Correcting the pandemic policy tack
published : 30 Jul 2021 at 04:00
newspaper section: Oped
That Thailand's coronavirus pandemic has been grossly mismanaged is self-evident. Infection rates have soared to new highs this month while vaccine availability and access remain shoddy and abysmal. The overstretched healthcare system is creaking under growing demand, while several scenes so far of Covid-afflicted people being left to die on the streets have shaken the country's collective morale and elicited soul-searching questions about how Thailand has managed to reach this dire juncture.
In the face of calamity, policymakers at the top from Prime Minister Prayut Chan-o-cha and his cabinet ministers to senior bureaucrats at the Ministry of Public Health have proved patently unable to turn the situation around for the better. As infections rise while the Delta variant runs amok and the availability of effective vaccines is still limited, the current Prayut-led government or any other that might come along in its place must rethink and rectify the pandemic strategy and policy based on three broad considerations.
First, despite government incompetence and policy short-sightedness so far, it is still not too late for Thailand to come up with objective criteria for its vaccine strategy. On the procurement side, objectivity and impartiality mean going with the most efficacious vaccines based on established scientific and medical evidence. The mRNA vaccines, namely the United States-made Pfizer BioNTech and Moderna, are more accepted and much sought after because of their higher efficacy, particularly in hedging against virus mutations, including the Delta variant.
While there is a local booster club rationalising the China-made Sinovac, many people in Thailand increasingly doubt this vaccine, and confidence in it plummeted after there were news reports of people inoculated with Sinovac getting infected with the Delta variant. Then, the pro-Sinovac club and government apologists argued that it was better to be vaccinated than not, and even that the Chinese jab works well by mixing it with the Anglo-Swedish AstraZeneca.
These claims are not substantiated by conclusive and well-tested medical science. They are a lame and potentially dangerous excuse owing to the government's inept miscalculation in not securing enough AstraZeneca doses and other more efficacious vaccines to begin with.
Impartial vaccine procurement in the coming months must be kept away from vested interests and aimed at the top-performing vaccines. Already the US has shipped 1.5 million Pfizer doses, with a pledge of another 1 million. Japan has donated 1 million AstraZeneca shots, while the United Kingdom is set to give 415,000 doses of AstraZeneca next month. Future purchases of vaccines should move away from Sinovac, and even its reputably better cousin, China-made Sinopharm, towards mRNA and viral-vector vaccines like AstraZeneca and Johnson & Johnson.
Thailand used to pride itself for having shifted to becoming a net donor country in the 21st century after decades of being an aid recipient. Yet for Covid vaccines, Thailand has transformed into a notable recipient because its government has spectacularly failed the pandemic test.
On the access and distribution side, the government must stick to the elderly and vulnerable groups with underlying conditions. Vaccine access so far has been a complete shambles. Able to offer just Sinovac and AstraZeneca, the government had to stand down and watch the Chulabhorn Royal Academy import Sinopharm unilaterally. Private hospitals understandably tried to fill in the procurement gaps with orders of Moderna and Pfizer. Now the Thai Red Cross has got in on the act by taking a stake in the Moderna purchase.
As the Prayut government is incapable of imposing order on the vaccine procurement chaos, it could at least ensure fair and equitable access. It could do so by offering vaccines that are proven to be efficacious to people who reside in Thailand regardless of nationality and legal status. The motto making the rounds about how "no one is safe until everyone is safe" is ultimately accurate from villages and nations to the entire world.
But one step at a time, we must treat all people as inhabitants of Thailand eligible for vaccines. Elderly groups and others who are more prone to catching the virus due to pre-existing conditions should be given first priority in descending order. Focusing on older age groups will also minimise the death toll as this segment stands a disproportionate chance of succumbing to Covid-19. Eligibility based on age and existing conditions can be verified, much better than the hitherto free-for-all approach based on economic sectors like tourism, not to mention personal connections. If vaccines become more abundant later in the year, this approach of sticking to objective criteria will be even more promising.
The second imperative is accountability and responsibility. This is an even harder part because Prime Minister Prayut is ultimately responsible for Thailand's vaccine mess and thousands of deaths. But since he clings to office and muddles through on a day-to-day basis, he needs to replace the minister and senior bureaucrats in charge, namely the public health minister and the heads of the National Vaccine Institute and Department of Disease Control. Heads must roll because fatal policy mistakes have been made. Leaving the same people in charge simply means the repetition of the same deadly mistakes.
Finally, a more holistic view and broader regionalism lens are needed. As Thailand is having a tough time coming to grips with its own virus and vaccine conundrum, it is difficult to think about next-door neighbours, particularly Myanmar, which is suffering just as much, if not more.
Despite this, in 2022-23, mainland Southeast Asia comprising Cambodia, Laos, Myanmar, Thailand and Vietnam must somehow find ways to reach herd immunity as a pact because they are economically interconnected. For example, workers from Cambodia and Myanmar are now indispensable to the Thai economy.
If we are not sufficiently vaccinated across the mainland neighbourhood, the virus could find its way to reappear relentlessly. The same logic can be widened to view Southeast Asia as a whole and even the global community beyond. But for the rest of this year, no one can fault Thailand for trying to take care of itself by streamlining and standardising its acquisition of vaccines that work to vaccinate enough people who need them most to reach critical mass.
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.