Imagine the world without a Covid-19 vaccine — three years into the pandemic and we would still be fighting a losing battle with the uncontainable virus, unending lockdowns, uncomfortable social distancing, widespread unemployment and catastrophic socioeconomic impacts.
What is more, the global pandemic will further negatively impact Sustainable Development Goals (SDGs) and hinder the implementation of SDG3, which aims to ensure healthy lives and promote well-being for everyone at all ages. The spillover effects would indirectly affect other goals such as SDG4 (Quality Education), SDG8 (Decent Work and Economic Growth), SDG9 (Infrastructure and Innovation), SDG10 (Reducing Inequalities), SDG11 (Sustainable Cities), SDG12 (Consumption and Production), SDG13 (Climate Action), and SDG17 (Partnerships for the Goals), among others.
We are all grateful beneficiaries of Covid-19 vaccination — the development, testing, manufacturing and global distribution of the vaccines. A study conducted by Public Health Scotland noted that the chances of being hospitalised with the virus were reduced by more than 85% for those who had received just one dose. This shows that the vaccines are as effective as non-pharmaceutical interventions such as social distancing and lockdowns.
However, the vaccines far exceed such interventions as they help build back the economy, allow businesses to operate and enable social interaction.
It clearly shows that vaccines are important for human health. The World Economic Forum, in “5 charts that tell the story of vaccines today” (2020), notes that up to three million lives are saved every year with vaccination and that it has been among the most successful health interventions. With improved global coverage, 1.5 million deaths a year could be avoided. The importance of vaccination has set in motion a race for vaccine development, with governments, scientific communities and pharmaceutical companies forging partnerships.
In view of the significance of vaccination, technology-enabled advancements are a way forward. One example is the use of a novel platform technology, mRNA, which has been used and approved in the United States and Europe in the development of Covid-19 vaccines. It is being used by both Moderna and Pfizer-BioNTech, as stated in a report by McKinsey in 2021. Another novel platform technology is viral vectors. The Ebola vaccine was developed with this technology, as has Covid-19 vaccines, by such companies as Oxford-AstraZeneca, Johnson & Johnson, CanSino Biologics and Sputnik V. Both the mRNA and viral vector platforms saw significant investments several years prior to the pandemic and by the time Covid-19 struck, they were ready for use.
Another area of focus in assisting the growth of vaccine development is a solid financing mechanism. A report by Johns Hopkins University School of Medicine notes that the cost of procurement and cost to secure Covid-19 vaccines are covered under partnerships formed by the governments of several high-income countries. They partnered and signed contracts with research and development (R&D) and manufacturing companies to cover the development costs.
Ultimately, public financing for Covid-19 vaccines is an important aspect of international initiatives to ensure equitable and affordable access for all countries. COVAX is an example of such a financing mechanism. The aim is to incentivise vaccine manufacturers to invest in production. This is done by having guaranteed purchase volumes prior to a vaccine being licensed.
In Asean, there is growing interest in the development of the vaccine production value chain among several biopharmaceutical companies. The Malaysian Investment Development Authority (MIDA) notes that there are currently five other countries in the region that are producing vaccines — Singapore, Thailand, Indonesia, Vietnam and Myanmar. Some have already advanced to clinical trials and are planning for vaccine roll-out this year. A way forward is to establish partnerships as contract manufacturers in the vaccine value chain. Currently, Malaysia and Indonesia are in collaboration with Sinovac, and Thailand with AstraZeneca, while BioNTech plans to set up a regional centre and factory.
Malaysian experts are already developing two types of Covid-19 vaccines. The first is an inactivated vaccine, similar to the Sinovac-CoronaVac vaccines that use viruses killed by chemicals, heat or radiation to trigger an immune response. The second is mRNA, which teaches human cells to make the protein that triggers an immune response in human bodies. This method is presently being developed under the Institute for Medical Research (IMR).
Malaysia has potential investment capabilities for vaccine production, with well-established manufacturing sectors leveraging the country’s competitive advantages. Organisations such as IMR are also active in conducting R&D and vaccine development. According to MIDA, opportunities for investors and interested stakeholders in Malaysia’s pharmaceutical industry are due to four factors: business-friendly policies, improving local manufacturing standards to guarantee efficacy, quality and safety, R&D capabilities and growing demand for halal pharmaceuticals.
In summary, a proper financing mechanism could greatly expand the development of vaccines in Malaysia. Public investment in R&D and the production of vaccines will help alleviate financial risk and heavy costs in the pharmaceutical industry, and accelerate production. At the same time, an adequate cold chain and appropriate infrastructure are needed for safe storing and delivery of vaccines. Other initiatives that can be considered in strengthening the potential and future of vaccines are conducting public engagement sessions to obtain suggestions and inputs, and ensuring transparency of information to enhance the effectiveness of policymaking.
Ultimately, all policies around vaccination must be guided by the principles of transparency and accountability. This also includes public and stakeholder consultation as well as ensuring that all data and information are made available publicly.
Abel Benjamin Lim is head of Development Economics and Benedict Weerasena is research director at Bait Al Amanah policy institute