Millions of doses of Covid-19 vaccines are anticipated this year under the COVAX AMC. Credit: GAVI

Thailand has yet to commit to WHO’s COVAX Facility to get cheap or free Covid-19 vaccines as it is classified as a “middle-income” country: Anutin

Deputy PM and Public Health Minister, Anutin Charnvirakul has stepped out to clarify points fired by leader of Progressive Movement, Thanathorn Juangroongruangkit regarding the government’s plans to seek vaccines for people for free, including efforts to get the vaccines from the WHO’s initiated system supporting pooled procurements, which could cut down deep prices for low-income countries

Mr. Anutin gave more details about the progress made under this global scheme to get cheap vaccines known as COVAX Facility, jointly initiated by the World Health Organization (WHO) and some few global partners including GAVI and CEPI, since the government’s directives over the country’s vaccine acquirements and administration were under attack by opposition groups, along with other clarifications. These were posted publicly on his FB Page on Tuesday.     

The Deputy PM said Thailand has been negotiating under the COVAX framework, but the fact is the country fails to meet its categorisation, under which the vaccines could be distributed for free for low-income countries, which have now been identified at 92.

Thailand, he said, has been classified as “a middle-income country’, the condition which could cost the country more if procuring the the vaccines under the scheme, compared with other ongoing bilateral agreements. It could not pick types of vaccines by its own either, prompting uncertainty and uncontrolled conditions in terms of the amount of the vaccines, the prices, as well as timing, the deputy PM added.

Mr. Anutin during a tele-conference early this month to give the vaccine policy to public health executives.
Credit: Anutin Charnvirakul’s FB Page

“It would be more beneficial for Thailand to acquire vaccines that are affordable and timely, and fitting our circumstances,” said Mr. Anutin.

The Deputy PM insisted that the government has not been sluggish in seeking Covid-19 vaccines as it began the work from the right start when they were first developed in last April. As the work was still under the process and negotiation, the government could not disclose much detail to the public as it was quite uncertain and could confuse the public.

Mr. Anutin also insisted that the government has been negotiating with “every manufacturer available”, but there are limitations that prevent it from making deals with them such as upfront payments and no re-funds.

The government has tried to pick vaccines, which fit the conditions including public safety and the country’s budget. And that’s the reason why AstraZeneca was picked as one of the candidates as its vaccine is cheaper than the others while fitting the medical conditions here.

Mr. Thanathorn questioned why the government has sought a large amount of Covid-19 vaccines from the company.

By receiving technology transfer from AstraZeneca, the country’s vaccination capacity would become strengthened and secured, he said, stressing the plans are under advices from leading medical experts of the country.

Thailand initially planned to acquire vaccines for 50% of the population this year, but according to the Deputy PM, about 31.5 out of 50 million people in need (children under 18 and pregnant women excluded) would be covered by 63 million doses set to be acquired following the ongoing negotiations. 2 million doses will be from China’s Sinovac, and the first 26 million doses and 35 million more from AstraZeneca.

That accounts for up to 63% of the population in need, he said. With these amounts of the vaccines, it’s enough to boost immunity among Thai people, he added.

The Deputy PM fell short to address the portion earlier set for COVAX, which was about 20% out of the initial 50%.

As shown by Thanathorn’s graphic information (as of November last year) he had acquired from one of Parliament’s committees, some few million doses of COVAX vaccines would be delivered this year before the amounts are increased up to the set percentage (20%) in the next two years, or around 18 million doses.

As checked by Bangkok Tribune, the status of Thailand under COVAX, as of December 15, 2020, was the country which has submitted just “non-binding confirmations of intent to participate in the COVAX Facility”.

There is another category, under which countries have signed “commitment agreements” to COVAX, both higher-income countries and low and middle-income countries. The latter, now 92, will be eligible to have their participation supported by the COVAX Advance Market Commitment (AMC), a financial instrument developed to support free or cheap prices of the vaccines for eligible countries.

