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[OUTLOOK] ASEAN vaccine solidarity in focus as virus persists

The COVID-19 pandemic must serve as a "wake-up call" for ASEAN's leaders to work collectively toward vaccine security, experts say.

Dian Septiari (The Jakarta Post)
Jakarta
Sat, January 9, 2021

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[OUTLOOK] ASEAN vaccine solidarity in focus as virus persists

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t the ASEAN Summit in Bangkok in November 2019, the leaders of 10 member states adopted a declaration, along with many other documents, on vaccine security and self-reliance, noting concerns that a vaccine shortage “would require a collective determination to address”.

Unbeknownst to the leaders, the 35th summit would be the last time they would all meet in person for an extended period of time, with northern neighbor China informing the World Health Organization just two months later about unidentified pneumonia cases the world would later come to associate with COVID-19.

The virus that causes the disease, SARS-CoV-2, would go on to spread rapidly around the globe, including Southeast Asia, where it has infected more than 1.5 million people and killed nearly 36,000, according to an ASEAN risk assessment report released on Wednesday.

No country was prepared for the unprecedented social and economic disruptions caused by the disease, but the promise of vaccines had become a beacon of hope for wider recovery.

Most governments have pinned their hopes on achieving herd immunity – to get enough people immune to the disease so that it stops spreading – and have joined the race to secure vaccine stockpiles from various producers from around the world.

Looking east and west

The COVID-19 pandemic has further accentuated geopolitical rivalries, especially between the United States and China. In the US, COVID-19 has been dubbed the Chinese virus, while the deepening crisis in the US has been mocked in the second-largest economy in the world according to gross domestic product.

Amid growing concerns that the vaccines could be used as a tool to increase China's global influence, ASEAN countries have negotiated supply deals with both Chinese and Western vaccine producers.

Indonesia has secured a firm commitment of 125 million doses from Chinese firm Sinovac, another 50 million from US-based Novavax and 50 million from the United Kingdom-based AstraZeneca, with another deal with the US-German team-up Pfizer/BioNTech on the way.

Indonesia also expects to acquire vaccine candidates for up to 20 percent of the population through the COVAX Advance Market Commitment (AMC) mechanism, a WHO-backed funding framework that aims to ensure that developing and least-developed countries get access to COVID-19 vaccines.

Neighboring Malaysia has secured 12.8 million doses from Pfizer and is set to secure 6.4 million doses of the AstraZeneca vaccine through the COVAX facility and another 6.4 million directly. It is also in final negotiations with China’s Sinovac for 14 million vaccine doses, CanSino Biologics for 3.5 million doses and for 6.4 million shots of Russia’s Sputnik V vaccine.

The Philippines has secured 2.6 million doses of the AstraZeneca vaccine and expects to receive 30 million doses of Novavax while planning to buy 25 million doses of Sinovac and strike deals with other vaccine producers, including Pfizer and Moderna.

Thailand, meanwhile, plans to get 26 million doses from the COVAX program: 26 million from AstraZeneca and 13 million more from other sources.

Myanmar has signed an agreement with the Serum Institute of India for an unspecified supply of vaccines, while negotiations with China’s Sinovac and Sinopharm are ongoing. The country has also sought arrangements with the US, UK and Russia.

Indonesian foreign policy scholar Dewi Fortuna Anwar said the diversity of potential vaccines being secured in the region should not only be considered as a means to make the country rely less on China, but rather as a practical strategy at a time when COVID-19 vaccine production had only just begun.

“I think it is a matter of securing supplies. Even Sinovac would not be able to meet the need for vaccines everywhere or to inoculate every group of people,” she told The Jakarta Post recently.

Emerging disparity

Dozens of countries are currently rolling out the first stages of vaccination campaigns hailed as the light at the end of the tunnel.

On Dec. 30, 2020, Singapore became the first ASEAN country to begin immunization, using the Pfizer/BioNTech vaccine on healthcare and frontline workers first.

Meanwhile, Indonesia was determined to start its own campaign on Jan. 13 using the Sinovac vaccine even before it firmly secured emergency use authorization.

However, new disparities are emerging as supplies are being snapped up by nations that can afford them.

“We will not be able to produce enough vaccines for 7 billion people overnight, so I think it's natural that countries who can afford it will have started negotiations with vaccine producers,” Jemilah Mahmood, special advisor to the prime minister of Malaysia, said on Thursday.

What is certain, however, is that without vaccination, the economic repercussions cannot be overstated, as investment and tourism won’t flow to the countries left behind.

“They might as well go down a very vicious cycle of not being able to protect the people and expand the economy,” she told the Post in an interview.

Experts estimate that the world can reasonably hope to have around 2 billion doses of effective COVID-19 vaccines by the end of the year if several of the leading candidates prove effective.

With the COVAX facility, concerned nations and global health regulators have tried to address the inevitability of disparity, Jemilah said, with aims to distribute doses for at least 20 percent of signed-up countries' populations.

However, by relying on a mechanism with a limited scope of distribution, it would take some time before large parts of the developing world are protected from COVID-19.

Cost-effective strategy

ASEAN leaders’ prepandemic declaration in 2019 might prove a good starting point for an implementable plan toward regional vaccine security, observers have said.

The declaration was the result of a series of workshops advocated by the Thailand-based National Vaccine Institute (NVI) between 2014-2015. They recommended that ASEAN pursue a systems-based development approach to vaccine security, human resources, pricing policy and coordination and communication.

However, much more could be achieved as a collective.

“I think there has to be a commitment from the leaders to turn that into a reality, whether it's a funding, procurement or research mechanism. I think that really pushing ASEAN to play that multilateral role [is necessary] because it's still quite bilateral in most cases,” Jemilah said.

The bloc already missed an opportunity to negotiate vaccine supplies collectively in order to ensure equitable distribution in the region, with the global health expert pointing to what other organizations such as the European Union have done.

“It would have been good for ASEAN as a region to see how it [could] protect its own people and what vaccine diplomacy was required, what kind of solidarity and collaboration that could have resulted,” she said.

The EU has kept prepurchase order negotiations with vaccine producers confidential as part of a collective strategy to get the most cost-effective results.

By negotiating on behalf of and in coordination with the EU's 27 member countries, "it reduces cost and it gives us a stronger negotiating position", the bloc’s commissioner for health, Stella Kyriakides, argued as quoted by AFP.

On Friday, the EU struck a deal to double its supply of BioNTech/Pfizer vaccines to a total of 600 million doses.

As the WHO pointed out at the end of 2020, the COVID-19 disease might not go away any time soon and it could even end up becoming endemic, which means that despite mass vaccination campaigns, countries need to think of a long-term strategy on how to live with the virus.

“I think this should be a little wake-up call to ASEAN to have its own centers for disease control, […] so that not only are we good at [detecting] signs of public health issues but in the future, also look at [collective] vaccine development and research because this pandemic is not going to be the last one,” Jemilah said.

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