Sinovac, AstraZeneca, and the Philippine vaccine situation


THINKING PINOY

RJ Nieto RJ Nieto

Over 7 billion human beings need the COVID-19 vaccine, and there are only a handful of people who manufacture them. There is a global vaccine shortage, hence the need to prioritize high-risk groups, especially medical frontliners. With demand vastly exceeding supply, we should concede that merely having the money to buy vaccines is not enough.

Second, the government cannot negotiate with pharmaceutical companies unless there's a congressional appropriation (READ: Budget). Sure, the executive can use his discretionary funds for it, but that won't be enough to buy the tens of millions of doses needed for herd immunity. 

Could the executive know how much we can buy if we don't even know how much money we might or might not have? With the amount of congressional politicking happening alongside the budget process, there was a pretty good chance that the budget may not have included a line item for COVID vaccines at all.

There was no significant appropriation for vaccines in the 2020 budget, and it was only in this year's budget that funds for vaccines were made available. The executive signed the 2021 Budget Law only in late December, and only then can the government feasibly and legally negotiate vaccine purchase agreements. 

Had a government official negotiated with vaccine manufacturers before the budget's enactment, he would expose himself not only to possible criminal lawsuits, but also the government to international arbitration cases. 

And we know how painful it is to lose an arbitration case. 

In 2010, then President Benigno Aquino III cancelled the Laguna Lake dredging contract with Belgian firm Baagerwerken Decloedt En Zoon (BDZ), arguing that the much-needed flood control project was just "naglilipat ng lupa." BDZ sued the Philippines in the International Court for the Settlement of Investment Disputes (ICSID), and the Philippines had to pay BDZ P800 million in damages. 

Yes, we threw away that much for nothing.

After President Duterte signed the 2021 budget, funds for vaccines have become available, and the government could, of course, start procuring vaccines. Unfortunately, that's just like going to an iPhone launch at noon. 

Sure, you have the cash but you're so far down the queue that supplies will run out before you get to buy yours.

That's the conundrum vaccine czar Carlito Galvez has been dealing with. Yes, we now have the money, but wealthier (or more efficient) governments like Australia, Canada, and United States were able to get in line first. 

There are many vaccine manufacturing facilities, but their combined capacity is nothing compared to the number of vaccines needed. Hence, pharmaceutical companies initially sold them on a first-come, first-served basis.

Obviously, we arrived late. 

Fortunately, the World Health Organization led the establishment of the COVID-19 Vaccines Global Access (COVAX) Facility to enable more equitable access to vaccines. Through COVAX, poorer (or less efficient) governments can get vaccines even if they weren't able to line up first. 

This is how the Philippines got its first shipment of AstraZeneca shots, and this also why some wealthier nations temporarily halted mass immunization so poorer countries can start theirs. But then, we are not the only developing country on earth, so COVAX cannot provide sufficient quantities to serve all our needs. 

Case in point is the AstraZeneca shipment of around 490,000 doses, which is only good for – give-or-take – 245,000 out of the over 100 million Filipinos living today.

I know that many of us are frustrated to see that our Southeast Asian neighbors have started inoculating their citizens. Indonesia, for example, is already in its second round. Indonesia under President Joko Widodo has so far immunized nearly 3 million of its citizens. 

This is not to say that our administration officials did nothing wrong. 

Yes, I would agree that while the Philippine vaccine dilemma is primarily due to a confluence of factors beyond anybody's control, but the government also has its share of shortcomings that made the problem worse. 

For example, we are aware of Foreign Secretary Teddy Boy Locsin's accusing Health Secretary Francisco Duque of bungling the paperwork for a supposedly gigantic shipment of Pfizer vaccines. As a result, the ready-to-inject doses for the Philippines went to Singapore, a country where Duque is NOT the health minister. 

Our current supply of vaccines come from two sources – China's Sinovac and the British-Swedish AstraZeneca. Yes, many regular Filipinos perceive Pfizer's and Moderna's offerings as the gold standard, but the reality is that we have to make do with what we've got. 

Unfortunately, politicians politicize. Many of them capitalized on local anti-China sentiment to discourage us from patronizing Chinese-made vaccines. 

While it's true that Sinovac's Coronavac is less effective (~50%) than Pfizer's (~95%) in preventing infections, Coronavac was shown to be extremely effective not only in preventing severe COVID-19 (>90%) but also in preventing COVID-19 cases that require medical attention (78%). That is, the Chinese vaccine can potentially reduce a COVID-19 experience to something akin to the run-of-the-mill flu. 

In short, you don't die. 

But no, it's from China, so even if the scientific data gathered by third-party Instituto Butantan of Brazil, it must still be bad. 

I don't know about you, but viruses couldn't care less about politics.

Meanwhile, AstraZeneca was found to be ineffective in preventing infections involving the South African COVID variant. For one, the South African government decided to use some other vaccine and gave away its AstraZeneca stocks to other member-countries of the African Union. 

The Department of Health has already detected South African variant COVID infections in the Philippines.

Note, however, that the South African government's findings did not specifically include data for AstraZeneca's effectiveness versus COVID-19's severe form. Because if that vaccine can still make COVID-19 as manageable as the regular flu, it may still be good enough for non-frontliners. 

  Just like what I said, we have to make do with what we've got. 

Welcome, everyone, to the developing world.

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