Pakistan’s vaccination plan for Covid-19

Does Pakistan have a vaccination plan for Covid-19?

Notwithstanding the global efforts to ensure fair access to the Covid-19 vaccine, it is not a level playing field for developing countries, which are struggling to acquire sufficient quantities of vaccine. Out of a total of 7.2 billion doses booked so far, 72% have been booked by high or upper middle-income countries, 28% by lower middle-income countries out of which 75% have been booked by India alone, and almost nothing by low-income countries.

So far, at least seven vaccines have been approved, out of which five have been approved for use outside their country of approval, including those by Pfizer, Moderna, Oxford-AstraZeneca, Sinopharm and Sputnik V. A number of other vaccines are in the advanced stages of approval including those by Johnson and Johnson, Novovax and Bharat Biotech.

Most of these vaccines require two doses to be administered. The approximate per-dose price is $20 for Pfizer, $10-50 (depending on the quantity) for Moderna, less than $10 for Sputnik V, and $3-4 for AstraZeneca. The price of Sinopharm’s vaccine is unknown but news reports suggest around $145 for two doses. However, unlike Pfizer and Moderna vaccines that need to be stored at -75˚C and -20˚C respectively, the Russian and Chinese vaccines can be stored at standard refrigerator temperatures, making them much more suitable for developing countries.

Pakistan has allocated $150 million to procure Covid-19 vaccines, to cover the most vulnerable 5% of the population. So far, we have only been able to book 1.2 million doses of the Chinese vaccine. These doses, however, would only be enough for 0.2% of the population. The price of the contract is unknown but if it’s anywhere close to $145 for two doses, then it would have taken $87 million or almost 60% of the allocated amount. This means that we are going to need way more money.

Pakistan has also joined UN’s COVAX alliance, which is aimed at facilitating equitable access to Covid-19 vaccine. COVAX is planning to make two billion doses available by the end of 2021, for high-risk and vulnerable populations. Out of this, 1.3 billion doses will be financed by donors for 92 low and lower-middle income countries including Pakistan, targeting up to 20% population. In addition, 80 wealthier nations have also joined COVAX, on a self-financed basis. However, it is not certain if the alliance will be able to meet its target within the stipulated time.

In addition, Pakistan has allowed the private sector import of the vaccine. While this is a good initiative, it is unlikely that the private sector would get significant vaccine supply in 2021.

Pakistan has set a target of vaccinating 70 million people to achieve ‘herd immunity’. This means that the country needs 140 million doses. So far, COVAX has committed 50 million doses, which leaves an unmet target of almost 89 million doses excluding 1.2 million Chinese doses. Even with AstraZeneca, this would require $300-350 million. But we are likely to be left with much pricier options, which could increase the price tag to a billion dollars or more.

But money is only one part of the problem. The other issue is the availability of vaccine, as orders from leading suppliers have already been booked for 2021. This leaves us with the Chinese or Russian vaccine or the ones in advanced stages of approval. Time is running out even to secure supply from them, as they are already getting orders.

So far Pakistan does not have a vaccination plan. It therefore needs to act fast and find more money and vaccines, or else it will be left far behind in this race.

Published in The Express Tribune, January 12^th, 2021.

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