Despite efforts to coordinate coronavirus vaccine delivery on a regional and global basis, Pacific Island governments are increasingly meeting their vaccine needs through bilateral arrangements, a situation which is leading to politicisation of the vaccination efforts.
The World Health Organisation’s Western Pacific Office says it will be some time before enough people are vaccinated in some Pacific countries to consider relaxing strict border restrictions.
“WHO would also like to stress that although global vaccine demand vastly exceeds supply, we must continue to work towards equitable distribution to ensure all countries have their most vulnerable groups protected, as soon as possible. Until all countries are safe, no country is safe; and even within countries, no community is safe until every community is safe,” the Western Pacific Office said WHO has said in response to questions from Islands Business.
“There’s some vaccine nationalism happening” agrees Sunia Soakai, who is working on the COVID response as part of the Pacific Community’s (SPC) Public Health Team.
“This is why COVAX was set up, to try and ensure there is equitable distribution of the vaccine” he says. “It has to some extent achieved that objective.” And are Pacific Islands getting vaccines in sufficient quality quickly enough? “If you asked me if I was at a country level, at a national health administration, my response would be that it is too small, it is too slow.
“In an ideal world there would be enough supply for everyone to be vaccinated, but that hasn’t happened. There was some thinking that by 2021 most of the Pacific would be vaccinated. We’re still using that as an end game…the more candidates (of vaccines) available, the better.”
A proportion of the Pacific’s vaccines are arriving through COVAX, a multilateral global access facility based on pooling procurement. This month, the World Health Assembly heard that while COVAX has shipped roughly 72 million doses to some 125 developing nations globally, that’s just 1% of their combined populations.
Pacific Island nations that have received the AstraZeneca vaccine through COVAX include Fiji, Solomon Islands, Samoa, Tonga, Nauru, Papua New Guinea and Tuvalu. Most recently (May 19), Vanuatu received its first batch of 24,000 doses, and Kiribati was due to get a batch late May.
However vaccines are increasingly being supplied directly, by the United States, Australia, New Zealand, France, China and India. Most recently, Russia has offered vaccines to Vanuatu.
Meanwhile WHO’s Western Pacific Office says it has observed recent bilateral deals between high income countries and manufacturers that have signed up to the COVAX Facility. “We’ve observed that companies will give priority to bilateral deals, which in this initial period of supply constraints inevitably affects the availability of batches that could have gone to COVAX AMC countries.
“This is why WHO has been advocating for a coordinated global plan. The current piecemeal approach favours those who can pay most and leads to some populations already vaccinating younger people while (many) others haven’t even started vaccinating health workers and high-risk groups.”
The QUAD
In the Pacific, the QUAD nations—Australia, India, Japan and the United States— are cooperating on the vaccine roll out to keep the region “safe, stable and secure” tweeted Australian Prime Minister Scott Morrison.
This effort has been somewhat hampered by the tragic rise in cases in India, where more than 300,000 people have died as a result of COVID-19. It means the Serum Institute of India is no longer exporting AstraZeneca vaccines internationally; Fiji was the early beneficiary of one donated batch from India under its Vaccine Maitri initiative.
In the south, Australia is the big player. Under an agreement with UNICEF, it will procure some six million doses of vaccines for allocation across the Pacific this year. It is now producing the AstraZeneca vaccine domestically at the Commonwealth Serum Laboratories [CSL] in Melbourne, and has pledged to ship 10,000 doses into the region every week. The impact of this is already being felt in Fiji, where vaccines are now arriving on a regular basis. Australia has also given A$80 million(US$62 million) in funding to the COVAX Facility. The recently-announced Australian federal budget included A$162.6 million (US$126 million) for “safe and effective vaccines in the Pacific and Southeast Asia.”
