In many countries in Asia and the Pacific, more than 95% of people are still not vaccinated against COVID-19. A new Regional Vaccine Advisory Group, launched in July by the Asian Development Bank, aims to help tackle that inequity.
Posing one of the biggest challenges to roll out doses in the region is vaccine regulation, said Dr. Patrick Osewe, chief of the health sector group at ADB, adding that different regulators in the region are at different stages of maturity. This affects the speed at which they’re able to approve a vaccine for distribution.
Comprised of public health experts, vaccine regulators, and policymakers both within and outside the region, the advisory group aims to convene on a quarterly basis and discuss regulatory oversight, risk management strategies, and the pharmacovigilance needed to safely introduce and monitor COVID-19 vaccine rollouts.
“We wanted to bring the regulators together to be able to advise on how vaccines are performing — those that have been authorized by regulators from the World Health Organization and stringent regulatory authorities and those that have not been authorized — to basically look at how they’re performing and share information,” Osewe said. “If they work together, they can share information and build capacity.”
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The inaugural RVAG meeting, held on 1 July, explored options on how to expand low- and middle-income member countries’ access to a wider number of safe, efficacious, and quality COVID-19 vaccines.
Speaking to Devex, Osewe explained the challenges in delivering the COVID-19 vaccine in the Asia Pacific region, how RVAG might help, and what others can do to support the efforts.
This conversation has been edited for length and clarity.
What can you tell us about COVID-19 vaccination efforts in Asia and the Pacific?
COVID-19 vaccine unpredictability complicates country-level planning
Donated doses of COVID-19 vaccines are arriving erratically in many African nations, sometimes with little warning on when they might arrive or what type of doses they might receive. This is making it a challenge for countries to plan their rollouts.
The biggest issue about vaccines is that about 85% of all the vaccines have been administered in rich countries. For example, in countries like Canada, 62% of the population has been fully vaccinated, in the United Kingdom it is about 59% of the population, in Germany about 55% of the population, in the United States about 50% of the population.
When we come to Asia, to give a few examples, in the Philippines about 10% of the population has been vaccinated. In countries like Vietnam, less than 1% of the population has been vaccinated, in Pakistan 2.4% of the population has been vaccinated, and in Papua New Guinea, 0.2% of the population. We have a significant divide between the [high-] income countries and the low-income countries. The serious challenges we’re facing with vaccines and the COVID-19 pandemic will not go away if one region is highly vaccinated and other regions are not highly vaccinated because more variants will come and affect populations that are fully vaccinated.
What are the biggest challenges that countries in the Asia Pacific region are facing in rolling out the COVID-19 vaccine?
At the global level, the biggest challenge we’re facing is that vaccines are not available. Most vaccines that are manufactured in 2021 have been bought. Many of our developing member countries just cannot get them. At the national level, there are also a lot of challenges. For example, when vaccines arrive at the national level, there needs to be a very clear plan on who is going to get it first because vaccines will arrive in small numbers.
The second is how to distribute from the national level to various levels, particularly that last mile. The whole logistics of supply and management is a big challenge. Once the vaccines arrive, what kind of information system do you have to ensure that people get the first dose, and also get the second dose. Many countries are mobilizing retired health workers — doctors, nurses — and others to increase their capacity to deal with this.
Lastly, this is the first time in the history of the world that people are being vaccinated more or less at the same time. We don’t know how many of the new vaccines might have side effects, for example — there has to be a system for monitoring adverse events following immunization.
How is the ADB helping to address some of those challenges?
We are providing significant technical assistance. We are hiring organizations that have experts in every aspect — in planning, in logistic supply management, in information systems — to ensure that when the vaccines arrive from the airport they can reach the last mile.
What can you tell us about this RVAG that the ADB is helping to host?
The biggest challenges facing developing member countries are regulatory challenges. There are many COVID-19 vaccines that have been manufactured. There are vaccines that have been authorized by stringent regulatory authorities, the second group of vaccines are those that have been authorized by WHO, and the third group of vaccines are those that have been widely used but have not been authorized. At ADB, we want to bring the regulators together to be able to advise on how vaccines are performing — those that have been authorized by stringent regulators or WHO and those that have not been authorized by them — and share that dossier of information with RVAG regulators.
We want to have experts from various regulatory authorities in Asia, Europe, and North America to be able to meet once every quarter, sometimes more if required, to brainstorm, to share information, to share knowledge, and to be able to build capacity. Because many regulatory authorities are at different stages of maturity, if they work together they can exchange information and build the capacity of the less mature ones.
How can others support the group and the wider efforts to tackle COVID-19 in the region?
Many of the global manufacturers are looking for partners in Asia. I think a concerted effort to support and have more contract manufacturing organizations that are producing vaccines, that have been authorized, or vaccines that are about to be authorized to be able to meet the demand in the region [is needed]. I think that, in the health sector, we can have a very significant dialogue on how to increase manufacturing capacity. Manufacturing is a critical issue that requires financing, technical assistance, and technology transfer.
Watch the full interview.
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