Despite issuance of Emergency Use Authorization (EUA) to three vaccines developed by European, Chinese and Russian companies, Pakistan has so far been able to get a donation of only half a million doses of Chinese vaccine Sinopharm, which will be used to inoculate 250,000 frontline healthcare workers while the same number of doses would be required to vaccinate all the frontline healthcare workers, whose estimated number stands at 500,000.
At the same time, Pakistan has been assured by international health agencies that through the COVAX facility it will receive 17 million doses of European vaccine AZD1222, developed by Oxford-AstraZeneca by June this year, of which six to seven million doses would be available in the first quarter – by the end of March 2021 – while the remaining doses would be delivered to Pakistan by the end of June this year. These 17 million doses will only be enough to vaccinate around 8.5 million people in a country of 220 million.
The COVAX facility is a global pooled procurement mechanism for Covid-19 vaccines, through which international health agencies including the WHO, Gavi and others will ensure fair and equitable access to vaccines for all 190 participating economies, using an allocation framework formulated by the WHO. It was launched in April 2020 jointly by the WHO, the European Commission and France in response to this pandemic. Through COVAX, 92 low-income countries including Pakistan will be provided different vaccines free of charge to cover a maximum of 20 percent of their populations.
At the same time, local authorities have also authorized a private importer – Sindh Medical Stores (SMS) – to procure and import AstraZeneca’s AZD1222 vaccine in Pakistan while another pharmaceutical firm AGP Limited has been allowed to import the Russian Sputnik vaccine, although there is hardly a chance that these companies would be able to bring a sizeable number of doses of these vaccines into Pakistan before July 2021. Even the prices of the European and Russian vaccines have not been fixed by DRAP yet so their import is unlikely in the next few months.
Pakistani authorities are also hoping to receive a small quantity of ‘cold vaccines’ – Pfizer-BioNTech vaccine doses in donation from the United States – for which the government has already started the process of procuring Ultra Cold Chain (UCC) equipment as these ‘cold vaccines’ need to be stored at minus 70-80 degrees Celsius. But Pakistani vaccine experts believe that cold vaccines are not an appropriate solution for the country where a cold chain mechanism to store such types of vaccines does not exist and can’t be put in place in the entire country due to limited resources.
In the meanwhile, it is believed that another Chinese vaccine candidate, Cansino, whose phase III trials have almost completed in Pakistan in addition to several other countries of the world and analysis of its safety and efficacy data is being assessed, will get Emergency Use Authorization (EUA) in the current month by the Drug Regulatory Authority of Pakistan (DRAP) – and by the end of the first quarter of this year, its supply to countries where its trials were conducted would be started.
So, when will an average Pakistani be able to get his or her first jab of the vaccine? According to officials of the National Health Services, this is not an easy question to answer. So far, Pakistan has managed to get only half a million a million doses this month while the remaining pledges and promises need to materialize.
At the moment, the government of Pakistan has not yet ordered any manufacturer to supply vaccine to it as they are demanding advance payment for the supply of vaccine while most of their doses have been pre-purchased by the developed countries and international health agencies while the private sector has also not been able to get any assurance of a sizeable number of doses, which they could then supply to the government or to private institutions in Pakistan.
As per Special Assistant to Prime Minister (SAPM) on Health Dr Faisal Sultan, Pakistan roughly has an adult population of around 100 million who are eligible to get the Covid-19 vaccine as it is not indicated for people below 18 years of age. “If we vaccinate 70 percent of this 100 million, theoretically we would be able to achieve herd immunity and virus transmission is supposed to be disrupted in the country. But vaccinating these 70 million people is an uphill task as several of them live in far-flung areas which are not easy to access; some will also resist getting vaccinated while there are several other issues”, he says. Dr Sultan also believes that a realistic target would be to vaccinate around 40-45 million people in Pakistan.
And when this target would be achieved, it depends on the continuous supply of vaccine from the manufacturers, especially Chinese firms Sinopharm and the Cansino Bio as well as British-Swedish giant AstraZeneca, which would be using Indian manufacturing facilities like Serum Institute of India to produce the mass doses and supply it to eagerly looking for vaccinating its populations.
Dr Faisal Sultan also believes that the role of the private sector in importing different types of vaccines in Pakistan would not be very significant as they would hardly be able to cover the 5 to 15 percent of adult population – and that too would not be possible in the current year due to pre-purchases and other factors.
The authorities, however, are hopeful that they will be able to start vaccinating common Pakistanis this year but that is still a distant dream and depends on many factors, especially the government’s efforts to get as many doses of vaccines as possible from various sources and manufacturers.
The writer is an investigative reporter at The News, covering health, science and environment and water issues.
Twitter: MWaqar_Bhatti