Precarious predicament of vaccine procurement

I was talking to public health expert Abul Jamil Faisal on Friday morning. I pointed out that while the coronavirus spread in India had reached alarming heights, in Bangladesh the number of cases and deaths were both on the decline. Was this a sign of hope? In reply he said, “I don’t see anything hopeful in this. The rate of infection is less because there are fewer tests. Most of those taking the tests are persons going overseas or job applicants. They are healthy persons, just having to test out of institutional compulsions. In an area if one person died of corona and then all the persons of that areas had to test for corona, then it could be ascertained whether the situation was actually hopeful or not.”

This public health expert raised another concern. The manner in which we have opened up everything ahead of Eid, the situation may suddenly take an alarming turn. So, I asked, what is to be done? He said, the first thing is to strictly follow the health and hygiene rules. Secondly, as many people as possible must be vaccinated.

It is the responsibility of each and every citizen to follow the health protocol. One must not only safeguard oneself, but also be alert so as not to infect others.

Vaccines are basically the government’s responsibility. Once the vaccines are procured and distributed, then the people can be told to get vaccinated, to be registered. But how to get the vaccine?

According to the Directorate General Health Services (DGHS), 3,313,424 (33 lakh 13 thousand 424) persons have been given the second dose of the vaccine. And 5,819,854 (58 lakh 19 thousand 854) have been given the first dose. And till now,7,248,829 (72 lakh 48 thousand 829) have registered for the vaccine. There is no guarantee when those who have newly registered will get their shots.

When the vaccination drive began in February this year, the policymakers quite loudly declared that even many developed countries hadn’t started the vaccinations. Bangladesh had managed to do so. This was a great success of the government. But within three months, the vaccination drive fell into uncertainty. The government had aimed at vaccinating 80 per cent of the population. If the country’s population in 170 million (17 crore), then 80 per cent means 136 million (13 crore 60 lakh). If everyone was to be given two doses, that would require 272 million (27 crore 20 lakh) doses in total. Bangladesh has received only 13 million (1 crore 3 lakh) doses so far, some purchased and some received as gifts.

India’s Serum Institute, which is supplying the vaccine to Bangladesh, has said that they will not be able to supply the vaccine at present due to restrictions imposed by the Indian government. When the corona outbreak took on serious proportions there in April, the Indian government placed prohibitions on export of the vaccine. As so the 7 million (70 lakh) doses sent by Serum and the 3.3 million (33 lakh) doses received as a gift, are all so far.

Meanwhile, the government has halted giving the first dose of the Covid vaccine. Those who have already taken the first dose are now being given the second one. According to Prothom Alo reports, there is no guarantee that over 1.3 million (13 lakh) of those who received the first dose, will be able to get their second jab.

Initially Beximco Pharma, the distributors of the vaccine in Bangladesh, was making loud protests against Serum Institute, but now they say there is nothing they can do. It is the government that has to make an effort. From two months back Bangladesh and India have been exchanging letters on a diplomatic level, but to no avail. Finance minister AHM Mustafa Kamal has said if Serum does not provide the vaccine, it is obliged to reimburse the payment. What will we do with the money? We need vaccines.

The government has stepped up efforts to procure the vaccine from three other sources – China, Russia and the US. The US will be able to provide the AstraZeneca vaccine. The vaccines of China’s Sinopharm and Russia’s Sputnik-V are different brands. Experts say that those who have had their first dose of AstraZeneca vaccine, cannot use a different brand for the second dose. So will they have to take two doses of the new vaccine. Abu Jamil Faisal said, the second dose must be given within 8 to 12 weeks of the first dose. That means there are four more weeks in hand. In the meantime, if Serum Institute doesn’t send the vaccines or the AstraZeneca vaccine can’t be brought in from the US, then the persons who have taken the first dose will be in trouble.

According to a Prothom Alo report, there is a non-liability clause in the tripartite agreement for the vaccines signed by Serum Institute, the Bangladesh government and Beximco Pharma. That means if any party faces damages due to indirect causes or special circumstances, no one will be held liable. According to the agreement, 30 million (3 crore) doses are to be supplied within six months. Advance payment has been made on 15 million (1.5 crore) doses. But in February and March, Serum provided 7 million (70 lakh) doses. Arrival of the vaccines has been held up since then.

The three sources from which Bangladesh is now trying to get the vaccines, are geopolitically in conflict which each other. The US will not be pleased at contracts being signed with Russia or China. Also, India will not be pleased with Bangladesh taking up the Chinese initiative. China from a long time back has proposed vaccine testing and supply to Bangladesh. But Bangladesh did not take up the offer in fear of incurring India’s displeasure. The government was so thrilled at signing the deal with Serum Institute that it did not look for any alternative sources. The people are having to pay for the government’s gaffe.

Procurement of the vaccine is now no longer just a business deal. Whether Bangladesh will be able to speedily procure vaccines from the three other sources and whether it will be possible to persuade India to lift its embargo on vaccine exports, all depends on geopolitical calculations as well as our skilled and astute diplomacy.

* Sohrab Hassan is joint editor of Prothom Alo and a poet. He can be contacted at sobrabhassan55@gmail.com

*This column appeared in the print and online edition of Prothom Alo and has been rewritten for the English edition by Ayesha Kabir