The never-ending charade of vaccine calculations

Let us begin with three news highlights related to our vaccine procurement scenario—No one can show an accurate breakdown of how many doses of vaccines have been procured by Bangladesh; astonishing anomalies lie in the price-related information of vaccines; and apparently, despite what the official narrative tells you, there is no workable vaccine procurement plan including precise timelines and quantities.

For the last few days, we have been constantly bombarded with announcements that within the six-day period between August 7 and 12, one crore people would be vaccinated. We were also told that there was a stockpile of one crore and 25 lakh doses, in addition to another 21 crore doses that would arrive in the country by the beginning of next year. We were assured that the trend of vaccinating one crore people per month would continue. "There are no shortages of vaccines, nor will there be any"—this message was generously and enthusiastically spread on behalf of the government, by both those you would expect to hear it from and those you wouldn't. But then, just one day before the inauguration of this massive drive, we were told that the promised vaccination campaign period has been cut short. No, it is not going to continue for six straight days. Instead, it'll simply be a daylong affair.

From this bizarre and by now perhaps a little predictable turn of events, we can understand that there are doubts and confusion regarding the timing and quantity of any subsequent consignments of vaccines. The question is, why then, despite having doubts and uncertainties, was such a massive promotion made and that too by multiple individuals?

Given the scenario, it appears that neither the relevant ministry nor the minister has an accurate idea of the actual inventory of vaccines. Coming against this backdrop, the threat to punish the unvaccinated by another minister and subsequent dismissive statements made to cushion its fallout—that "it was not our statement", or "we are withdrawing the statement", etc.—rather made a mockery of the whole situation which could be, frankly, done without at this critical time in our fight against the coronavirus.

Let's also recall that an announcement was made about importing 21 crore vaccine doses but no other information was given. Despite questions raised about the authenticity of this statement, we were given no subsequent information or explanation. It has been claimed that among the 21 crore doses, seven would come from Russia and seven from Johnson & Johnson. We have had no information thus far—from public, private or foreign sources—validating the claim that Bangladesh has struck a deal to buy seven crore doses of the Russian vaccine. What we know instead is that Gonoshasthaya Kendra (GK) had sent a letter to the foreign minister along with supporting documents and informed him that Gonoshasthaya Nagar Hospital had been nominated as the official agent of Russia's Sputnik-V vaccine in Bangladesh. They reportedly gave a proposal to the government for the procurement of two crore vaccines. The government did not respond to that proposal. The government did not make a deal on its own either. In that case, how will these seven crore doses of Russian vaccine arrive? And when will they, if at all?  

Now the question is about the seven crore doses of the Johnson & Johnson vaccine. There is a big question mark on Johnson & Johnson's capability to export such a large quantity of vaccines. Bangladesh did not even sign a contract with them. That means, all this talk of the Johnson & Johnson's seven crore vaccines is probably just a charade. A source tells us that Bangladesh will get seven crore doses of Johnson & Johnson as part of the COVAX initiative. Even if this information is accurate, it cannot be claimed with certainty that we will get the vaccines. Production of vaccines by Johnson & Johnson, their storage at COVAX and then the chance of getting it—the whole thing is based on possibilities. Even if we end up getting our hands on the doses, those are likely to arrive in consignments of lakhs, not crores.

Among the 21 crore doses, it has also been mentioned that three crores will come from India. India, as we all know, is itself in a bind in terms of vaccinating its own populace. It is highly unlikely that it will lift the export ban on vaccines this year.

All this simply means that the possibility of getting 17 out of the 21 crore vaccine doses is completely uncertain. Bangladesh might get some vaccines from COVAX and China, but that will not be sufficient enough to keep a massive countrywide vaccination drive running.

Now let us come to the issue of pricing.

A glaring calculation error was identified in the health ministry's claim of procuring one crore and one lakh and 50 thousand doses of vaccines at a price of Tk 3,045 crore. The claim was made through a newspaper advertisement some time ago. On that advertisement, approximately 11 lakh free doses of vaccine received from COVAX were also included in the price calculation of paid vaccines. According to that flawed calculation, the price of each dose was shown as Tk 3,000 (or USD 35-36). However, the government procured seven million doses of vaccine from India's Serum Institute at a cost of USD 5 per dose, including carrying costs. Also, it bought vaccines from China at a price of USD 10 per dose, with carrying costs to be added to it. Thus, it's evident that the health ministry in its ad inflated the prices of each dose by at least USD 25 to 30. Till date, the health ministry has offered no explanation for this anomaly.

Now, Bangladesh government is vaccinating people from the age group of 25 and above. The possibility of further lowering the age bar to 18 has been discussed but is yet to be put into effect. In our country, the number of people above the age of 18 is almost 14 crores, and all of them need to be vaccinated. Given the two-dose requirement for each individual, we need at least 28 crore doses of vaccine. Till now, one crore and 40 lakh people have received a single dose, while 40 lakh people received both doses. Still, another 13 crore people need to be included in the vaccination drive. Even if we manage to deliver one crore doses per month, 26 months will be required to cover the entire target population. This, too, depends on an uninterrupted supply of vaccines. At this point, we neither have the required stockpile nor can we hope to have the needed amount in the near future. 

What, then, are the next steps for Bangladesh?

We need to urgently learn how to add and subtract properly, and we also need to eliminate all anomalies within the calculations in order to establish transparency. The most important factor is to increase the national capacity. We have to take effective steps for collecting the required amount of vaccines—mere words will not suffice. Even if we manage to do that, we still cannot save everything. The only path to our survival and recovery is through producing vaccines locally. It doesn't matter whether the formula comes from China, Russia or any other country. Going ahead, Bangladesh has no other choice but to produce its own vaccines.

Golam Mortoza is a journalist at The Daily Star. The article was translated from Bangla by Mohammed Ishtiaque Khan.