Hard-working medical staff treat a patient in a hospital during the second hit by Covid-19.
Credit: Anutin Charnvirakul’s FB Page

COVAX Facility

As explained by WHO and its alliances, COVAX Facility is a global pooled procurement mechanism for COVID-19 vaccines, through which the Facility will ensure fair and equitable access to the vaccines for all 190 participating country, using an allocation framework formulated by WHO.

It will do this by pooling buying power from the participating countries especially higher-income countries, and providing volume guarantees across a range of promising vaccine candidates.

The initial aim of the Facility is to have 2 billion doses available by the end of 2021, half of which will go to lower-income countries, thus ensuring fair access to this promising cure of Covid-19.

To get the mechanism to function, higher-income countries are persuaded to place orders for the doses they need with upfront payments, which in turn, will help the Facility ensure that manufacturing is ramped up timely, “before, not after the vaccines are approved, the organizations note. 

This is seen as the only way to ensure that vaccines can be delivered “at scale”, being enough for all, including those that cannot afford to pay, they claim.

Credit: WHO

The doses for lower-income countries will be paid for via a separate financial instrument, the Gavi COVAX AMC. It is largely funded through Official Development Assistance (ODA), plus some low payments from the AMC eligible countries, estimated to be around US$ 1.60-2 per dose.

Gavi, the Vaccine Alliance, is a public-private partnership of the world’s leading organisations and foundations such as WHO, the World Bank, the Bill & Melinda Gates Foundation, and other partners, which have been working on boosting primary healthcare and immunity among the world’s citizens especially children from deadly viruses such as Ebola. It takes a role in this scheme as a body that leads on procurement and delivery for the Facility, while coordinating the design and implementation of the Facility and the COVAX AMC. 

Another key partner, CEPI is a global partnership launched in Davos in 2017 to develop vaccines to stop future epidemics. It takes a role in this scheme on the vaccine research and development portfolio, while investing in R&D across a variety of promising candidates.

In mid-December last year, COVAX announced that it has managed to have arrangements in place to access nearly two billion doses of COVID-19 vaccine candidates, the first prime target for this year.

The arrangements would enable all participating countries to have access to doses in the first half of 2021, with first deliveries anticipated to begin in the first quarter of 2021, upon regulatory approvals and countries’ readiness for delivery, WHO announced.

At least 1.3 billion donor-funded doses will be made available to 92 COVAX AMC countries, with the target up to 20% population coverage by the end of the year, according to the organization.

The new deals have included the signing of an advance purchase agreement with AstraZeneca for 170 million doses of the AstraZeneca/Oxford candidate, and an MoU with Johnson & Johnson for 500 million doses of the Janssen candidate.

These are aside from the existing agreements COVAX has with the Serum Institute of India (SII) for 200 million doses, with options for up to 900 million doses more, of either the AstraZeneca/Oxford or Novavax candidates, as well as a statement of intent for 200 million doses of the Sanofi/GSK vaccine candidate, WHO elaborated.

COVAX also has the first right of refusal in 2021 to access potentially more than one billion doses that will be produced through R&D partnership agreements, WHO added.

“The arrival of vaccines is giving all of us a glimpse of the light at the end of the tunnel,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General “But we will only truly end the pandemic if we end it everywhere at the same time, which means it’s essential to vaccinate some people in all countries, rather than all people in some countries.”

The AMC has met its 2020 fundraising target of US$ 2 billion, but at least US$ 4.6 billion more is needed in 2021, the organization said. Overall, the Facility needs to raise an additional US$ 6.8 billion.

Last week, the Facility made further progress as it got an advance purchase agreement with Pfizer for up to 40 million doses of the Pfizer-BioNTech vaccine candidate, which has already received WHO emergency use listing, while some 100 million doses from India’s SII would be received and delivered to the COVAX AMC countries in the first quarter.

WHO also said it would launch a “Country Readiness Portal” this month, which will allow the AMC countries to submit final national deployment and vaccination plans (NDVPs).