The Latest on Covid-19 in Southeast Asia: December 3, 2020

December 3, 2020

Across Southeast Asia, states are working to ensure adequate access to Covid-19 vaccines when they become available in the months ahead. Indonesia and the Philippines, which continue to see widespread community transmission, are betting heavily on the ability to vaccinate much of their populations as quickly as possible next year. And both have made significant moves in that direction recently, but effectively distributing vaccines will be at least as challenging as acquiring them in the first place. Immunization drives in both countries will face serious logistical and social hurdles.
 
Indonesia this week saw its highest increase in new daily cases since the start of the pandemic, gaining 6,267 cases on November 29. While the government struggles to impose partial lockdowns across the country, it is hard at work to acquire vaccines from foreign governments and ensure that the paperwork is in order to begin mass distribution by the end of the year. Minister of Health Terawan Agus Putranto announced on November 17 that Indonesia has made a $36 million down payment for the China-developed Sinovac vaccine. Coordinating Minister for the Economy Airlangga Hartarto told reporters on November 13 that Indonesia has also secured 30 million doses  of the vaccine being developed by U.S.-based Novavax. That vaccine is expected to enter phase three trials soon. These preorders bring the country’s expected supply to 250 million vaccine doses by the end of 2021.
 
Philippine president Rodrigo Duterte on November 19 allowed his government to preorder vaccines directly from manufacturers, despite having sharply criticized drugmakers’ demands for advance payment. On November 23, he approved pre-payment for Pfizer’s vaccine, although details regarding number of doses and price remain confidential. Vaccine czar Secretary Carlito Galvez Jr. also announced on November 23 that the Philippines was in talks with AstraZeneca, Pfizer, and Sinovac to lock in 60 million vaccine doses in 2021.
 
On the logistical front, both Indonesia and the Philippines, along with many other developing countries, will struggle with refrigeration during vaccine distribution. Pfizer’s vaccine must be stored at a blistering minus-94 degrees Fahrenheit. AstraZeneca, Novavax, and Sinovac’s vaccines might be favored in Southeast Asia as all three can be stored, transported, and handled at more palatable refrigeration temperatures between 36 and 46 degrees Fahrenheit for at least 6 months. However, in a tropical region where electricity is often unreliable and dry ice is scarce, challenges will still arise.
 
Another logistical challenge will be keeping track of vaccine recipients. Most existing vaccines require two doses to be effective. Maintaining a database of those who have taken vaccines in Indonesia and the Philippines, both of which will need to account for people in both overcrowded cities and isolated communities, will prove difficult. Geography and poor infrastructure will present obstacles. Both countries are far-flung archipelagos with challenging terrain. For example, Indonesia’s Central Sulawesi province—currently a Covid-19 hotspot—has no airport and the only delivery route requires a seven-hour ferry ride.
 
Low public trust may also prove a serious impediment. According to a Social Weather Stations survey in September, 31 percent of Filippinos remain unwilling to get vaccinated when a vaccine becomes available. A study published in The Lancet medical journal showed that public trust in government vaccine programs in Indonesia had already dropped significantly between 2015 and 2019, “triggered in part by religious leaders questioning the measles, mumps and rubella vaccine, and by local healers promoting natural alternatives to vaccines.”
 
Even if the Philippines and Indonesia are able to receive sufficient vaccines, logistical and social obstacles will leave the two coronavirus hotspots struggling to effectively vaccinate much of their populations.
 
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