Are Asian countries choosing US or China for the Covid-19 vaccine?
Will the first Covid-19 vaccine be manufactured in China, the United States or Britain? With 160 vaccines under development globally, countries are hammering out deals with pharmaceutical companies and state-owned firms to get first dibs on one, in the hopes it will allow them to fully reopen economies that have taken a battering from trade disruptions, lockdowns and border closures.
Singapore, for example, is funding research by American biotech company Arcturus Therapeutics to secure the first doses of any successful vaccine. Arcturus, partnering the island nation's Duke-NUS Medical School, is now in the early stages of human testing with the goal of producing 30 million doses of a single-shot vaccine, Bloomberg reported on Wednesday.
Ooi Eng Eong, deputy director of Duke-NUS' emerging infectious diseases program, said the number of doses produced in the first batches would likely exceed the quantity required by Singapore and might be available for distribution to other countries.
The likes of US, Britain and Japan have secured potential vaccines from companies such as AstraZeneca and Pfizer, India is among those that have created their own candidates, while other countries such as Singapore have teamed up with smaller pharmaceutical producers.
Here is a look at the front-runners of the vaccine race, the ones Asian nations are eyeing, and the potential challenges of wide-scale vaccination.
WHO ARE THE KEY PLAYERS IN THE VACCINE RACE?
China, the initial epicentre of the Covid-19 outbreak, is among the countries at the forefront of the global vaccine race. In July, Chinese media reported that a vaccine developed by Tianjin-based CanSino Biologics and the country's military research unit had shown some promise in early human testing.
Though it is set to launch a phase three trial, Beijing said the vaccine could already be used by the military. This makes CanSino the first company to have a coronavirus vaccine approved for limited use.
Other Chinese companies, including Beijing-based Sinovac and state-owned Sinopharm, have also launched their final phase three trials. The former will conduct trials in Brazil, while the latter is set to test its vaccines in the United Arab Emirates.
Switzerland is close to signing a deal to secure access for a coronavirus vaccine being developed by Moderna, according to a Swiss government official.
Russia is also hoping to bring two vaccines - one developed by Gamaleya Research Institute and the defence ministry, and the other by the Siberia-based Vector state research laboratory - to the market by the end of this year. Gamaleya has completed clinical trials for its vaccine, leading Russia's health minister to prepare a mass vaccination campaign for October, according to local news agencies.
Some 160 vaccines are currently under development around the world. Photo: Reuters alt=Some 160 vaccines are currently under development around the world. Photo: Reuters
WHICH VACCINES ARE ASIAN NATIONS EYEING?
In Asia, some countries have chosen to go with China-produced vaccines or co-develop one with the mainland, while others have opted for those produced by Western drug makers.
Falling in the first category is Indonesia, Southeast Asia's largest economy. Its state-owned pharmaceutical company Bio Farma has been working with Sinovac to develop a coronavirus vaccine since April. It is set to launch phase three trials later this month, which if successful would herald production of up to 250 million doses a year.
The Philippines, dealing with an unprecedented surge in infections that has prompted a second lockdown, is also eyeing a China-made vaccine. Last month, President Rodrigo Duterte said he had asked his Chinese counterpart Xi Jinping to help the Philippines get priority access to a Covid-19 vaccine.
The Philippines now has over 112,000 cases and is set to overtake Indonesia for the most cases in Southeast Asia.
Similarly, Malaysia's science, technology and innovation minister Khairy Jamaluddin last week spoke with China to express Putrajaya's interest in securing early vaccine access, even though he had earlier said the country was also looking at other options produced by the US and Britain.
When deciding on which vaccine to procure, Kavitha Hariharan, director of healthy societies at Marsh & McLennan Advantage, said safety and efficacy would be the top considerations but cost could not be discounted. This was especially the case for developing countries with large populations that had relatively lower health care spending per capita, she said.
Jeremy Lim, an associate professor at the National University of Singapore's Saw Swee Hock School of Public Health, added that geopolitical reasons could also explain why some countries chose certain vaccines. He said that countries would "naturally align" to their broader national priorities beyond health.
Said Leong Hoe Nam, a Singapore-based infectious diseases expert: "If you look at the Philippines and Malaysia, there is also a strong Chinese overture to those countries, and we also saw China providing medical supplies to them so they are likely to get vaccine supplies from China easily."
Leong added that the availability of a vaccine also played a part as demand would likely outpace supply.
WHY IS THERE SCEPTICISM OVER VACCINES PRODUCED BY CHINA OR RUSSIA?
Last week, top US infectious diseases official Anthony Fauci said it was unlikely the US would use vaccines developed by either China or Russia, citing how their regulatory systems were far more opaque than in the West.
"I do hope that the Chinese and the Russians are actually testing the vaccine before they are administering the vaccine to anyone," he told a US Congressional hearing on July 31. "Claims of having a vaccine ready to distribute before you do testing, I think, is problematic, at best."
Leong said part of the reason for doubts over China-made vaccines could be due to "bad press" that Chinese companies have had in recent years, with "poor quality and ineffective" vaccines manufactured.
For example, in 2018, drug producer Changchun Changsheng violated standards in the making of some hundreds of thousands of vaccine doses for diphtheria, tetanus and whooping cough, administering 200,000 children with the defective product and causing paralysis in a few cases.
For Russia, Leong said the worry stemmed from the lack of medical publications on the vaccines. Other countries' vaccine results were published, allowing scientists and researchers to scrutinise the findings and evaluate the data.
HOW DIFFICULT WILL IT BE TO ADMINISTER MASS VACCINATIONS?
Hariharan of Marsh & McLennan said one major challenge would be to convince enough people to get vaccinated, given how vaccines had been manufactured at unprecedented speeds and against the backdrop of rising vaccine hesitancy in many countries.
"Another challenge is affordability. Co-payments or out-of-pocket payments could discourage some people from getting vaccinated," she said, also noting that there are initiatives, including Gavi, the vaccine alliance founded by the Bill & Melinda Gates Foundation.
Gavi had brought down prices for other vaccines by pooling demand from low-income countries, said Kavitha, who added that the alliance had also introduced Covax, a global financing scheme for Covid-19 vaccines.
Leong, the infectious diseases physician, felt that while the government should foot most of the bill for the vaccine, he suggested that those from better-off backgrounds, such as "those of the middle class and above", should pay a small portion of it. This, he said, would show that citizens were taking ownership of the vaccine.
Lim, the National University of Singapore professor, added that the administration of the vaccine would be a challenge for every country. While Singapore has rolled out mass vaccinations, such as for H1N1 influenza in 2009, most Southeast Asian countries do not have similar experience.
Lim said health care professionals, essential workers, and the most vulnerable segments of the population would likely be first in line for a vaccination.
This article originally appeared on the South China Morning Post (SCMP).
Copyright (c) 2020. South China Morning Post Publishers Ltd. All rights reserved.
