Bangladesh must devise the Covid-19 vaccination plan ‘now’, an international public health expert said on Thursday, as a new vaccine is on the horizon.
Dr Farhad Ali Khan, an epidemiologist in Sweden, told Bangladesh Post that the government should also have an “active collaboration” with the international stakeholders working on equitable distribution of vaccines at affordable prices.
The comment came following reports that The Lancet medical journal would publish the keenly-awaited phase 1 clinical trial data of the vaccine being developed by Astrazeneca and Oxford University on Monday, July 20.
There are media reports that suggest that this vaccine can hit the market by this year. Pharmaceutical giant AstraZeneca is aiming to produce 2 billion doses of a coronavirus vaccine, including 400 million for the US and UK, and 1 billion for those in low- and middle-income countries.
It plans to start distributing the vaccine to the US and UK in September or October, with the balance of deliveries likely to be made by early 2021, AstraZeneca CEO Pascal Soriot told journalists last month.
It had also signed a licensing deal with the Serum Institute of India to provide 1 billion doses to low- and middle-income countries, with 400 million of those shots set to be delivered by the end of 2020.
What can Bangladesh do at this moment? Bangladesh Post asked Dr Farhad, who studied at Dhaka Medical College and now working as a director epidemiology at AstraZeneca.
“The government should prepare and finalize the plan immediately,” he said, while the prevention programmes will go on extensively.
“Plan to build and strengthen the immunization system components which includes service delivery, vaccine supply, quality, logistics, disease surveillance and advocacy, communication and social mobilization.
“Other key capacity building processes such as management, sustainable financing and human and institutional resources should be initiated immediately,” he said, suggesting the government to have active collaboration with the international stakeholders working on vaccine distribution at an affordable price.
There are already local, regional and global initiatives to secure vaccine availability, including the important Covid-19 Vaccine Global Access (COVAX) Facility.
The WHO is also spearheading some initiatives. There are also ongoing efforts by the vaccine alliance, GAVI, and the Coalition for Epidemic Preparedness Innovations (CEPI) as part of the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator.
The International Vaccine Institute (IVI) also works to make vaccines available and accessible for vulnerable populations in developing countries.
“The government needs to keep in touch with them,” Dr Farhad said.
Eight world leaders, in a Washington Post op-ed Wednesday, also called on the international community to ensure that people across the globe have equal access to a future vaccine for the coronavirus.
They were: Prime Minister of Canada Justin Trudeau, President of Ethiopia Sahle-Work Zewde, President of South Korea Moon Jae-in, Prime Minister of New Zealand Jacinda Ardern, President of South Africa (also chairperson of the African Union) Cyril Ramaphosa, Prime Minister of Spain Pedro Sánchez Pérez-Castejón, Prime Minister of Sweden Stefan Lofven, and Prime Minister of Tunisia Elyes Fakhfakh.
They wrote: “While global cooperation in terms of resources, expertise and experiences is paramount for developing a vaccine, manufacturing and distributing it while leaving no one behind will truly put global cooperation to the test”.
“Therefore, we must urgently ensure that vaccines will be distributed according to a set of transparent, equitable and scientifically sound principles. Where you live should not determine whether you live, and global solidarity is central to saving lives and protecting the economy.”
United Nations Secretary General António Guterres also pushed for equitable distribution saying that “none of us is safe until all of us are safe.”
“The commitment of the world leaders indicates that the vaccine will be available for all. AstraZeneca (who is making the vaccine) also said that the vaccine is not aimed at making profits. So now we, Bangladesh, need to take our own preparations,” Dr Farhad said.
“First of all, we have to build the immunization plan for the next two years,” he said, adding that priority must be set to who will get the vaccine first.
“Of course, healthcare workers of any country will get the first priority. And then who? You (Bangladesh) cannot afford to immunize all 160 million people. So, a mass vaccination strategy may not be feasible for Bangladesh.
“Then comes the strategy to immunize the high-risk people those who have comorbidities such as diabetes, respiratory and heart diseases, kidney problems or others.
“And another strategy can be ‘ring vaccination’ in which you will vaccinate people in the community around the Covid19 detected cases.
“But for everything you need real time data. You need to know where the problem is. So, you have to prepare an emergency plan, a public health plan and strengthen all the mechanisms to implement the plan,” he said.
“And everything has to be done in a scientific and transparent way,” he said, adding that next few months are important for this much-needed capacity building and strengthening the surveillance system.
“Covid-19 disease registration system should be built up now,” he said.
Dr Farhad, however, said that those who are affected may not need the vaccine. “As of now, it is not yet confirmed that reinfection can happen,” he said.
Bangladesh is famed for mass vaccination for children with its EPI programme. But that deals only with the children, not the whole population.
“This Covid19 vaccination will cover millions of people. So, you will need additional manpower and additional facilities for that.”
He also said that Bangladesh has the “capacity to be included in the supply chain via may be not by manufacturing, by packaging and others such as making storage boxes.
“Bangladesh has the capacity to be part of the supply related things with the main vaccine supplied from outside,” he said, adding that the government can explore this potential also.
Bangladesh first detected the Covid-19 cases on March 8 and confirmed the first death on March 18. The number of total confirmed cases stood at 196,323 on Thursday with 2,496 deaths.
