Vaccine Announcement Gives Malaysia Head Start, But Hurdles Are Significant — Galen Centre

We need to review the Budget 2021 allocations, especially those related to Covid-19 vaccination activities. It involves more than just the cost of the vaccine, but also the supporting infrastructure.

Yesterday’s news that the government has signed its first vaccine preliminary purchasing agreement with US pharmaceutical manufacturer Pfizer for 12.8 million doses of the Pfizer-BioNTech Covid-19 vaccine is a remarkable development but has implications to the ongoing Budget 2021 discussions.

This welcome news represents a major leap forward in the race towards improving the management of the coronavirus epidemic among the Malaysian population.

It certainly gives a boost of confidence. In the coming year, at least 20 percent of the population or 6.4 million Malaysians will have access to this two-dose regimen vaccine while another 10 percent can expect to benefit from a COVAX initiative vaccine.

However, this is a marathon and this is only at the first leg of the race.

The Covid-19 vaccine by Pfizer and BioNTech, which is a two-dose regimen like most of the leading vaccine candidates, is expected to be priced at US$19.50 per dose. This would mean that Malaysia has committed to paying an estimated US$249.6 million (RM1 billion) for 12.8 million doses.

However, the investment is worth it if we are able to prioritise and quickly assure the protection of our personnel working in essential public services such as in health, law enforcement, sanitation and utilities sectors, as well as those vulnerable, such as the elderly, and patients with non-communicable diseases.

We are also concerned about the logistical burden that will be shouldered by the Ministry of Health. This vaccine requires ultra-cold storage of negative 70 degrees’ Celsius, a capacity which is beyond most existing primary care health care facilities.

Therefore, the reliance will be on the availability of suitable storage units at the state level to ensure that the vaccines’ cold-chain is not interrupted. We expect the most challenging part of the process will be the delivery of the vaccine to rural areas.

Due to limitations and pragmatic concerns, will urban areas end up being prioritised over rural areas? Distributing vaccines in a potent state from the manufacturer to the actual vaccination sites in the community can be extremely challenging, especially when it involves messenger RNA (mRNA) vaccines.

This past decade has seen a significant increase in vaccine hesitancy, particularly among the Malay population. The government must invest in vaccine communication to address and overcome the high levels of widespread misinformation regarding Covid-19 and vaccines in general. It cannot depend on corporate social responsibility initiatives from the private sector for that purpose.

We need to review the Budget 2021 allocations, especially those related to Covid-19 vaccination activities. It involves more than just the cost of the vaccine, but also the supporting infrastructure.

We need to ensure that the Ministry of Health gets the necessary funds and manpower needed to hit the ground running when the vaccines become available in 2021, especially since this vaccine has specific logistical and storage requirements which will require investing in required infrastructure and training.

Are we going to acquire Pfizer’s special ice boxes? Have we allocated for the record-keeping system that will be needed? As it stands, we do not believe that the existing allocations are adequate for this purpose. The health allocations need to be reviewed and increased.

Under the agreement announced yesterday, Pfizer has agreed to deliver to Malaysia one million doses in the first quarter of 2021, followed by 1.7 million doses in the second quarter, 5.8 million in the following quarter and 4.3 million doses by the end of the year. It will be free for all Malaysians, while foreigners will be charged.

Azrul Mohd Khalib is the CEO of the Galen Centre for Health and Social Policy.

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