Thailand's murky jab considerations

Thailand's murky jab considerations

A healthcare worker poses with a vial of the Oxford/AstraZeneca coronavirus (Covid-19) vaccine at the Pentland Medical Practice, in Currie, Scotland yesterday. (Photo: AFP)
A healthcare worker poses with a vial of the Oxford/AstraZeneca coronavirus (Covid-19) vaccine at the Pentland Medical Practice, in Currie, Scotland yesterday. (Photo: AFP)

Thailand is off to an unpromising start in 2021. As the global coronavirus pandemic rolls into its second year, much of the country is gripped by a new wave of Covid-19 infections after nearly nine months of minimal cases. As case numbers have more than doubled in recent days, the fresh wave has revealed the gross incompetence and corruption among Thai authorities. More alarmingly, while other countries are seeing light at the end of the Covid-19 tunnel with expanding vaccination, Thai people's vaccine accessibility and affordability appear murky.

As is widely known, the fresh wave of Covid-19 infections came from border areas between Thailand and Myanmar. When Myanmar's case numbers spiked suddenly from late August, the Thai border security management needed to tighten and become more vigilant. But the opposite happened. Both immigration police and military forces in charge of the long porous borders reportedly allowed selective entry in exchange for bribes and commissions. When infections began to spread from illegal gambling dens around the country, we then learned that Thai police have allowed this vice to operate for a fee.

The systemic corruption among Thai security and police forces is endemic, and not surprising news. What is different this time is its connection to the pandemic and the amplified scrutiny that accompanies it. What is worse than in the past is the sense of impunity and lack of accountability in the face of corruption and incompetence.

Bad Covid-19 news and unaccountable structural graft are just the start to the longer-term challenges of pandemic management and vaccination. According to Fitch Solutions, an international research firm, Asian countries that can vaccinate their priority populations, such as the elderly and healthcare workers, are likely to roll out in three groupings, first by June, then September and thereafter. The first group includes China, Singapore and Malaysia, whereas Thailand appears to be in the third group, able to provide jabs to its frontline segments towards the end of 2021.

As more than 37 countries are beginning their vaccination campaigns, Thailand's strategy is still inchoate. Prime Minister Prayut Chan-o-cha has just announced a timeline to inoculate two doses for each of 100,000 most vulnerable Thais in February, adding another 900,000 people in the following two months. The big bet is a plan to vaccinate 13 million Thais, using 26 million doses, in May, sourced from AstraZeneca and Oxford University. And then the prime minister mentioned another 35 million doses for 17.5 million people thereafter from international sourcing as well as local production by Chulalongkorn University's faculties of medicine and pharmacy.

Headline news in the Thai press over the past week have indicated that Thailand has already begun manufacturing the vaccine. If this is true, the prime minister should have confirmed it in his announcement. Thais have also been asked here and there to donate 500 baht towards vaccine purchase but the prime minister confirmed that the government will provide 70 million doses, enough for 35 million Thais, free of charge.

Moreover, the initial doses in February–March will come from China's Sinovac Biotech, whose Sinovac Life Sciences recently received a 15% investment worth US$515 million (15.4 billion baht) from the Hong Kong-listed CP Pharmaceutical Group, a subsidiary of the Charoen Pokphand Group. Yet the biggest player in Thailand's vaccine considerations appears to be the crown-affiliated Siam Bioscience, which is apparently the main agent in procuring, manufacturing and administering the much-sought-after Covid-19 antidote. The government has stated that Siam Bioscience eventually will be able to come up with some 200 million, although the precise timing of this prospect is unclear.

However it turns out, it seems clear at this point that Thailand is well behind in the global vaccine hunt. The Thai government should have mapped out a strategy since the country's first wave, using its diplomatic resources and all leverage available to source and purchase the vaccine from the most promising candidates, not just AstraZeneca but also market-leading Pfizer and Moderna's 95% efficacy.

According to Prime Minister Prayut's timetable and number of doses, it is unclear if inoculating just 45% of the Thai population will achieve the critical mass to keep the coronavirus at bay. International experts on the subject have suggested a 60% threshold to reach herd immunity for a given population.

Amidst the confusion and controversy, the Thai people seem to be vulnerable pawns in a vaccine game. There are false insinuations that Thailand has produced or will soon produce a viable vaccine. Unless this is true, the government should state clearly that there will be no original vaccine from Thailand, only licensed manufacturing from foreign producers, such as AstraZeneca and Oxford University. It would further allay public concerns if the government can also tell us a clear process and credible timetable for such local manufacturing of other countries vaccines.

It is irresponsible and dangerous to suggest that local entities have or will come up with Thailand's own vaccine. Vaccination delays can come with huge costs later on. For example, Thai students and businesspeople may require a longer wait to travel because other countries will have been more widely vaccinated and protected.

The best bet is to buy it, and the government should foot the bill. At 500 per jab, for a 60% threshold of 42 million out of 70 million Thais, the cost would be roughly 21.5 billion baht. Even doubling the price or increasing the herd threshold to 70%, the marginal cost would be a mere fraction of the Thai government's 3.3 trillion baht budget. The huge increase in discretionary budget expenditures of more than 600 billion baht, for example, could be used to easily cover vaccine costs. As it has used taxpayer money on less urgent projects, such as submarines and other military hardware, the Prayut government should not be asking Thais for donations.

Thailand's vaccine strategy should also be hedged and diversified. As Sinovac's product went through less rigorous clinical trials compared to Pfizer-Moderna and AstraZeneca-Oxford University, we should reach out to the latter two and procure more doses. Thailand's private healthcare sector should also be allowed to enter the vaccine market. Those who can afford, and perhaps others with government subsidies, should also be able to seek vaccine available.

Thailand's vaccine strategy needs clarity and communication. It should not be about who gets credit for public health and safety but more about the Thai people's right to an antidote that can move them past this terrible pandemic quickly for their own and the country's prospects and well-being.

Thitinan Pongsudhirak

A PROFESSOR AT CHULALONGKORN UNIVERSITY

A professor and director of the Institute of Security and International Studies at Chulalongkorn University’s Faculty of Political Science, he earned a PhD from the London School of Economics with a top dissertation prize in 2002. Recognised for excellence in opinion writing from Society of Publishers in Asia, his views and articles have been published widely by local and international media.

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