Trucks rolled out of an American pharmaceutical company to deliver across the United States doses to give people immunity from the coronavirus disease (Covid-19) that surfaced in China last year. Shipments of the vaccines were also airlifted to the United Kingdom, Canada and our neighbor Singapore.
There were reports the Pfizer vaccines going to Singapore should have been delivered next year to the Philippines, but some Duterte administration officials were slow enough to sign some documents.
But that is water under the bridge. The Philippines will have to do it the hard way to get the vaccines, which, Rodrigo Duterte has repeatedly said in his public addresses, is the only way to stop the disease.
Duterte has anchored his coronavirus pandemic response on two things: movement control through quarantine restrictions and the elusive vaccines.
The Philippines has the world’s longest and strictest lockdown, resulting in business losses and job cuts and making the country’s economy the worst performing in Asia from one of the fastest growing in the world.
Gross domestic product is projected to contract to 8 percent this year from a high growth rate of 6 percent last year.
There is definitely something wrong when the pandemic response plan was left to ex-generals and medical experts were sidelined, unlike in other countries that have successfully controlled the spread of the virus.
There were projections the country will have 500,000 Covid-19 cases and nearly 9,000 deaths by the end of the year. Another surge in virus infections is expected after the Christmas holidays.
Since the start of the outbreak in the country early this year, Duterte has been saying only a vaccine can address the health crisis, the toughest problem the administration has faced in four years.
He said the country can only return to normalcy, including face-to-face learning in schools and increased mobility and tourism activities, once the vaccine arrives.
This month, the United States and United Kingdom started inoculating their citizens with doses from Pfizer and a second vaccine from Moderna was nearing approval from the Food and Drug Administration for emergency use authorization.
A British-developed vaccine from AstraZeneca is completing human trials although it has taken advanced orders from several countries, including the Philippines, for its doses, which are relatively cheaper than Pfizer’s and Moderna’s and don’t require cold storage for safe keeping and transportation.
Vaccines from Russia and China are also on the way although these were in limited use in their countries.
It seems the Duterte administration has not done anything to secure the vaccines as it did not fund vaccine procurement in next year’s national budget.
Only P2.5 billion was allocated under the Department of Health budget to buy the vaccines for about 60 percent of the more than 110 million population, the necessary number of people needed to have an herd immunity from the virus.
More than P70 billion was placed in unprogrammed projects of the budget, which can only be used if there were enough funds left under programmed projects, betraying the kind of priority given to the vaccination program and the lack of urgency of the government in addressing the pandemic.
Duterte and his officials have been promising that the vaccines would soon arrive, probably by the second quarter of 2021, but the truth is the government has not signed any supply contract with any of the world’s biggest drugmakers.
There are no government-to-government agreements with Russia and China for the supply of vaccines because no funds have been allocated for the doses.
It is still strictly business for these pharmaceutical companies, even with China and Russia. The Philippines is relying on multilateral lending institutions, including the World Bank and the Asian Development Bank, to provide loan facilities for the procurement of the vaccines.
But, until the money is there, the Philippines cannot sign any vaccine supply agreement. It seems the government is raising false the vaccines will be available early next year.
Health Secretary Francisco Duque III did not sign the document for the Pfizer vaccines maybe because the government has no funds to back up the procurement, including the shipment and other logistics that go with the vaccine delivery.
With no funds to procure Pfizer and AstraZeneca vaccines — the contract for 2.6 million doses from AstraZeneca was funded by the private sector, which contributed to P600 million — the government will turn to China to get vaccines through a loan agreement under government-to-government negotiations.
That’s why retired general Carlito Galvez, the vaccine czar, was so confident the Philippines would have Sinovac doses by March next year.
Some sectors have questioned the government’s faith in Chinese vaccines because it has not released any data to show its efficacy and safety. Sinopharma has released data in the United Arab Emirates showing more than 80 percent efficacy.
Brazil stopped Sinovac’s human trials in the South American country after one death was reported, although it was not directly related to the vaccine.
There were also bribery issues and risks of biased reporting on the results of Phase 3 human trials.
Many local healthcare workers were also worried of the Sinovac shots, as there is lower trust in anything coming from China.
Dr. Ted Herbosa, a medical practitioner who has been advising the government’s national task force implementing the pandemic response, also would not risk getting the vaccines either from China or the Western pharmaceutical companies.
He said vaccines normally took years to develop, recalling that the hepatitis shots in the 1990s were made after 10 years of research and trials.
The anti-COVID-19 vaccines were developed only after less than a year although the research began in early 2000 when the world struggled against the SARS (Severe Acute Respiratory Syndrome) virus. There are some similarities between SARS and Covid-19.
Herbosa said the Western vaccines were developed not from the live virus that causes Covid-19. Instead they used a new technology called “messenger RNA.”
These vaccines give instructions to the cells to make a harmless piece of what is called the “spike protein.” The spike protein is found on the surface of the virus that causes Covid-19.
In contrast, the Chinese vaccines put a weakened or inactivated germ into the body to trigger an immune response.
The mRNA, instead, teaches cells to make a protein that triggers an immune response or antibodies that protects people from getting infected if the real virus enters.
It was a new technology that Herbosa said might cause some adverse side effects because it was still untested.
That could be a reason why AstraZeneca had required countries buying its doses to sign a waiver exempting the company from any lawsuit arising from side effects from the vaccine.
Unlike the Chinese and American vaccines, the Oxford University-developed AstraZeneca is based on a chimpanzee adenovirus-vectored vaccine.
This means the company took a virus that infects chimpanzees and genetically modified it to avoid any possible disease consequences in people.
The adenovirus-vectored vaccines have been in development for a long time for diseases, like malaria, ebola and HIV. But no adenovirus vaccine has been approved for human use in the US. In fact, some of the adenovirus vaccines in past trials were ineffective.
Johnson & Johnson is also working on a similar adenovirus-vectored vaccine and plans to release its data early next year.
China’s CanSino is likewise developing an adenovirus vaccine called NantKwest.
Duterte’s silver bullet to address Covid-19 rests on vaccines from the West and from China. But there are some potential risks in using them as the doses were produced quickly and without long periods of trials for efficacy and safety.
If the government’s medical adviser is hesitant to get shots from any of the vaccines available, can Duterte force the people to get immunized when the doses become available? Perhaps not early next year as the government does not have the funds yet to procure them.