Distribution of vaccines: Challenges Bangladesh will face

The tension between vaccine diplomacy and vaccine nationalism continues which reflects a lack of cooperation among countries. Even though some initial trials have been successful, it would be difficult to ensure sufficient doses for the global population within a short period of time. How will the race to a COVID-19 vaccine influence the global economic landscape and what will it imply for Bangladesh? How can we ensure efficient distribution and equitable access to the vaccine?

The fifth episode of ESC Dialogue titled, ‘Vaccine diplomacy: Prospects and challenges for Bangladesh,’ hosted by the Economics Study Centre (ESC), University of Dhaka (DU) has been successfully held focusing on the issue mentioned above. ESC Dialogue is the signature panel discussion event of the organisation which facilitates discourse on pressing socio-economic issues related to Bangladesh. This episode was chaired by Dr Rumana Huque, professor of DU Economics with Dr Delwar Hossain, professor of DU International Relations department, Dr Ashikur Rahman, senior economist of Policy Research Institute (PRI) and Dr Senjuti Saha, scientist at Child Health Research Foundation (CHRF) Bangladesh as the esteemed panellists.

Ms Namira Shameem, president of ESC opened the session by introducing the panellists. Prof Dr Rumana began the discussion by talking about the global struggle to contain the highly pervasive virus including how the authorities in Bangladesh only began to take preventive measures after the first Bangladeshi COVID-19 patient was identified. The discussion, however, has now shifted towards the distribution of vaccines and the challenges countries like Bangladesh will face to implement it successfully. Ensuring efficient budget allocation, sufficient acquisition of vaccines and equitable distribution will prove daunting for Bangladesh. She also informed the audience that Bangladesh had already taken measures to secure 60 million doses of vaccine from Gavi, the Vaccine Alliance and  30 millions from India.

Dr Delwar expressed his perplexity at the lack of global cooperation regarding vaccine distribution despite the COVID-19 pandemic evolving into a global humanitarian crisis. He argued that instead of collaborating, many developed countries have resorted to vaccine nationalism to secure vaccines for their own people, which reflected the growing dissatisfaction of multilateral governance.

From a Bangladeshi perspective, however, Dr Delwar said that the country had resorted to both bilateral (with China and India) as well as multilateral agreements (Gavi, COVAX) to secure vaccines. He elaborated that Bangladesh has made it loud and clear that vaccines should be considered a public or collective good with the Prime Minister Sheikh Hasina saying so at the UN Assembly. He also hinted at the scope for aid diplomacy as Bangladesh tries to secure funding from the World Bank and JICA to ensure a smooth distribution process while he noted that the country has sufficient currency reserves to finance the process herself.

Finally, Dr Delwar emphasised that the level of success in the distribution of vaccines by Bangladesh depended on how well it executes its plan, which tries to ensure coverage of 80 per cent of the population in three phases, the extent of cooperation and support from its bilateral and multilateral partners, and whether vaccine patents and intellectual property rights will be relaxed to enable the country’s pharmaceutical industry to produce its own vaccines.

Dr Ashikur shared his opinions to supplement the discussion. He responded by reemphasising Bangladesh’s stance on designating vaccines as a collective good and arguing that Bangladesh herself does not need to engage in vaccine diplomacy as she has kept all options (bilateral and multilateral agreements) open to secure vaccines. He also added that despite the ongoing tension between China and India, Bangladesh has been able to effectively navigate the geopolitics to ensure vaccines as quickly and as cheaply as possible. He expressed “cautious optimism that Bangladesh will get on the vaccine ladder as soon as it’s available.” He addressed the need for equity in meting out vaccines to the cohort with the most vulnerability, comorbidity and high mortality.

On the other hand, he highlighted the efficacy of the vaccines that Bangladesh will acquire by pointing out that most of them may ensure immunity for up to six months and may be less successful than the ones produced by Pfizer or Moderna. He also said that even though Bangladesh had been luckier than other countries regarding the worst experience of pandemic, unlike developed countries like the US, UK or France, it should approach the process of vaccine acquisition cautiously. He also considers vaccine nationalism by the developed countries normal as they have been affected the most.

The discussion then moved to Dr Senjuti Saha who recognised that although mankind is facing a new virus and is forced to come up with new vaccines, the equitable distribution of vaccines is an old issue that is obstructed by the lack of health data especially in developing countries like Bangladesh. She explained that the genetic composition of the COVID-19 virus may vary geographically which could render foreign vaccines less effective. That is why genomic sequencing of the SARs-CoV2 strain in Bangladesh (a project she led) was so important to ensuring that the vaccines distributed in Bangladesh were tailored to the type of virus introduced.

However, Dr Senjuti was rather optimistic about Bangladesh’s vaccine distribution capabilities as it hosts one of the highest vaccine coverage and lowest vaccine hesitancy in the world. Bangladesh has an accessible landscape due to high population density and has had a commendable track record in immunising children. Still, she pointed out, the degree of success depended on a multidisciplinary approach and the country’s ability to use its experience in disaster relief and vaccination campaigns. She also highlighted the need to collect health data while vaccines are provided to gauge the success of implementation.

Finally, Dr Senjuti emphasised on the need for the development of vaccine production capability by the country’s own pharmaceutical sector as she argued that the equitable distribution of vaccines is highly unrealistic even in the future. In explaining the difference between equality and equity, she ended by saying, "Nobody is safe until everyone is safe."

 The writer is a first year student at the Department of Economics, University of Dhaka. He can be reached at [email protected]