BY MIRA NADARAJAH
As the COVID-19 pandemic rages on, we are still struggling to find normalcy a year since the initial outbreak of the virus. Medical authorities, public health officials, and allied professionals have consistently stressed the importance of effective vaccine deployment to end the pandemic—the hope being with equitable and extensive vaccination across populations, work, school, and travel will gradually pick up and the global economy can begin to recover.
However, as many countries begin their vaccine rollout, efficient distribution and administration is proving to be a challenge. Complications range from supply shortages, difficulties in cold-chain logistics, to resistance from the public to be vaccinated. As such, APC invited leading experts who are at the forefront of vaccine deployment around the world to share the key issues on the ground, and how collaborations are key in overcoming these challenges.

In his opening, Laurence said he hoped the session could shine a light on the role of philanthropy in the rollout of vaccines. While we often presume vaccine procurement and distribution to be the job of governments, however, governments alone cannot achieve the necessary scale to effectively protect the population against the virus. There is also the need to think beyond COVID-19, he notes, such as ensuring that other vaccine regimens are not disrupted and do not lead to outbreaks of preventable diseases like measles.
Inequity in vaccine deployment across continents is evident—with countries in the global North accelerating their rollout, and the global South lagging behind with little to no access to the vaccine. Many low-income countries are relying on the COVAX mechanism, which has only just begun its distribution in early March.
Even if wealthier countries do achieve their vaccination targets by Q2 or Q3 of 2021, noted Dr Padmini Srikantiah, Senior Programme Officer in Global Health at the Bill & Melinda Gates Foundation, while low-to-middle income countries remain widely unvaccinated, the economic repercussions will continue to be felt globally. A coordinated response across the globe is needed to abate the knock-on effects of the virus.
This is why the Gates Foundation has been adopting a multi-pronged approach to address the pandemic—leveraging its existing relationships, projects, and capacity to tackle the virus, collaborating with global agencies on information campaigns in rural communities, and working with local partners to build up emergency operational capacity, surveillance, and testing capacity of countries.
She also offered a number of ways how philanthropists can contribute to global vaccination efforts: setting up collaborative funds like the India COVID Response Fund to ensure last mile delivery of healthcare, humanitarian aid, and livelihood support; providing resources such as manpower, cold-chain and logistics support to enable procurement and the safe distribution of vaccines and medical equipment; and most critically, using their influence and voice to combat vaccine hesitancy and convince communities to inoculate.

There are however, other challenges to contend with. Vaccine cold-chain storage is often misunderstood and inadequately funded, shared Jesal Doshi of B Medical Systems, which has managed last mile vaccine cold chain storage in more than 140 countries. Asian countries focus on logistical costs per dose but fail to look at the overall total cost of ownership—that is to say, failing to look at the total system cost. Consequently, while countries try to save by not investing in proper infrastructure, they end up losing money in the course of vaccine administration, such as through wastage.
He also highlighted the wide disparity of vaccine expertise and management across Southeast Asia. While Malaysia and Indonesia are effectively deploying local financing to invest in new vaccine technologies and innovation, others such as Cambodia, Laos, Myanmar and the Philippines are depending on existing or inadequate cold chain systems, and are in need of external funding.
The pandemic has also brought upon humanitarian implications, most especially on children and on their education. According to Dr Kunihiko Hirabayashi, Regional Advisor at the UNICEF Regional Office for East Asia and the Pacific, children are particularly at risk in falling into poverty as education is disrupted by the pandemic—and vaccines are necessary to ensure children can go back to school safely.
Despite rising inequality exacerbated by the pandemic—there are global mechanisms in place to help equitable access for vaccines. Marie-Ange Saraka-Yao, explained how global vaccine alliance Gavi, which manages the COVAX facility, has been helping create economies of scale by pooling demand from different countries to effectively negotiate vaccine pricing with manufacturers; while the COVAX facility pools philanthropic funds to distribute vaccines to countries that cannot afford them en masse.
APC Members rally to enable equitable access to vaccines
Following the dialogue, APC members came together to collectively co-fund US$1.5 Million towards the COVAX Facility, which has to date helped distribute over 38 million vaccine doses to over 100 economies across the world. This amount will be matched by the Gates Foundation.
Working together is necessary to tackle the virus
Fundamentally, a collaborative, multi-faceted approach is necessary to tackle the virus. Neither vaccines nor diagnostics alone are sufficient in tackling the virus. Technical responses need to be paired with humanitarian and economic perspectives. Interventions have to be used in tandem, with non-governmental actors and philanthropists needing to work in tandem and not apart from governments. And only then, by joining forces and integrating our efforts, can we truly put an end to the pandemic.