Govt's shambolic jabs plan is 'un-Thai'

Govt's shambolic jabs plan is 'un-Thai'

A health official prepares a Covid-19 shot at Bang Khunthian Fresh Market last month. Despite being lauded for successfully controlling the epidemic last year, the government's vaccination plan faces growing criticism for its overreliance on the AstraZeneca jab. (Photo by Apichart Jinakul)
A health official prepares a Covid-19 shot at Bang Khunthian Fresh Market last month. Despite being lauded for successfully controlling the epidemic last year, the government's vaccination plan faces growing criticism for its overreliance on the AstraZeneca jab. (Photo by Apichart Jinakul)

The government's planned procurement and distribution of Covid-19 vaccines has become a saga that keeps circulating in news headlines. For much of last year, Thailand was lauded worldwide for its ability to contain the Covid-19 virus. But as the coronavirus pandemic increasingly moves from the virus stage to vaccine procurement and mass inoculation, Thailand faces a double whammy with a virus surge and vaccine scarcity. Unless the government changes course quickly, it risks gambling national health and local lives for what looks like a shambolic vaccine strategy.

To be sure, the government's vaccine plan so far appears patently "un-Thai". Thailand's outward orientation has congenitally been diversified. This is a country that almost never puts its eggs in one basket, always hedging among multiple sides and having alternative sources and solutions. In foreign relations, the Thai approach -- not exclusive to Thailand but it worked more successfully here than elsewhere -- is famously known as "multidirectional", following varied pathways.

During the height of Western colonialism in the 19th century, the Thais (then-Siamese) played the French and the British off against one another, and sought support from imperial Russia, to maintain independence. In World War I, the Siamese sat on the fence until they joined the side that was about to win. In World War II, Thailand famously joined both the Axis and Allied powers, officially and covertly. In the Cold War, Thailand bit the bullet and joined the United States against communist expansionism. But even then, a year after signing the US-led Manila Pact in 1954, the Thai government met Communist China's Zhou Enlai at the Bandung Conference of the Non-Aligned Movement, ultimately normalising relations with Beijing just two decades later.

Thailand's openness and absorptive capacity also can be seen in the culinary realm. While Thai food has gone abroad in myriad directions, foreign cuisines have been adapted and enmeshed into all sorts of hybrid flavours, whether it be a curry touch in burgers or spices in a spaghetti. In the movement of peoples, Thais can be found in far-flung corners of the world, just as foreign travellers of all stripes keep visiting this country, some staying for the long term.

So why was it that, when confronting a health crisis of a lifetime and a national security threat claiming lives and endangering livelihoods with economic contraction, the Thai government was so bent on placing one single bet from the outset when others were available? This bet is a recurring issue that will not go away as long as public health remains at grave risk. It is the monopoly focus of Siam Bioscience as the government's hand-picked procurer and AstraZeneca as the choice vaccine.

With a nine-month pre-order of 61 million doses signed in October 2020, well before the Food and Drug Administration even approved Siam Bioscience as a licensed manufacturing facility for the vaccine, the government not only put all eggs in one basket, but also bet on a relatively new player in vaccine production.

To be fair, Siam Bioscience must have met AstraZeneca's requirements before it was selected as one of the multinational's global production units. Having a local company as part of AstraZeneca's complex global supply chain, along with more than 20 supply partners in 15 countries, is a crucial step forward in Thailand's scientific capabilities. Linking up with AstraZeneca made sense but only as long as it was not the only one.

The process of Covid-19 vaccine production is new and untested. Delays and disruptions in the production process can occur due to unforeseen circumstances even for existing production facilities. AstraZeneca is facing production delays across a number of countries, from Belgium and Argentina to South Korea and India. While no news from Siam Bioscience may mean that all is on track, it would be more prudent for the government to anticipate and plan for possible hiccups in the company's first-ever foray into vaccine production.

The government's decision to procure 2 million more doses from Sinovac, while waiting for the local production of AstraZeneca also raises questions. There are two major Chinese vaccines under review by the World Health Organization (WHO), namely Sinovac and the other developed by Beijing Institute of Biological Products as part of its cooperation with the large state-owned enterprise, Sinopharm. Given these two options, the Sinovac choice deserves scrutiny because Sinovac Life Sciences, the Beijing-based biotech company, is partly owned by a Hong Kong subsidiary of the CP Group, one of Thailand's largest conglomerates.

The costs of betting on AstraZeneca and then making do with Sinovac in the interim are now being felt acutely because the ongoing third wave of virus cases is making people more desperate for an antidote. Thailand is not the only country facing a renewed wave of infections, but it is on a lower rung when it comes to vaccine prospects, ranking near the bottom in the Asean neighbourhood.

More confusion and frustration now abound with no clear plan on whether, when, and how other vaccines could be procured to accelerate the country's inoculation needs. Even when the government finally yielded to pressure from leading business organisations to allow private vaccine purchases, there is no clear plan nor timetable for how the private market for vaccines will be managed to supplement the public vaccine strategy.

Price hikes are certainly to be expected, given the limited availability and the huge demands for the two major vaccines that score higher in their efficacy, namely the United States-manufactured Pfizer and Moderna.

Unequal access to vaccines is not exclusive to Thailand, and is becoming a global concern. The US and the European Union together have received almost 40% of total global vaccine deliveries compared to only 4% delivered to the Covid-19 Vaccine Global Access, or Covax, for distribution to 121 countries.

The vaccine world is being divided into three distinct groups. Countries in the vaccine "First World" are fast approaching herd immunity by mid-2021, thanks to several choices of more expensive and more effective vaccines.

While Russia and China are using their own vaccines to inoculate their populations, they are sending their Sputnik V, Sinovac and Sinopharm around the world as part of their vaccine diplomacy whose recipient countries are in the "Second World". Vaccines in "Third World" countries are confined to those with limited access and not much option but to rely on the Covax scheme and vaccine donations.

Thailand's shoddy vaccine plan is leading to inequality, elitism and nepotism, with arbitrary and subjective, rather than objective, criteria for access. If, or when, the more sought-after Pfizer, Moderna and Johnson & Johnson vaccines arrive, they are likely to be distributed among the wealthier and upper rungs of society who can pay for access via private hospitals. The majority of Thais will have to make do with second-tier vaccines.

Sadly, the least privileged and yet the neediest -- vulnerable frontline workers -- could be the last group to take whatever is left.

Had the Thai vaccine strategy been more like Thai foreign relations in the past, we would be having a more balanced procurement and distribution where diverse vaccine types would have been administered widely by now.

Pavida Pananond, PhD, is Professor of International Business at Thammasat Business School, Thammasat University, and Thitinan Pongsudhirak is Professor at the Faculty of Political Science and Director of its Institute of Security and International Studies at Chulalongkorn University.

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