ISLAMABAD — On Wednesday, the first shipment of the privately imported Russian COVID-19 vaccine, or Sputnik V, comprising 50,000 doses, arrived in Pakistan. The vaccines will be available for commercial sale for those who can afford to pay.
Pakistan is one of the first countries to allow the private sector to import and sell COVID-19 vaccines. It has also exempted them from price caps, which have raised concerns about access inequality. Experts say this move could lead to disparity under an already fragile health care system and expensive private health care facilities.
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Per the government figures, Pakistan has recorded 615,810 cases of COVID-19 and over 13,717 deaths as of March 18. While the country has received 1 million doses of Sinopharm vaccines donated by China and expects 17 million doses of the AstraZeneca-Oxford vaccine through COVAX, it has turned to the private sector to meet its vaccination demands for its population of 220 million people.
Health Minister Faisal Sultan said that even as the government is focusing on vaccinating the population for free, a small population group can afford to pay for the vaccine from the private importers in the market. “With the availability of the different types of vaccine in the market in March, the competition will set the prices,” he told Devex.
The country also battles with misinformation and vaccine hesitancy as historically experienced in its polio inoculation efforts. In this scenario, experts are wary that convincing people to pay for vaccines will be an uphill battle.
Need for private sector
“The market price regulation of the vaccine is an issue as we have seen shortages and price hikes in masks and sanitizers last year. I suggest the government set uniform prices which are accessible to middle class people,” Dr. S.M. Qaisar Sajjad, Pakistan Medical Association’s secretary general, told Devex.
“Regulating the vaccine prices always fails and market competition will automatically set the price itself. ... Guidelines [on imports] from the government...will thwart the import.”— Fawad Chaudhry, federal minister for Science and Technology
The discussion of importing COVID-19 vaccines for the people who can bear the private
sector’s price is not new. In January, Asad Umar, federal minister for Planning, Development Reforms and Special Initiatives, said that the government would not hinder the import of SARS-CoV-2 vaccines, assuring that the private sector and provincial systems were allowed to import the vaccines subject to the endorsement of the Drug Regulatory Authority of Pakistan.
So far, the authority has agreed for China's Sinopharm, Russia's Sputnik V, and the Oxford University-AstraZeneca vaccine.
Federal Minister for Science and Technology Fawad Chaudhry is confident that the policy will be successful in meeting the dual needs of helping businesses and providing vaccines.
“The inclusion of the private sector within the vaccination drive is useful, and it would not be possible for Pakistan to vaccinate the entire population of 220 million. The government has approved unlimited imports of the vaccines. It will help in terms of business, and the government will provide vaccines to the people who cannot afford [them] from the private companies,” Chaudhry told Devex.
The U.S. and the U.K., presiding over the U.N. Security Council in February and March, have important roles to play in ensuring that international solidarity is possible with COVID-19 vaccine distribution.
On the lack of a price cap, Chaudhry stated, “Regulating the vaccine prices always fails and market competition will automatically set the price itself.” Justifying why he had recommended Pakistan's regulatory authority against a price cap, he said, “Guidelines from the government on the imports for private companies will thwart the import.”
The government guidelines say private companies will set the rules for identifying the drafting and prioritizing people for vaccination, its management, surveillance monitoring, and cold-chain management. The private firms will also be responsible for ensuring the staff and nurses' training in vaccine administration and management, including infection prevention and maintaining the use of recording on prescribed formats and facility centers, will be asked to share daily reports and records with government health management teams.
Need for guidelines
A health official working with the Ministry of National Health Services Regulations and Coordination told Devex talks are ongoing with various countries about a cutoff on the prices.
"It's impractical to have vaccination endorsement in Pakistan for commercial use without proper guidelines on [the] price cap," he said, requesting anonymity as he was not authorized to speak on the issue.
Some experts are also concerned about the implications of the lack of governmental supervision on the vaccination program and warn of the vaccines' potential of being sold in the black market.
The government must supervise it's storage, cost, delivery, and quality, Dr Khizer
Hayat, chairman of the Young Doctors Association Punjab, told Devex.
“Access to the vaccine will also be minimal, and it will be hoarded like other commodities in the black market such as sugar, flour. After this, they will be sold at higher rates,” he said.