Uttam Maharjan

The coronavirus has been wreaking havoc in the world for nearly two years. Since the outbreak of the disease in December 2019, scientists have made much headway in developing coronavirus vaccines in a short span of time. The only way out from the raging COVID-19 pandemic seems to be vaccination. That is why countries around the world have been in the race to vaccinate their people as quickly as possible.

The vaccination drive in Nepal began in January with one million doses of the Covishield vaccine provided for the country by India in grant assistance. Since then, a large number of people have got inoculated. Nepal has a population of 30 million. And the country aims at vaccinating 72 per cent of its people.

Initial setback
In the initial days, there was some setback in the vaccination drive when India stopped exporting Covishield vaccines, citing a surge in the number of COVID-19 patients there. This also hampered the COVAX plan for providing poorer countries with vaccines owing to the vaccines manufactured in India being part of the jabs to be distributed to poorer countries under the COVAX facility. Nepal tried its best through political, diplomatic and other means to procure vaccines. As a result, the country was able to procure Vero Cell, Johnson and Johnson and Astra-Zeneca vaccines. So the once stalled vaccination drive has picked up momentum to the delight of people.

Nepal is all set to sign an agreement with manufacturers of COVID-19 vaccines for the procurement of six million doses of the Pfizer-BioNTech vaccine. The agreement is to be inked on a non-disclosure basis. The Nepali law does not allow such an agreement. However, the country has recently signed a similar deal with China for the procurement of 10 million doses of Vero Cell.
Nepal has signed concessional agreements with multilateral funding agencies like the Asian Development Bank and the World Bank for the supply of COVID-19 vaccines. The country and the World Bank singed a $ 150 million (Rs. 18 billion) concessional loan agreement in June. In August, the country made agreements with GAVI for the procurement of four million doses of the Moderna vaccine financed by the World Bank through the COVAX co-share option. In August itself, the country and the Asian Development Bank signed a $ 165 (Rs. 19.8 billion) loan agreement for the procurement of vaccines.

Nepal has set a timeframe for the inoculation of its people. The government intends to inoculate two-thirds of the eligible population by the end of Poush and all the eligible population by the end of Baisakh 2079. The number of people fully vaccinated is around 6.4 million, which is about 21.5 per cent of the total population. Those who have received the first dose have reached around 37 per cent of the population. There is some doubt that the goals of the vaccination drive may not be achieved by the set timeframe. However, given that around 24 million doses will arrive in the country within the next few months, hope is alive that the goals will be fulfilled. In next few months, 7.6 million doses of the Sinopharm vaccine (6 million under a purchase agreement and 1.6 million under grant assistance), 6 million doses of the Pfizer-BioNTech vaccine, 4 million doses of the Moderna vaccine and 6.5 million doses under the COVAX facility will be arriving in the country.

The Pfizer-BioNTech vaccine, which has not been used in Nepal, is 95 per cent effective at preventing lab-confirmed infection as per the US Centres for Disease Control and Prevention (CDC). The vaccine is also effective at controlling infection in adolescents (12-15 year-olds). The Department of Drug Administration has already given authorisation for emergency use of the Pfizer-BioNTech vaccine in the country at the request of the Department of Health Services. So there is no hitch in administering the vaccine to Nepalis.

Nepal is considering vaccinating children aged 12 to 17 years old. The Moderna vaccine is safe and effective for such children. The country has signed agreements under the COVAX facility for the procurement of 9.9 million doses of vaccines (5.9 million doses of Vero Cell and 4 million doses of Moderna) under a cost-sharing mechanism.
Unlike Covishield, Astra-Zeneca, Vero Cell and Johnson and Johnson vaccines, the Pfizer-BioNTech vaccine needs to be stored at minus 70 degrees Celsius. There is a growing challenge for the country to set up such storage facilities before the arrival of the vaccines. The Health Ministry officials, however, claim that work has already been started to build such ultra-cold storage facilities. Such facilities should, however, be ready when the Pfizer-BioNTech vaccines arrive.

Under the COVAX facility, four ultra-cold freezers have been provided for Nepal for the storage of Pfizer-BioNTech vaccines. These four freezers can store 100,000 doses of the vaccine. The Ministry of Health and Population is mulling over administering these jabs to immunity-compromised people: those suffering from cancer, renal failure and heart disease. The government has planned to vaccinate children 12 years old and above by revising its previous plan of vaccinating children 14 years old and above.

Revised plan
Nepal should improve its health infrastructure. The COVID pandemic has thrown lessons for the country. Health scourges like the COVID-19 pandemic may emerge in the future as well. To cope with such emergency situations, investments in the health sector should be increased, especially for the sake of building health infrastructure not only in urban areas but also in rural areas. In fact, the need for health infrastructure is acutely felt in rural areas. The government should take the initiative to address the problems relating to health in rural areas before it is too late.

(Former banker, Maharjan has been regularly writing on contemporary issues for this daily since 2000. uttam.maharjan1964@gmail.com)