KUALA LUMPUR, Oct 9 — The first round of Covid-19 vaccines from COVAX for Malaysia will only cover three per cent of the population, which the government intends to give to frontliners and the most vulnerable, said Khairy Jamaluddin.
People aged above 60 years or who have underlying medical conditions, like diabetes, lung or heart disease, or conditions that affect their immune system, are more likely to develop severe disease from Covid-19. About 18 per cent of Malaysian adults have diabetes.
The science, technology and innovation minister said as a middle- to high-income country, Malaysia will not get any subsidy or financial assistance from the global Covid-19 vaccine access plan, co-led by the World Health Organization (WHO); the COVAX facility allows governments to purchase vaccines to cover up to half their population.
“If you go for optional purchase and decide to immunise 10 per cent of your population, just the down payment alone is going to be RM90 million,” Khairy told The Star in a virtual interview yesterday.
“You’re talking about a big commitment here. So, obviously, cost is an issue.”
In COVAX’s optional purchase agreement, countries can decide whether to buy any approved vaccine allocated to them, while retaining the ability to receive its full share of doses of other approved vaccines, subject to supply availability.
“Don’t expect that once a vaccine is approved, Malaysia buys, we’re going to get 30 million doses on day one. It comes in stages,” Khairy said.
He added that he has asked the finance minister to set aside a few billion ringgit in the federal budget next year for a Covid-19 vaccine. Budget 2021 is scheduled to be tabled in Parliament next month.
Khairy also said that although the deadline for advance payments to reserve Covid-19 vaccine doses with COVAX is today, based on his discussions with COVAX, the facility will not shut its doors to any countries after the deadline.
Hence, he said that Malaysia is still in negotiations and discussions with COVAX.
According to the Global Alliance and Vaccine Immunization’s (Gavi) list of participating countries, Malaysia has not been listed under countries that have signed commitment agreements or under confirmations of intent to participate in the COVAX facility, while countries like Brunei, Japan, Singapore, and Australia among others have already signed commitment agreements.
A Gavi spokesperson told CodeBlue that the list on Gavi’s website is being updated in real time: “If the country isn’t yet on the list, means the commitment agreement hasn’t come through.”
The Gavi spokesperson also said that certain countries have requested additional time to submit their agreements, hence Gavi is working with these governments to ensure they receive the agreements as soon as possible. COVAX is led by Gavi, WHO, and the Coalition for Epidemic Preparedness Innovations.
COVAX is a pool procurement mechanism, whereby higher income countries will finance the Covid-19 vaccines from their own national budgets, while 92 low- and middle-income countries will receive financial support to access the vaccines. COVAX aims to have two billion vaccine doses available by the end of 2021.
The Gavi spokesperson also told CodeBlue that COVAX is expecting the upfront payments from countries who have submitted commitment agreements to arrive by mid-October, as the facility is entering negotiations with vaccine manufacturers and developers for the doses requested through the agreements.
Furthermore, Khairy highlighted several issues with regards to the COVAX facility — issues with negotiations with pharmaceutical companies that are entirely done by the COVAX facility, tax payments, indemnities, transportation cost, and liability. However, he said that he can only speak of these issues in general themes as COVAX has insisted on confidentiality of the terms.
Khairy also said that he has been discussing COVAX with the Ministry of Finance (MOF), the Ministry of Health (MOH), Health director-general Dr Noor Hisham Abdullah, and he has even presented it to Prime Minister Muhyiddin Yassin twice.
“We obviously want to still intend to join as this is also bulk purchase, global solidarity, but the terms have to be fair to the countries who decide to join.”
Recently, AP reported a WHO executive board member, Clemens Auer, as saying that that COVAX plan is not transparent on how it will work. Auer claimed that WHO never consulted any countries about its proposed vaccine strategy. It is to be noted that countries like the United States and Russia have not expressed intentions in joining the COVAX facility.
A global health law professor at Georgetown University previously said that COVAX will not have the financing and political muscle to assure global equity, with major countries like the US and China sitting on sidelines.
China announced earlier today that it has officially signed an agreement to join COVAX, making it the biggest economy to back the WHO-led vaccine plan.
First Vaccine Dose May Be Free, Subsequent Doses May Not
Khairy mentioned that many pharmaceutical companies themselves are unable to tell how long the vaccines they are producing will last and if a booster dose may be required .
Hence, he said that maybe, the first round of immunisation will at least be free, but subsequently it may not. However, he said as a science minister, his recommendation is for free vaccines for the public’s good.
He stressed that there is limited data on the Covid-19 candidate vaccine to come up with numbers to decide on the percentage of the population to be vaccinated to achieve herd immunity.
Bilateral Agreements
According to Khairy, the COVAX facility only allows governments to get vaccines to vaccinate up to 50 per cent of the population, hence the government still has to make bilateral agreements to procure a vaccine.
Khairy said that the government has signed non-disclosure agreements with many pharmaceutical companies, is in the process of finalising a memorandum of understanding with China, and is trying to have government-to-government agreements of understanding to secure a supply of vaccine once it is approved.
The minister also said that many countries have put down a lot of money for advance purchases and are doing that on a risk basis, as some of the vaccines purchased in advance may not be approved.
“Malaysia — we have to be careful because our financial abilities are not as broad as some of these other countries.”
Khairy said that the cost of the vaccines vary and have a wide range, saying that the range can go from US$5 (RM20.76) per vaccine dose to US$60 (RM249.15).
“For me, it’s worth spending the money, because this is the biggest public health crisis that we’ve confronted in our lifetime.”
Deployment Of Blockchain
Khairy said that discussions are ongoing on how to ensure that one is vaccinated, considering the vaccines Malaysia purchases may be coming from different pharmaceutical companies.
He suggested that an electronic health certificate can be put on the MySejahtera Covid-19 management application and people can prove that they have received the vaccine on a particular date.
Besides that, the government is also hoping to work with other foreign governments to mutually recognise the electronic health certificate to allow people to travel.
Health Risk Communication Around A Vaccine
Since Malaysia, like many other countries, has a robust group of anti-vaxxers, Khairy stressed that public health risk communication around the vaccine is very important.
He is in discussion on how to communicate with the public so that they are confident to get the vaccine.
Khairy said that assuming phase three clinical data of candidate vaccines come out in November or December, and the regulatory process will be in a couple months after that, following which, there will be the production of the vaccine somewhere around the middle of next year, communication with the public on the vaccine should be started by December.
