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Asia Pacific must fix its broken vaccine system

Prevailing zero-sum mentality and parochialism need to be overcome

| Australia
Indonesian President Joko Widodo talks with locals during a visit to inspect a door-to-door mass vaccination program against COVID-19 in North Kalimantan province on October 19. Many Asia Pacific countries including Indonesia have struggled to reach minimal vaccination targets.   © Reuters

Malcolm Turnbull was prime minister of Australia from 2015-2018 and is a co-chair of the Reform for Resilience Commission. Syaru Shirley Lin is the Compton Visiting Professor at the Miller Center of the University of Virginia and Chair of the Asia-Pacific Hub of the Reform for Resilience Commission.

We all now know that the world is not safe until all are safe, but how can we accelerate the fight against COVID-19 when the virus continues to mutate and spread?

To better manage the current pandemic and to create a healthier and more sustainable post-pandemic future, the Asia-Pacific Hub of the Reform for Resilience Commission has gathered leading policy-makers and public health experts to study the Asia Pacific experience and draw lessons for managing the current pandemic and preparing for future pandemics.

The Hub identified a triple challenge: equitable global vaccine distribution, effective and rapid administration of these vaccines, and a more distributed and therefore resilient pharmaceutical production system.

While the Asia Pacific performed exceptionally at first, vaccination rates remain very low in most countries in the region, with the need for prolonged lockdowns and quarantines in Australia, for example, resulting in widespread public fatigue, and a decline in mental wellness, especially among young people.

If the triple challenge can be met, then the pandemic is also an opportunity for the world to become more resilient in public health, economic productivity, and environmental sustainability. Ahead of the World Health Assembly, G-20, and COP26 meetings in the coming weeks, each of which will prioritize one of these goals, leaders should view the pandemic as an opportunity to devise an innovative policy to promote healthier and more sustainable growth, starting with a renewed focus on the Asia Pacific.

Given its central place in the world economy, the region urgently needs access to more vaccines to enable normal economic activity to resume. Effective management of the pandemic in 2020 protected the Asia Pacific and reduced COVID-19's spread, but only a handful of mostly high-income societies are expected to reach high vaccination coverage in 2022. This is because relatively few of the most effective vaccines are produced or available in sufficient quantities in the region.

As an engine of growth and leader in manufacturing products essential to the rest of the world, the Asia Pacific must quickly return to a healthier environment to resume global travel, restore the global supply chain, and enable economic recovery. The region also plays a crucial role in a future global surveillance system that can detect and prevent the next pandemic. And yet many Asian and Pacific countries lag far behind Europe and the United States in vaccination.

In addition to high-income countries such as Australia and Taiwan not obtaining sufficient vaccines before the recent surge of variants, other countries are having problems administering them, with countries including Indonesia, the Philippines, Vietnam, and Myanmar unable to reach minimal vaccination targets.

Given the lack of regional contract production facilities, Asia-Pacific countries have resorted to alternative market mechanisms and vaccine diplomacy to acquire the doses they need, which are inadequate.

Only a small group of countries source components from each other and manufacture COVID-19 vaccines.   © Reuters

Vaccine administration is also difficult. Even wealthy societies with sufficient vaccines have struggled with vaccine hesitancy, caused by mistrust of governments and experts. Compare Singapore, which has vaccinated 80% of its population, with Hong Kong, which has ample supplies of several vaccines but finds it nearly impossible to vaccinate enough people to reach herd immunity.

Regional cooperation among governments, businesses and civil society to spread objective scientific knowledge about the need for vaccinations may be a way forward to build trust and consensus on vaccination.

Finally, we have learned since the development of vaccines against COVID-19 that agile contract manufacturing is needed in the region, rather than relying on a few production sites outside it. For long-term resilience, distributed regional manufacturing capacity must be developed to enhance responsiveness to global health emergencies.

Furthermore, the variety of regulatory processes in the region has hampered vaccine rollout. Experts in this commission believe that formulating coordinated regulations for approving vaccines for emergency use across the region is an important supplement to regional vaccine research, development, and agile manufacturing.

Only a small group of countries source components from each other and manufacture COVID-19 vaccines. With no global agreement on vaccine distribution during a health emergency, market and political forces dominate the process and leave smaller and weaker players vulnerable. Those countries may then become reservoirs of unvaccinated populations, unable to stop new waves of the pandemic as variants emerge and spread.

Many governments preordered excessive quantities of vaccines for themselves, or restricted exports to the Asia Pacific, without any coordination to support the rest of the world. Thus, a few countries have surplus vaccines, while many more have short supplies.

But the pandemic also gives the world the opportunity to increase its resilience against both another pandemic and the even greater threat of climate change. These most pressing global issues all require cooperation.

We must combat the prevailing zero-sum mentality and parochialism to make everyone safer together. Multilateral organizations can facilitate meaningful cooperation in the long term, but they must be complemented by immediate action by the private and public sectors.

Effective cooperation in global crises will be hard if we treat other countries as competitors, especially in a pandemic. We must make COVID-19 an opportunity to find urgent solutions to increase equity in vaccine manufacturing, rollout, and delivery to accelerate our transition to a post-pandemic world, further improve health for all, and increase our resilience in future crises.

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