Short-sighted Thai vaccine plans
published : 2 Apr 2021 at 04:00
newspaper section: Oped
In a rush to reopen its economy and hard-hit tourism industry after more than a year of Covid-19 doldrums, Thailand has come up with misguided priorities in vaccine allocation and distribution. As vaccine rollouts in other countries appear structured and methodical based on objective criteria, Thailand's early approach is decidedly subjective and arbitrary in favour of economic interests over public health risks. Unless this direction is corrected and rebalanced, the risks to public health will mount and could end up undermining the economic recovery.
Not long ago, the balance of risks was the reverse. Thailand went into a hard lockdown in late March last year and remained vigilant for the rest of the year. The twofold results were very low case and death numbers and a deep economic contraction. Back then, the goal was to keep Covid-19 down and out at all costs.
By late December, when the second wave emerged, the Thai authorities took a different tack and chose to live with the virus while imposing severe restrictions without another mandatory lockdown. The mixed outcome has been moderately higher infections while economic activity was gradually allowed as restrictions were eased. The jury is out on whether the current approach of living and putting up with the virus while minimising casualty numbers would have been the better way to handle matters last year. As just about all economies were adversely affected by the pandemic, the Thai government and public health authorities deserve credit for managing the virus stage in a way that enabled the people to maintain a relatively normal lifestyle inside the country under dire circumstances around the world.
The vaccine stage now looks very different, however. Thailand's health authorities and cabinet ministers in charge made an early bet last year by banking on one procurer by way of Siam Bioscience and one supply in the AstraZeneca Covid-19 vaccine, supplemented by China's Sinovac jabs for a smaller number of people. This one-horse bet is costing Thailand dearly as the country's vaccine rollout appears comparatively slow and uncertain.
The Thai public is repeatedly told that the palace-linked Siam Bioscience is well-equipped to manufacture the AstraZeneca vaccine under licence, that millions of doses have actually been produced and are ready to roll as soon as the required approvals come through. An official timetable with monthly inoculation numbers has been laid out to suggest herd immunity of around 60% of the 70-million population will be achieved by year-end.
Yet there is no sign of the locally manufactured AstraZeneca vaccine after the first quarter of 2021. The AstraZeneca jab itself has become problematic for reportedly causing blood clots. A number of European countries and beyond have suspended its use. As a result, Thailand is stuck with a procured vaccine which has yet to hit the ground and whose performance is under global health scrutiny.
Clearly, it would have been smarter to bank on all major vaccines in their early stages of development. For Siam Bioscience as the procurer, vaccination has become politicised when an opposition politician questioned the whole AstraZeneca deal and was consequently slapped with a lese majeste charge under Section 112. This means the Thai people are just supposed to take it on good faith and at face value that the vaccines will be produced and become available in time. If so, then to whom the AstraZeneca vaccines will be given first and in what order for the rest of the population are now in question.
In other countries that have rolled out vaccines with noticeable success, priorities are given to health criteria. Groups with health risks based on age and underlying health conditions are ranked the highest on the vaccination totem pole.
According to ourworldindata.org, Gibraltar leads the world with 92% of its population inoculated as of this week, with Israel second at 60%. No longer required to abide by European Union standards, the UK ranks as the world's third most vaccinated country per capita at 46%, while the EU average is much lower at 11.6%. The US, which fared poorly in the virus stage, is having a successful vaccine distribution at already 30% of its population.
In Asia, Singapore tops the chart at about 16%, while Asia averages around 2%. With its huge vaccine manufacturing capacity, India stands higher than the region's average at about 4%. Thailand, on the other hand, is among the lowest and slowest, with just 0.14% as of a week ago.
Factors such as size are crucial to the rapid rollouts in Gibraltar, Israel, and Singapore. While the ability to produce its own vaccine outright in the US, UK and China or under licence as in India certainly plays a critical role, a clear strategy of prioritisation is just as important.
For example, Israel's rapid vaccine rollout is due to priority criteria that target individuals with the highest risk of death and hospitalisation, and those with frequent contact with infected people. Israel defined four broad groups for its vaccine distribution that are aged 60 and over or with pre-existing conditions, apart from nursing home residents and front-line health workers. The UK and Singapore's vaccine access criteria are similar.
Yet in Thailand priority is being given to economic interests and targeted industries, particularly tourism. The notion of "social and national security" has also been mentioned as the selection basis. If Phuket and Samui can be designated as priority provinces as tourist attractions, why not Pattaya, Rayong, Hua Hin, and Chiang Mai? Every province in Thailand has dubbed itself a tourist attraction because of the government's official promotion.
The chief lesson from other countries going through vaccine rollouts is that public health and risks to lives are paramount. Also, for countries that are unable to manufacture vaccines, multiple suppliers are a must.
The Pfizer and Moderna jabs, for example, have proved to be the most appealing so far. Finally, vaccine access has to derive from objective and balanced criteria based on the sanctity of human life, and not be subjective and arbitrary based on tourists and a quick baht.
Doing the vaccine rollout right will ensure and better sustain a longer-term economic recovery. Distributing the anticipated jabs with short-sightedness and vested interests is likely to be counterproductive in the long run.
Pavida Pananond, PhD, is a professor of International Business at Thammasat Business School, Thammasat University, and Thitinan Pongsudhirak, PhD, is professor at the Faculty of Political Science and director of its Institute of Security and International Studies at Chulalongkorn University.