The third wave and the vaccination emergency

Author: Ikram Sehgal

Covid-19 has struck Pakistan with a third wave and has the country head-locked in a vice-like grip. This has come as a shock to many. For unlike Europe and the rest of the world, including neighbouring India, where the virus had been hurtling along at accelerated speed, Pakistan had so far been doing quite well. Now the number of infections is rising rapidly and it seems that these cannot be stopped by routine SOPs and appeals to common sense. A new and complete lockdown is on the cards, threatening more hardship for the poor and the economy at large. The Army has been called in by all the provinces and Islamabad Capital Territory (ICT). As Prime Minister Imran Khan rightly said: “we should and would not endanger human lives to safe the economy.”

One reason that the situation is getting out of hand is peoples’ growing weariness with the restrictions that have been looming over our heads for more than a year. And now Ramzan is upon us once more and for the second year in row, we cannot go out or have friends over for iftari and neither do we feel confident about attending prayers outside the home. In fact, all the pre-Eid festivities have been put on hold. There will be no post-iftari shopping, no roaming around bazaars as we scour gifts and new clothes. And definitely no visits to the tailor. This has become all too dangerous due to the inevitable close proximity of customers as well as the reduced opening hours that cause a surge in shoppers.

The only way to stop the Covid spread is to vaccinate as many people as possible. Yet with COVAX deliveries running severely behind schedule — part of the answer must lie in private sector vaccinations

Elsewhere, the vaccination campaign has effectively stalled, or, at least, is not spreading its net as wide as had been anticipated. Some 1,13.4 million adults in Pakistan require immunisation. Back in February, China gifted Pakistan half-a-million doses of its Sinopharm vaccine, making the country the very recipient of its benevolence. Earlier this month, Pakistan received a fresh 500,000-batch of Sinopharm as well as 600,000 doses of China’s single-shot CanSino vaccine. If we include a pending additional request for another half-a-million doses of Sinopharm — this will bring the total number of vaccines (potentially) circulating in the country to just over 2 million. This sounds all well and good until we remember that this is a country of 220 million. However, it seems that the government may have failed to buy additional vaccines insofar as the initial reports of procurement of one million doses of the Pfizer vaccine remain unconfirmed. Though this could, of course, be linked US control of supply.

Then there is the financial problem to confront. For the most part, Pakistan has been relying on donated vaccines, which the government has passed on to citizenry free of cost. This last part is as it should be. For there is already much apathy towards immunisation and when combined with high poverty rates, asking people to pay for shots was never going to work across the board.

Right from the beginning, it has been clear that the key to stemming the spread of this virus rested not just in developing vaccines — but ensuring equal distribute and access. For unless the poor are included in mainstream immunisation processes, the virus will continue to spread and trigger new mutations. Toward this end, the WHO (World Health Organisation), in partnership with the European Commission and France launched COVAX; a global initiative aimed at equitable access to Covid vaccines by bringing together governments, global health organisations, manufacturers, scientists, the private sector, civil society and philanthropists under a single umbrella.

Certainly, this is a valuable endeavour; with COVAX pledging to deliver 100 million vaccines by the end of March. To date, however, it has come good on around 38.5 million doses. That is quite a shortfall. Pakistan is earmarked for 15 million doses under this framework, thereby positioning it among the top five donor recipients. Yet this remains up in the air given the question marks around delivery schedules. Especially since current production capacities are strained. Add to this the fact that vaccines were doled out on a ‘first come, first served’ basis, thereby allowing rich western countries to secure early contracts and exerting near monopoly control.

In a very reasonable initiative, the Pakistani government allowed the private sector to import vaccines. Thus, 50,000 doses of the Russian-made Sputnik V and a small number of single-dose Chinese vaccines made their way here. However, their sale was massively delayed over seemingly endless negotiations about retail prices. The Sputnik was sold to and administered in private hospitals in for a total of Rs 15,000 (for the two required shots). This is by no means a small amount but remains vastly cheaper than the expenses incurred for Covid treatment at a private hospital, running into hundreds of thousands of rupees. Unsurprisingly, the Russian vaccine has already run out and the Chinese one is on the verge of doing so. Yet private sector vaccine sales have not been resumed in light of the Drug Regulatory Authority of Pakistan (DRAP) halting the programme, taking into account that all imported vaccines have limited sell-by dates. By now, many of these have either now expired or been procured for sale on the black market. The fallout of which represents a serious bump in the vaccination road. And the longer vast swathes of people remain un-vaccinated — the more at risk the entire world is, while Pakistanis will be prevented from overseas travel. A recent Bloomberg report estimates that, given the current pace of the vaccination campaign, it will take Pakistan over a decade to immunise 70 percent of the population and reach so-called herd immunity.

The third Covid wave is here in Pakistan and looks set to stay. To date, only a comparatively small number of people have been immunised and as of the beginning of the week — the official number of active cases totalled 795,627, an 11.5 percent rise from the week before. The government has now warned that if the infection rate does not go down by next week, which seems increasingly unlikely, the country will enter into complete lockdown; the upshot being that we are now looking forward to a difficult second half of Ramzan and an even more difficult Eid. The only thing that can be done therefore is to vaccinate as many people as possible. Yet with COVAX deliveries running severely behind schedule — part of the answer must lie in private sector vaccinations.

The writer is a defence and security analyst

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