Best for CARICOM to purchase Covid-19 vaccines as a group – experts advise
Two days ago, on the morning of Friday, February 12, Charles Savarin, the 77-year-old president of the sister Caribbean Community (CARICOM) state of Dominica, became the first person in his country to be vaccinated against COVID-19.
The jab was one of 70,000 doses of the AstraZeneca vaccine gifted to Roseau by the government of India. It’s enough to immunise about half of the population of under 72,000. And with a further 28,800 doses expected through the COVAX scheme – a mechanism to distribute 330m COVID-19 doses fairly to 145 countries by June – the country felt generous enough to donate 5,000 doses to Antigua and Barbuda, with donations to Grenada, St Lucia, and other countries of the subregional grouping the Organisation of Eastern Caribbean States (OECS) to follow.
“We are an island but we are not isolated nor are we immune from what is happening in the rest of the region, and while we would like to see herd immunity here in Dominica, our safety will depend on herd immunity in the region, Barbados and the OECS,” said Savarin immediately after receiving the injection.
“I believe that the efforts being made here in Dominica of the sharing of resources with the rest of the OECS will help us in managing more effectively and efficiently this pandemic and hopefully in the short run create herd immunity in the OECS.”
One day earlier, and 196 miles to the southeast, in Barbados, Dame Sandra Mason, the 72-year-old governor general, was among the first group of high-ranking public officials to take the vaccine. As was the case in Dominica, the jab was one of 100,000 doses donated by India. But, unlike its CARICOM neighbour, this is enough to immunise less than 20 per cent of its population. Still, Bridgetown will donate some of these vaccines to Guyana, Trinidad and Tobago and some OECS states.
The prime ministers of the two countries – Mia Mottley of Barbados and Roosevelt Skerrit of Dominica – worked together to secure the donations from New Delhi, according to Mottley. However, on a region-wide basis, CARICOM leaders have been silent on any form of cooperation to secure adequate supplies of COVID-19 vaccines to inoculate their populations.
The Sunday Gleaner sought comment on several occasions from CARICOM chairman, Dr Keith Rowley of Trinidad and Tobago, on the matter, including sending questions via email, but he failed to respond.
The political scientist, Peter Wickham, an avowed regionalist, told The Sunday Gleaner that while a unified approach might be preferable, “it is almost every man/woman for himself/herself in this situation, and with good reason”.
“I don’t really know that this is the time where there are any huge benefits of coming together,” stated the former lecturer in political science at The University of the West Indies. “This joint action is going to give way to reality.”
Wickham cited the situation in the 27-member European Union where just 17 million of its 447.7 million people have received the first dose, according to Our World in Data, a scientific online publication that focuses on large global problems, including disease, climate change and existential risks. In contrast, more than 13 million people have so far received their first doses in the United Kingdom, which is aiming to give the first dose to 15 million people in four key groups by mid-February.
CHAOS AND COUNTERPRODUCTIVE TO COMPETE
The EU, which decided to undertake the vaccine hunt as a single bloc, has been criticised for delaying the approval process and for lagging the UK and the United States in delivery of the injections. However, the leaders have defended the decision to work collectively, arguing, as the French president, Emmanuel Macron, did recently, that it would have been “chaos” and “counterproductive, economically and from a public health perspective” if the major European powers had been in competition with each other for the purchase or production of COVID-19 vaccines.
This joint approach means the smaller countries were able to secure the vaccines on better terms than they would have been able to negotiate on their own, even though it meant the richer ones like Germany and France – which could have afforded to deal directly with manufacturers – had to sacrifice somewhat.
This is precisely the approach that Dr Justin Ram, the former Caribbean Development Bank economist and co-founder and CEO of the fintech company, GSEC, recommends that CARICOM should adopt.
Ram argues that it would make economic sense if the 15-member regional grouping were to combine resources to purchase sufficient doses to inoculate their entire population of 18.5 million people.
