The future of Covid-19 vaccines in Malaysia
This article first appeared in Forum, The Edge Malaysia Weekly, on August 1, 2022 - August 07, 2022.
Imagine our world without a COVID-19 vaccination: Three years into the pandemic and we are still fighting a losing battle with the uncontainable virus, unending lockdowns, uncomfortable social distancing, widespread unemployment and unimaginable catastrophic socio-economic impacts.
What is more, the global pandemic will further intensify the impact on Sustainable Development Goals (SDGs) and is an obstacle for the implementation of SDG3 to ensure healthy lives and promote well-being for all at all ages. Its spillover effect indirectly affects other Goals such as SDG4 (Quality Education), SDG8 (Decent Work & Economic Growth), SDG9 (Infrastructure & Innovation) and SDG10 (Reducing Inequalities), SDG11 (Sustainable Cities), SDG12 (Consumption & Production), SDG13 (Climate Action) and SDG17 (Partnerships for the Goals) among others.
Gratefully, we are all beneficiaries of the COVID-19 vaccination – the development, testing, manufacturing and global distribution of COVID-19 vaccines. A study conducted by Public Health Scotland noted a reduction by more than 85% of chances of going to the hospital with COVID-19 for those who received just one dose. This demonstrates similar results of vaccine effectiveness as non-pharmaceutical interventions such as social distancing and lockdowns. Notably, vaccines far exceed such interventions as they help build back the economy, allow businesses to operate and provide social interactions.
With that, vaccines are inevitably important in human health. An article from the World Economic Forum (5 charts that tell the story of vaccines today, 2020) stated that up to 3 million lives are saved every year with vaccination and this has been among the most successful health interventions. With improved global coverage, deaths could be avoided by 1.5 million deaths a year. The importance of vaccination has set a race for vaccine development. Governments, scientific communities and pharmaceutical companies are forging partnerships.
Knowing the significance of vaccination, technology-enabled advancements are a way forward for vaccines. The use of a novel platform technology such as the mRNA is a notable example and has been used and approved in the United States and Europe in the development of COVID-19 vaccines. This technology has been used by Moderna and Pfizer-BioNTech, as mentioned in a report by McKinsey in 2021. Adding on from McKinsey’s article, another novel platform technology is the viral vectors. The Ebola vaccine was developed with this technology. Similarly, the COVID-19 vaccines have also been developed with viral vector technology. Companies which adopt that technology are Oxford-AstraZeneca, Johnson & Johnson, CanSino Biologics and Sputnik V. Both the mRNA and viral vector platforms were significantly invested several years prior to the COVID-19 pandemic and by the time the pandemic struck, the technology was ready for use.
Another focus area to assist with the growth of vaccines development is a solid financing mechanism. A report by Johns Hopkins University & Medicine stated that the cost of procurement and cost to secure COVID-19 vaccines are covered with the partnership forged in several high-income country governments. The governments partnered and signed contracts with R&D and manufacturing companies to cover those 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 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 a growing interest in the development of the vaccine production value chain among several biopharmaceutical companies. The Malaysian Investment Development Authority (MIDA), in an article, stated that there are currently five other countries producing vaccines namely Singapore, Thailand, Indonesia, Vietnam and Myanmar. Some of which have already advanced to clinical trials and are planned for vaccine rollout in 2022. A way forward is to forge partnerships as contract manufacturers in the vaccine value chain. Currently, Malaysia and Indonesia are in collaboration with Sinovac, 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. This type of vaccine is similar to Sinovac-CoronaVac vaccines which use killed viruses either 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 under the Institute for Medical Research (IMR).
Malaysia has potential investment capabilities for vaccine production with the well-established manufacturing sectors, leveraging the country’s competitive advantages. Also, with organisations such as IMR being active in conducting R&D and vaccine development. According to MIDA, opportunities for investors and interested stakeholders in Malaysia’s pharmaceutical industry come in four components namely business-friendly policies, improving local manufacturing standards to guarantee efficacy, quality and safety, R&D capabilities and growing demand for halal pharmaceutical.
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 from the pharmaceutical industry, diverting away from heavy costs and accelerating 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 include suggestions and inputs, and ensuring transparency of information to enhance the effectiveness of policymaking.
Ultimately, policies revolving around vaccination must be guided by 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