“Australia is doing a fair bit, it’s just that we’re not doing it multilaterally,” says Development Policy Institute Director, Dr Stephen Howes, of Australia’s approach on COVID-response. “I guess that’s for that’s because we want the money to go to our region, we want it to go to Asia and the Pacific. And I guess we want diplomatic recognition, or the soft power recognition, the goodwill that comes with that.
“I guess the downside of that is that while the Pacific is important, Australia is also a middle power, a global player, we’re part of the G20, we’ve been invited to the G7 and we have an interest in the global response to the pandemic…I think it is both in our interests and we are going to come under a lot of pressure to do more multilaterally,” he says.
“This government has a much stronger regional focus—especially a Pacific focus—than it does a global focus, and I personally think that is a weakness.”
Pacific countries and territories affiliated to the US were the earliest recipients of vaccines in our region thanks to Operation Warp Speed and have had a choice of the Moderna, Johnson and Johnson and Pfizer-BioNTech vaccines, enabling them to send the most logistically-appropriate vaccine to remote outer islands.
France has kept vaccines flowing to French Polynesia, New Caledonia and Wallis and Futuna, all of whom have seen community transmission of COVID-19.
New Zealand has taken the lead on vaccine support in its realm states; Cook Islands, Niue and Tokelau. Pfizer vaccinations started in Cook Islands on May 19, with enough stock in hand to vaccinate all Cook Islanders aged 16 and over.
While this support is consistent with the foreign policy focus of the region’s partners (Australia’s Pacific Step-Up, New Zealand’s Pacific Reset etc), the QUAD mobilisation is also seen as a response to China’s offers to provide vaccines.
China was quick to ship the Sinopharm vaccine into Solomon Islands (50,000 doses) and has donated 200,000 doses to PNG. It has also offered to give 20,000 doses to Vanuatu.
In a midnight ceremony to welcome the Sinopharm shipment on April 12, PRC Ambassador to Solomon Islands, Li Ming said: “The move testified to our people’s true friendship and strong partnership based on mutual trust and sincere cooperation.”
A conservative newspaper The Australian, accused China of vaccine diplomacy last month, editorialising that it was using the supply of vaccines: “to further its strategic interests in countries desperate for help. Doing so is a perverse contradiction of the responsibility China bears for the pandemic. But that has not stopped it cynically seeking to exploit the crisis for its strategic advantage by pledging vaccine supplies to at least 53 countries.”
Managing the competing agendas of international development partners is hardly a new experience for Pacific leaders. And in countries such as Fiji, where the pandemic is having a devastating effect on the economy and community transmission has dashed any hope that borders will be reopened to tourists soon, leaders are desperate to keep the flow of vaccines and other forms of health and budgetary support coming.
WHO’s Western Pacific Office says the recent listing of the Sinopharm vaccine for emergency use “has the potential to rapidly accelerate COVID-19 vaccine access for many countries in the Pacific and globally. To ensure that that these vaccines are being appropriately absorbed into national vaccination plans and regulatory requirements completed, WHO is urging the manufacturer to participate in the COVAX Facility and contribute to the goal of more equitable vaccine distribution. It will be up to Sinopharm to say how many doses of its vaccine it can provide to COVAX.”
Meanwhile Russia has also indicated it is ready to deliver the Sputnik V vaccine to Papua New Guinea. In other regions such as South America, the US has worked to discourage countries from taking the Russian vaccine, but it has been taken up in many other countries, including parts of Europe.
Still, regional coordination still plays an important role in eliminating duplication and creating efficiencies says Soakai at the SPC.
“Just to have a mechanism where we can get more than 22 partners sitting around the table, trying to agree on a common way forward in supporting the countries is a significant achievement.
“Otherwise it would have been a real mess where you have bilateral conversations going on between countries and organisations. And again, okay, for instance, this this Fiji response, because we had the structures of the IMT (Incident Management Team), the government had already circulated some medical supplies and PPE requests, so the first thing the donors, all the partners did was call and say, ‘look we have these requests, can we meet, can we see how we can contribute.’”
