Govt must take vaccine responsibility

Govt must take vaccine responsibility

In file photo from last November, National Vaccine Institute (NVI) director Nakorn Premsri, left, joins Disease Control Department director-general Dr Opas Kankawinphong, centre, and AstraZeneca Thailand president James Teagee at a signing ceremony at Government House to buy Covid vaccines. (Photo: Government House)
In file photo from last November, National Vaccine Institute (NVI) director Nakorn Premsri, left, joins Disease Control Department director-general Dr Opas Kankawinphong, centre, and AstraZeneca Thailand president James Teagee at a signing ceremony at Government House to buy Covid vaccines. (Photo: Government House)

After more than six months of virus policy bungles, vaccine shortages and repeated denials, senior public health officials at last have admitted their mistakes and apologised to the public. But these apologies came with attachments and excuses that fall short of owning up squarely to the pandemic calamity that is besetting Thailand. Worse, the ultimate decision-makers in charge, from Health Minister Anutin Charnvirakul to Prime Minister Prayut Chan-o-cha, have been nowhere to be seen. The Prayut government has yet to take full responsibility for Thailand’s pandemic mismanagement that is claiming hundreds of lives with many thousands more infected and untold hardship across the country.

First, it should be noted that health bureaucrats — in this case, National Vaccine Institute (NVI) director Nakorn Premsri — issued a public apology just days after a leaked letter from AstraZeneca dated  last June was publicised. The self-evident and damning letter became the talk of the country for pointing out that Thai authorities underestimated and therefore under-booked AstraZeneca vaccine doses more than 10 months ago in September 2020.

In fact, AstraZeneca prioritised Thailand’s order because its vaccine was being manufactured locally by Siam Bioscience on a licensing and technology-transfer agreement. The letter said AstraZeneca encouraged the government to join the global vaccine cooperation deal under Covax — an initiative launched by the World Health Organization (WHO) to provide vaccines to middle- and low-income countries. Between direct purchases and Covax access, Thailand’s vaccine supplies would have been secured.

In other words, the Prayut government as advised by health ministry experts could have ordered millions more doses within local manufacturing capacity, certainly more than the original request of 26 million. Giving two jabs each to 70% of Thailand’s 70 million population, or roughly 49 million people, to reach herd immunity would have required around 100 million shots. But those who made the decision somehow came well under what was needed.

After not ordering enough jabs, the government also chose not to join Covax. Indeed, Thailand is currently one among seven countries that are not in the Covax scheme, next to the likes of North Korea and Belarus. Turning down Covax membership stemmed not just from complacency but outright hubris. The public health authorities were overconfident with both Thailand’s low virus caseloads last year and the local manufacturing deal. Under their logic, joining Covax was moot since the international health cooperation scheme would largely rely on the non-profit AstraZeneca vaccine which Thailand was going to produce anyway.

After the second wave of infections last December amid growing public concern, the cabinet in February added 35 million doses to the original order, thereby citing 61 million to be in the pipeline.

But this was misleading because AstraZeneca had committed its vaccine supplies above and beyond Thailand’s original 26 million doses to other regional governments, as the AstraZeneca-Siam Bioscience manufacturing agreement was contracted as a regional production centre, thus having to supply countries in the region accordingly. Yet the British-Swedish company reshuffled its delivery portfolio to provide Thailand with 5-6 million per month instead of 3 million. This is why AstraZeneca doses have been uncertain and in short supply. Thailand did not order enough and its sudden request for millions more can only partially be met.

For months, the government’s blunder was kept from the public. Meanwhile, it kept on importing more and more Sinovac, a China-made jab whose efficacy against the Delta variant has been in doubt and considered lower than AstraZeneca and mRNA vaccines — namely Pfizer-BioNTech and Moderna. Sinovac orders quickly reached millions, including the latest order last month of another 10.9 million shots. As locals who have been vaccinated with Sinovac might have been more vulnerable to the Delta virus variant, this Sinovac vaccine has faced mounting doubts as a Thai conglomerate happens to be small shareholder in this Beijing-based vaccine company, raising questions about conflicts of interest. Moreover, a Sinovac shot is priced at 500-600 baht, more than twice the cost of an AstraZeneca jab.

In view of the authorities’ inept handling, Dr Nakorn of the NVI cited a lack of pandemic experience and an inability to foresee the chance of virus mutations. He also conceded that Thailand will now try to join Covax. These rationalisations are understandable but not easily forgivable in view of the trail of deaths and damage.

To be fair, Dr Nakorn should not be singled out for blame. His colleagues, such as Disease Control Department director-general Opas Karnkawinpong, are in the same boat that gravely missed Thailand’s vaccine needs and the Covax lifeboat. But at a minimum, this lot of public health bureaucrats should no longer be part of the decision-making process that affects the lives and livelihoods of people who live in Thailand.

At least the health professionals and bureaucrats in charge are facing up to the public for their shortcomings. The same cannot be said of Health Minister Anutin. This costly pandemic debacle effectively shuts the door on his aspirations of being prime minister some day. He has offered contradictory statements on the virus and vaccine situations and strategies, and has not taken accountability for deadly policy mistakes. More time is needed to know whether conflicts of interest have been part and parcel of the health ministry’s spectacular vaccine screw-up beyond policy miscalculations. If so, criminal charges could be in the offing.

As head of government, Prime Minister Prayut is the ultimate decision maker. These are tough times for leaders worldwide who are there to make difficult decisions amid hard choices and limited information during an unfolding once-in-a-lifetime pandemic. For Thailand, this pandemic crisis has shown that Prime Minister Prayut, a retired general who has continued in office since he seized power in a military coup in 2014, is unfit for the job.

What to do about it is Gen Prayut’s and his backers’ dilemma and Thailand’s collective predicament. While what needs to be done to move forward is murky, what is clear is that the longer the Prayut-led regime continues in office, the more people will suffer.

Thitinan Pongsudhirak

Senior fellow of the Institute of Security and International Studies at Chulalongkorn University

A professor and senior fellow 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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