On 2 March 2021, Nigeria received 3.92 million doses of AstraZeneca COVID-19 vaccine. It was the first shipment of the over 16 million doses allocated to the country through the COVAX Facility, aimed at vaccinating 20% of the population.
As countries are planning and managing COVID-19 vaccine rollout to turn the tide of the pandemic, issues arise on how to properly manage and speed up the immunisation campaign, while ensuring equal access to high quality and affordable vaccine.
Regrettably, Africa lags behind the rest of the world on vaccine rollout. The continent accounts for less than 2% of all COVID-19 vaccines administered worldwide. European countries like Britain have given almost half of the population the first dose. America recently recorded vaccination for half of her population.
Meanwhile, the World Health Organisation (WHO) recommended 60% to 70% COVID-19 vaccine coverage worldwide to control and eventually end the pandemic. According to the latest data from NPHCDA online portal, nothing less than 3.1% of Nigeria’s population have been vaccinated. Nigeria’s commercial city, Lagos, which has recorded the highest number of cases, has vaccinated just 36,009 people out of its over 14 million residents.
The head of NPHCDA, Faisal Shuaib, in an interview had said that the country intends to “cover up 70% of the population just to ensure that we’re able to stop transmission.” Shuaib said 40% of the population was expected to get shots this year and the remaining 30% by the end of next year. But there are no coherent plans on how to achieve this margin.
Apart from this, the online registration requirement for vaccination excludes more than half of the country’s population who do not have access to internet connection. Experts have also said Nigeria does not have adequate storage facilities to hold vaccines at the required temperature of minus 70 degrees Celsius. Whereas, the urgency to ramp up is important given that the shelf life of the vaccines is transient.
As such, there have been calls for private inclusion in the vaccination process. That is, leveraging the infrastructure, skills, and resources of the private healthcare sector to successfully inoculate Nigerians against COVID-19. Those who propose this hinge their point on a number of strategies.
For instance, private companies could purchase their own vaccine and provide it to end users willing to pay. In a situation where vaccines are sold directly to the public through private sector pharmacy chains or provided by employers, it will scale up the vaccination process, as well as reduce the pressure on government, and overburdened public health systems.
This will also enable people choose the time and location in line with their schedules. This, according to pundits, would expunge vaccine hesitancy given that the earlier people get to see the efficacy of the vaccines, the more the acceptance and economic rebound.
But there are fears that if people willing to pay are able to get vaccinated ahead of the priority schedule set by the government, countries risk creating a two-track vaccine rollout. Besides, the rich will be vaccinated before the poor. It may also drive up prices for vaccines as a commercial product, tempt manufacturers to prioritise higher-paying private sector purchasers, and lead to an increase in fraud and black market activity.
In Indonesia for instance, businesses are allowed to buy vaccines along with the government. According to the Indonesian Chamber of Commerce and Industry, there are more than 5,000 firms registered to purchase COVID-19 vaccines. On the surface, this strategy sounds effective with more resources on hand, and allowing for more people to be vaccinated in a shorter time period. However, when one takes a closer look, the approach have some potential drawbacks.
Private companies are widely known for prioritising profit. With the current limited supply and high demand, the firms that possess the doses will enjoy some level of market power. Therefore, they can raise the price to increase their profits. As a result, people on lower incomes may have difficulty affording the vaccine resulting in inadequate vaccine coverage in low-income communities.
While there is a critical and positive role for the private sector in the equitable distribution of vaccines at the national level in many countries, the key risk is when these companies work outside of the government priority schedule. Vulnerable people around the world need to receive the vaccine on the same timescale to ensure the best results for everyone.
As Forbes proposes, it is critical to leverage and empower the private healthcare sector, which has three key capabilities—technology, skilled manpower and customer marketing capability. It states that the government can set up a task force of senior representatives and experts from the public and private sector, as well as healthcare associations that can help with with organisation, allocate doses, manage supply chain, monitor and oversee reporting, conduct quality audits, and provide digital integration support.
Also, hospitals, nursing homes, pharmacies, diagnostic labs, home care centres, mobile clinics, and community health organisations, can be contacted for training and supply chain capabilities, with appropriate incentives for safe coverage and community mobilisation.
The private sector can additionally contribute to several other areas apart from rapidly scaling up delivery. These would include supporting the logistics for transport, storage, and distribution of vaccines, while deploying technology and data analytics to drive data integration.
Although most people propose that the private sector be allowed to deliver government-purchased vaccine, the susceptibility to counterfeit will always be a cause for worry if such option is allowed.