“In reality, we need to get all of CARICOM back together, all of the working population being able to go back out there and work. And so we need to get many more vaccines than what we have already received via the bilateral channels,” Ram told The Sunday Gleaner. “One of the issues we have is that there seems to be a hesitation to spend the money on these vaccines … but there’s no better way to spend money right now than invested in human capital. That will ensure that our people can feel safe and they can get back to work. We don’t want to be in this position where we’re constantly in lockdown.”
He estimates it would cost just over US$1 billion – 1.2 per cent of CARICOM’s total GDP – to purchase the required supplies, and recommends that instead of allocating cost based on population size – this would leave Haiti with by far the largest bill of $652 million – the cost should be allocated based on GDP. By this measure, Jamaica, whose estimated 2.9 million people make up 15 per cent of the CARICOM population, and has 17 per cent of the region’s GDP, would pay US$182 million, US$22 million more than if the cost were allocated based on population. Trinidad and Tobago (eight per cent of the population, 27 per cent of GDP), would have a bill of US$288 million – US$203 million more than it would have been had the bill been allocated based on population, while Barbados and Guyana would pay US$64 million each.
On the other hand, Dominica and St Kitts, both of which have populations that are barely above zero per cent of the CARICOM population and therefore would have paid next to nothing – would each have to contribute US$11 million.
The rebalancing of the costs would likely raise issues of nationalism, according to Kiran Mathur Mohammed, a Trinidadian economist, who, together with Ram, penned an article in a local newspaper, calling on Caribbean countries to join forces now to buy 20 million vaccine doses for the entire region, “or the pandemic will continue to devastate our lives and economies for another two years”.
“It is in our own selfish, self-interest as a country to collaborate. Even if we spend a bit more, that means that we can actually get the vaccine for our people,” Mohammed told The Sunday Gleaner. “Otherwise, the alternative is to not get the vaccine.”
JOINT APPROACH IS BEST
Dr James Hospedales, the first-ever head of the Caribbean Public Health Agency (CARPHA), has been there before. In the 1990s he was part of joint efforts among CARICOM countries to deliver mass vaccination campaigns against measles, with 92 per cent of people over the age of 14 in 19 countries vaccinated in one month.
Intensive monitoring showed the region succeeded in interrupting indigenous transmission in the region, he said.
There was also the rubella elimination exercise in the 2000s, which included adults in the workplace.
“So we have been here before in a way,” Hospedales told The Sunday Gleaner. “[CARICOM] countries would be well advised to use these mechanisms, prepurchasing and pooling … to secure the supplies of COVID vaccine they need. This joint Caribbean cooperation in health approach has seen us leading the world many times.”
However, this time there appears to be no attempt at Caribbean-wide cooperation, with many within the 15-member bloc seemingly depending on the COVAX scheme. It’s a scheme that will acquire sufficient vaccines to immunise no more than 125,000 Jamaicans by the end of February into March.
Like Jamaica, CARICOM states will get just enough vaccines from the programme to inoculate no more than about 20-25 per cent of their populations, leaving at least three-quarters of the people vulnerable. Making up the difference will not be easy, as rich countries strike private deals with the manufacturers that push up vaccine prices, and making it difficult for the less fortunate to secure doses.
For example, Canada has reserved approximately 10 doses for each of its citizens in direct deals with pharmaceutical companies. Yet, it chose to receive 1,903,200 doses of the AstraZeneca vaccine through COVAX, enough to vaccinate about 2.5 per cent of its population.
Ram, the former CDB economist, told The Sunday Gleaner the only way around this is for the region to purchase in bulk and to reserve the supplies immediately.
“I think the point is that we should have come together. If we needed to procure 20 million vaccines, that’s a lot better than going to a company and saying that you need to get 300,000 because it’s rather much easier to procure a larger amount than if you’re procuring a smaller amount,” Ram said. “You may not get all the vaccines at once, but at least you would have a significant order with the manufacturer in place.”