No duopoly in Thai jab procurement

No duopoly in Thai jab procurement

A woman is injected with a Covid-19 vaccine at the Chulabhorn Royal Academy in Bangkok. His Majesty the King’s sister has approved coronavirus vaccine imports by an institution she sponsors, bypassing the government as it deals with surging infections and growing public anger over a slow and chaotic rollout. (Photo: Varuth Hirunyatheb)

Just as Thailand’s murky vaccine plan has gone from bad to worse, the plot keeps thickening. The latest development centres on the May 25 publication in the Royal Gazette of the Chulabhorn Royal Academy’s authority to procure Covid-19 vaccines within the country and from abroad as needed for public health benefits. As has been promptly noted elsewhere, this vaccine bombshell could be perceived as a snub to the government of Prime Minister Prayut Chan-o-cha, particularly Public Health Minister Anutin Charnvirakul. Thailand’s effectively dual-track vaccine strategy is now likely to engender major repercussions.

Evidently, Thailand’s vaccine programme has been botched and bungled at every step along the way. While the Thai government did well during the initial virus-containment stage for much of last year, its response to the second and third waves of infections since December has been shoddy and abysmal. As with the Spanish Flu just over a century ago, second and third waves tend to be stickier and deadlier with virus mutations.

As virus spikes are seen across large part of the world, the difference this time is that vaccines are at hand, depending on procurement strategies across countries. Those that performed poorly in virus management but effectively in vaccine accumulation and rollout, such as the United States and the United Kingdom, are faring much better with promising prospects. Both the US and the UK as well as the European Union are on their way to herd immunity and a resumption of economic activity and social life.

Thailand is suffering not just a new and deadlier round of infections but also government incompetence amidst relative deprivation. As other countries roll out their vaccines, Thais can only watch with envy at outsiders’ health and safety amid resentment that their government has not done better. It is abundantly clear now that the Thai government last year placed the wrong bet in the beginning by linking up the UK’s Oxford-AstraZeneca exclusively with the palace-backed Siam Bioscience for licensed manufacturing.

The government failed to source other suppliers that were in the vaccine hunt, particularly the US-made Pfizer and Moderna, the two vaccines widely deemed as most effective against Covid-19. While most countries in the world joined the World Health Organization-sponsored Covax international cooperation for vaccine production and distribution, Thailand became the only country in Southeast Asia to opt out. The Covax programme, for example, has yielded AstraZeneca vaccines to Cambodia.

As local virus cases and the death toll have mounted in recent months, Thailand has been left with China’s Sinovac and limited doses of AstraZeneca after an entire year of miscalculation and ineptitude. As a result, Thailand has been forced to take in more Sinovac jabs, which have as yet to be approved by the WHO. Such a lack of choice and availability has made Thailand more dependent on China, whereby public health desperation may lead to geopolitical implications, because the Thai government may feel like it owes its Chinese counterpart.

At issue now is whether the new Royal Gazette announcement of the Chulabhorn Royal Academy’s entry into the fray will make a difference at this stage in the vaccine game. Often when facing a national crisis, the typical Thai way is to muddle with different responses, characterised by chaos, confusion and complications and underpinned by inter-agency and personality conflicts. But sometimes one of the responses ends up providing a way out to save the day.

Many will hope that the Chulabhorn Royal Academy will be able to diversify vaccine offers and procure them from outside monopolistic government channels. The announcement indicates that the academy will have a free hand to handle vaccine matters as it sees fit, procuring within the country and abroad as necessary. This is potentially good news but not without debate.

First, many countries are being hit with vaccine scarcity, including the likes of India and Japan. As virus waves lead to more fatalities all over Asia outside China, domestic vaccine sufficiency is imperative for most governments to first take care of their own populations. Without local licensed manufacturing of AstraZeneca, Thailand will be hard pressed to locate and secure vaccines internationally. Yet it is worth a try. There is no better option. If the Prayut government can’t get the job done, then let’s have the Chulabhorn Royal Academy have a go. By the same logic, it would have been be even better to open up the procurement process to private hospitals to also get into the vaccine arena.

Second, as Royal Gazette publications take immediate effect with complete legality, many will wonder if this means the Prayut government is on its way out, whether this is the writing on the wall. It appears inescapable that the academy’s intervention is a direct indictment of the performance of both Prime Minister Prayut and Health Minister Anutin. Will either or both go and will the government be forced out?

Many who have suffered from the vaccine saga will want to see the back of both Gen Prayut and Mr Anutin but constitutional mechanisms are tricky. The 2017 constitution was crafted to keep parliamentary opposition weak and the military strong, spearheaded by a Prayut-led administration. Getting rid of Gen Prayut and staying within constitutional boundaries while at the same time would require going back to the candidates proposed by the contesting political parties ahead of the March 2019 election. Alternative candidates from the opposition Pheu Thai or Move Forward parties — the latter succeeding the banned Future Forward party — may not be palatable to the military. Yet sticking with Gen Prayut cannot be the answer for Thailand after seven subpar years with him at the helm.

Finally, both the Chulabhorn Royal Academy and Siam Bioscience — a pharmaceutical company owned by the Crown Property Bureau are connected. On Wednesday, the director-general of the academy made a five-point statement to explain how his team will proceed. Yet, we have not heard much from Siam Bioscience.

Timing and latitude are revealing. The Chulabhorn Royal Academy’s assertion at this time that it will find and obtain all available vaccines for Thai people suggests that its role is paramount. Its complete freedom above and beyond the Prayut government and its related laws and rules may be a power play to say that public health supersedes government longevity.