The world has now surpassed 61 million Coronavirus cases and 1.4 million deaths. Ever since the disease emerged in Wuhan, China and Chinese scientists decoded the genome sequence of the virus in early 2020, scientists and researchers in universities and pharmaceutical companies around the world have been pursuing two options – a cure and a vaccine.
It is generally well known that viral diseases have no cure. One can only treat the symptoms such as fever and headache. Fatalities occur when the symptoms develop to such an extent that heart attacks or pneumonia occur. Scientists have been trying with limited success to find drugs that can address the symptoms and send patients back home from hospitals. So far, only a few drugs and drug ‘cocktails’ including Remdisivir have shown some success.
Developing a vaccine is a far more sensible approach, given that it can slow down infections in the first place. One theory is that the virus will literally have nowhere to hide if at least 80 percent of the population is vaccinated and immunised against the virus. There are two aims – preventing infection at individual level and a wider spread in the society.
Vaccines prevent millions of deaths every year, from a range of diseases. Vaccination is the best possible answer to viral diseases. But developing vaccines is no easy task. It generally takes years to develop a vaccine and bring it to the market. But a combination of factors has helped ramp up research and development of Covid-19 vaccines, from the emergence of new vaccine technologies to massive funding by Western and Eastern Governments.
So far, there are five promising vaccines – two developed by US-based companies (Pfizer and Moderna), one by Oxford University/Astra Zeneca and two others by Russia (Sputnik V) and China (Sinovac). All five vaccines are likely to be available by mid next year worldwide, though there are several others too in the trial stage. Both Moderna and Pfizer have committed to producing a combined total of 2.3 billion doses next year. But herein lies the challenge. Delivering vaccines for seven billion people is a huge logistical challenge and many developing countries might not have the facilities to handle at least some of the vaccines.
Take for example, the Pfizer/BioNTevh vaccine candidate, which needs to be stored at -70 Celsius. While Pfizer has developed special boxes for transport, not many countries have the cold chain facilities needed for this kind of sensitive cargo. Moderna’s vaccine candidate is a better alternative as it can be kept at -20 Celsius, which many commercially available freezers can reach. Even so, it is doubtful whether rural hospitals in developing countries have such medical grade freezers.
As for Sri Lanka, the country is a vaccination and immunisation success story. It has eliminated many diseases including most recently, measles and rubella as well as malaria, the latter even without a vaccine. Sri Lanka already has a robust vaccination infrastructure and unlike in many other countries, total public support towards immunisation. Thus, it comes as no surprise that Sri Lanka is already making plans to provide Covid-19 vaccines to its citizens.
We have learned that health authorities are in discussions with COVAX, the global United Nations and World Health Organization (WHO) - led procurement facility for vaccines to purchase Covid-19 vaccines. Health Minister Pavithra Wanniarachchi informed Parliament that Sri Lanka had already joined the Global Alliance for Vaccines and Immunization (GAVI) and the Government was making efforts to make the Covid-19 vaccine available to 20 percent of Sri Lanka’s population initially (4.2 million citizens).
She said vaccines will be available as soon as they receive approval from the WHO. A national committee had been appointed to look into Covid-19 vaccines though there is no fixed date as to when they will be available to the public.
Three technical subcommittees will be focusing on matters such as target groups for the vaccines, prioritisation, cost and usage.
Just for comparison, Pfizer will price a dose at US$ 20 (Rs.3,700), Moderna at US$ 10-50 (Rs.1,800-Rs.9,200) per dose depending on the ordered quantity and Oxford/Astra Zeneca at US$ 3 (Rs.550) per dose to developing countries. It is worth noting that AstraZeneca is a member of COVAX, which aims to distribute two billion vaccine doses to 92 low- and middle-income countries at no more than US$ 3 a dose. Neither Pfizer nor Moderna has joined the initiative. One can calculate the cost for procuring the vaccines for the rest of the population, at two doses per individual, from the above pricings.
There is no debate that frontline health workers and Security Forces personnel as well as other first responders should be immunised first. Then it could be given to other essential workers, those over 70, those suffering from NCDs, those over 60 and so on. The health authorities must immediately assess the availability of cold chain facilities (inclusive of transport) for distributing the vaccine(s).
A network of vaccination centres must also be earmarked, for example, hospitals and rural dispensaries. An awareness campaign must also be undertaken to educate the public on the benefits of vaccination. Private hospitals must be given the opportunity of importing the vaccines of their choice and those who can afford may avail themselves of that facility, but strictly under government supervision. A proper record should be kept of all those who get the vaccine and perhaps a QR code system can be implemented to easily identify those who have been inoculated. It should be a well-coordinated effort that makes certain that we ultimately defeat the virus.