMPUR, Oct 5 — Malaysia can make bilateral agreements with drugmakers or countries to procure a Covid-19 vaccine, as the global COVAX plan may not be able to meet the needs of the population, health experts said.
Dr Awang Bulgiba, an epidemiologist and public health expert, said that the number of vaccines being offered under COVAX is limited, as many pharmaceutical companies have yet to sign up to the agreement.
“COVAX does not limit any country to vaccines in its stable, thus any country within COVAX is free to pursue bilateral agreements,” Dr Awang told CodeBlue.
The COVAX global vaccine access plan — coordinated by Gavi, an international vaccine alliance; the Coalition for Epidemic Preparedness (CEPI); and the World Health Organization (WHO) — is evaluating nine candidate vaccines for its portfolio in its aim to fairly distribute a Covid-19 vaccine to all countries regardless of their income levels.
Former Health deputy director-general (public health) Dr Lokman Hakim Sulaiman pointed out that in negotiating for a bilateral agreement to procure a vaccine against the coronavirus, Malaysia should not cede national sovereignty.
“Any bilateral agreement will always have political and economic interest in it. Malaysia should never compromise on the national and economic security in any bilateral negotiation,” Dr Lokman told CodeBlue.
A 2006 study showed that there is potential to expand global health activities through partnerships with security and foreign policy communities. Treating global health issues as national security threats, however, may focus disproportionately on security threats on wealthier nations, rather than threats to global health issues itself.
The study called for scrutiny of the overlaps between global health and national security interests as without such scrutiny, there is a risk that global health will be reduced to a bit player on the grand stage of power politics.
China was claimed to turn its health crisis — where Covid-19 was first discovered — into a geopolitical opportunity by dispatching supplies to countries hit hard by the coronavirus. China is in the process of making bilateral agreements with countries like Indonesia, Philippines, and Brazil to give them priority access to a Covid-19 vaccine that is being developed in China.
“These actions must be placed in the context of both China’s economic interests and its exercise of soft power,” Lidya Christin Sinaga, international relations expert at the Jakarta-based Indonesian Institute of Sciences, wrote on Financial Review last August.
Furthermore, Dr Lokman said that the Malaysian government has to decide if the Covid-19 vaccine should be included in the National Immunisation Program (NIP) and therefore, decide if it should be free to a targeted public, subsidised, or paid by people out-of-pocket.
“All these must be considered before you decide how much vaccine to procure.”
Health systems and policies specialist Dr Khor Swee Kheng told CodeBlue that joining COVAX is just the first step and the government should regularly inform the public about their next decisions, including other legal arrangements that are being made by the government.
“Information should be regularly provided for the funding, for example, the pricing structure — where the funds are coming from and implications for Budget 2021,” Dr Khor said. The federal Budget 2021 is scheduled to be tabled in early November.
Although the Ministry of Science, Technology and Innovation announced last September 19 that Malaysia would join COVAX, Minister Khairy Jamaluddin said last Tuesday that the COVAX Facility’s procurement model was “quite extraordinary”, as it required advance payments even before a safe and effective vaccine had been found.
According to CodeBlue’s calculations, Malaysia would be required to make payment of US$135.04 million (RM558.46 million) by October 9 to vaccinate 20 per cent of its population (6.4 million people) on a two-dose regimen through COVAX, comprising a down payment of US$20.48 million (RM84.7 million) and financial guarantee of US$115.46 million (RM473.76 million). This payment, under COVAX’s Committed Purchase arrangement, is based on an all-inclusive price of US$10.55 (RM44) per dose, or US$21.10 (RM88) per person.
COVAX’s all-inclusive price of US$10.55 per dose of Covid-19 vaccines is nearly seven times cheaper than China-owned Sinopharm’s experimental coronavirus vaccine at US$72.50 per dose. Participating countries in COVAX — which are buying the Covid-19 vaccines from their national budgets — must make upfront payments and financial or risk-sharing guarantees by this coming October 9 to reserve vaccine doses.
Khairy said Malaysia was in direct discussions with other international pharmaceutical companies without having to go through COVAX, besides attempting to expedite agreements with China on a coronavirus vaccine.
The science, technology and innovation minister later clarified that the Malaysian government was still negotiating with COVAX coordinators, stressing that the terms and conditions must be “fair” to Malaysia.
Science, Technology and Innovation deputy minister Ahmad Amzad recently told the Dewan Negara that Malaysia has expressed its intention to work with the Chinese government through biotechnology and pharmaceutical companies Sinovac Biotech and Sinopharm respectively, to secure a Covid-19 vaccine.
On top of that, MOSTI has also signed a Letter of Intent (LOI) to the Russian Embassy to obtain more information on their Sputnik V vaccine besides signing a LOI with the Cuban Embassy to express a desire to collaborate with the Finlay Vaccine Institute (BioCubaFarma) and the Centre of Genetic Engineering Biotechnology (CIGB), Cuba.
MOSTI has also discussed with the Imperial College London on a potential collaboration on their Phase Three clinical trial and with the National Vaccine Institute of Thailand for a vaccine development joint venture on a Covid-19 vaccine.