Dose and don’ts

February 21, 2021

Some challenges to tackle for a successful Covid-19 vaccination drive

The availability of vaccines for Covid-19 in the market has lit a glimmer of hope. These vaccines are being administered in several countries. There are long wait times because of the large number of people who need them. While there are still some concerns about the efficacy of these vaccines and the risks related to their use, a large number of people are going for them.

There are countries where governments placed orders for Covid-19 vaccines well in time so that their citizens should be among the first to benefit from those. There are also those still contemplating how to secure enough vaccine for their people.

Pakistan has also been grappling with this menace and there has been a significant death toll and infections in large numbers. Till February 17, according to the figures on the website of the National Command and Operation Center (NCOC), around 566,000 people had been infected with this virus, of which 12,436 had lost their lives.

While the reported mortality rate among Covid-19 patients in Pakistan is a bit low when compared to neighbouring countries and even those in Europe or North America, the severity of the infection cannot be ignored.

Pakistan too has started its vaccinating programme but for the moment only the health sector professionals are being given the vaccine. Aged people who are more vulnerable to this infection are the next priority.

This does not mean that Pakistan has sufficient vaccine to administer to its citizens. In fact, the jabs given so far came from the lot of 500,000 doses of Chinese-origin Sinopharm vaccine that have been donated to the country by China. The figure is insignificant compared to the population requiring vaccination.

The question here relates to what plan the government of Pakistan has in order to ensure that no one is left out and everybody gets the required dose of one of the vaccines, regardless of their financial status. The country expects free vaccine for 20 percent of its population from Covax, an international alliance with the mandate to provide free vaccine for the needy but it is not still clear how vaccination will be extended to the remaining population.

The latest development in this context is that the federal government has awarded permission to the private sector to import Covid-19 vaccines and exempted it from a price cap. The rationale given for this exemption is that the huge demand cannot be met without the cooperation of the private sector and that fixing a price cap is not possible because there is no meaningful reference price in the global market, which is emerging. A government representative has even said that the government’s interference in private businesses is always a spoiler, and hence it will stay away.

This announcement has elicited severe criticism and opposition from various quarters. It has been said that in this case only the affluent will be able to get the privately imported vaccines and those with limited means will remain unserved. There are fears that in the absence of a price cap, the importers will seek huge profits.

The jabs given so far came from the lot of 500,000 doses of Chinese-origin Sinopharm vaccine that have been donated to the country by China. The figure is insignificant compared to the population requiring vaccination. The question here relates to what plan the government of Pakistan has in order to ensure that no one is left out and everybody gets the required dose of one of the vaccines, regardless of their financial status.

While these words are being written, it has been reported by Reuters that a Pakistani diagnostic company Chughtai Laboratories has entered into an agreement to buy the Russian origin vaccine, Sputnik V and sell it for $10 per dose. Contacted by The News on Sunday (TNS), Omar Chughtai, the director of Chughtai Laboratories says that they are “simply following the government policy” and “entering into a legal agreement. He refuses to comment on the rumours about the cancellation of the deal, and says he is not responsible for statements given by anybody other than him.

Osman Khalid Waheed, the CEO of Ferozsons Laboratories, says that the best way to procure Covid-19 vaccine is through “inter-governmental negotiations over price and timeline for its supply”. His point is that the timeframe within which the supplies are made is as important as the price.

Waheed asks why, given that governments across the world are in direct negotiations regarding the Covid-19 vaccine, Pakistan cannot do the same. He says only once a reasonable price is negotiated at the inter-governmental level should the businesses be allowed to import. In case, he says, a committee of the Drug Regulatory Authority of Pakistan (DRAP) works out a price and the supplier agrees, who will ensure that the vaccine does not take too long to reach here?

The Ferozsons CEO says that their goal is to “manufacture Covid-19 vaccine here in Pakistan after getting approval/licence from the original manufacturers rather than importing it”. This is not a new thing, he says, as they are already producing Remdesvir injection under the brand name of Remidia, under licence from the principals, Gilead Sciences Inc, USA.

Ashraf Nizami, the Pakistan Medical Association (PMA) Lahore chapter president and senior vice president (SVP) of the Confederation of Medical Associations in Asia and Oceana has strong reservations against the government policy on Covid-19 vaccine procurement. He says that the government is counting on “donations only” and “does not want to spend from its resources on saving lives because health care is not their priority”.

Nizami says Federal Minister Asad Umar has said they are “not placing orders for vaccine due to the possibility of the National Accountability Bureau (NAB) later questioning them about it”.

He also challenges the policy of giving the private sector a free hand and suggests that the supply chain must be monitored and the importer should be allowed to “make only a reasonable profit”. Given a free run, he says, they are likely to “over-invoice, and make fortunes”.

Nizami says that the government has the responsibility to vaccinate the entire population and “it cannot run away from this responsibility”. There are varying prices for medicines produced by multinationals for the developed, the developing and the underdeveloped countries. Pakistan must get concessional rates, as it is a poor country, he adds.

One recalls, that the medicine Sovaldi meant to treat Hepatitis-C was made available in Pakistan for around 1.5 percent of its price in developed countries under a special agreement with its manufacturer.

Amid reservations, the government claims it will monitor the procurement process and allow purchase from countries that are themselves using those vaccines. But doubts around the unintended effects of Chinese vaccine on recipients above 60 years of age have affected public opinion and not many in this age group are turning up. This situation calls for revisiting the government’s strategy to ensure proper public messaging for citizens about vaccines and enable a successful vaccination drive.


The author is a staffer and can be reached at [email protected]

Dose and don’ts: Some challenges to tackle for a successful Covid-19 vaccination drive