The Bhutanese Leading the way.
GoI has assured support
Bhutan has requested India for help in procuring 1 mn doses of the Oxford-AstraZeneca vaccine or Covishield that is being manufactured in the Serum Institute of India (SII) to vaccinate the whole Bhutanese population.
The Foreign Minister Dr Tandi Dorji said that the Government of India has assured support and it has said that Bhutan has been prioritized and its request has been locked in. Lyonpo said that the vaccine would be made available to Bhutan whenever India did its own roll out.
The minister said that Bhutan’s Ambassador to India is communicating with the Indian counterparts on working out the modalities of picking it up and transporting it when it is available.
However, the minister said as per the international trend initially those below 18 will not get the vaccine as Oxford-AstraZeneca vaccine trials are going on for the age group of 18 and 12 years and the papers which will state the efficacy and any effects will only come out in March 2020.
He said that once the papers are out in March and it is safe then vaccinations for those between 18 and 12 can also go on.
Lyonpo said it may take a few more months for the efficacy data for children below 12 to come out as here the dose and timings may be different.
The minister who is a pediatrician and a public health expert said that he has been closely following the science on the vaccines.
Given that every person needs two doses of the vaccine with some time gap in between the 1 mn doses will be enough to vaccinate 500,000 people in Bhutan.
Lyonpo said this would cover everybody in Bhutan minus the children for now who are not eligible until the data comes out for them.
Last Monday the Prime Minister Dasho (Dr) Lotay Tshering said that His Majesty had issued a Royal Command on getting the vaccines and the government has been working on it more than six months ago.
Lyonchhen said that the vaccine protocol which lays out who gets the vaccines in what priority and also the laws related to vaccines are ready.
Lyonchhen also said that the government also has documents prepared with the GoI to get the Oxford-AstraZeneca vaccines from India which is the main manufacturer of the vaccine.
The Foreign Minister explained that the Royal Command had said that the vaccine must be gotten as early as possible and cost or resources should not be an issue.
Lyonpo said that the government has been in touch with its Indian counterparts since May 2020 following up on potential vaccines. He said a Note Verbale or written diplomatic correspondence had been exchanged between India and Bhutan at the Foreign Ministry level on this.
He said that the Prime Minister had also written to the Indian Prime Minister Narendra Modi on the vaccines.
Bhutan is also in touch the SII for the vaccines.
Bhutan is also talking with Pfizer and the Ministry of Foreign Affairs is scheduled to have a virtual meeting with them to discuss details.
Lyonpo said that currently Pfizer is only selling to governments but the problem is that they have already made commitments to richer countries and there will not be much left for others.
Bhutan is also trying to pursue options to buy the Moderna vaccine.
However, the foreign minister candidly admitted that initially Pfizer was not even entertaining calls or efforts from Bhutan to contact the company given that Bhutan is a much smaller market.
The USA has assured that it would help Bhutan get the Pfizer and Moderna vaccines but there is no indication on the amount or the timeline.
They wanted to know if Bhutan has the logistics to handle the -70 degrees celsius temperature to be maintained for Pfizer and -20 degree celsius temperature for Moderna.
Bhutan has said given that the shelf life of the vaccines are 10 days in the thermal boxes Bhutan has the facility and can vaccinate its people within a week.
The aim is to get around 100,000 doses of either the Pfizer or Moderna vaccines and give it to the frontline workers.
The Pfizer vaccine cost is around USD 30 and the Moderna one is priced at around USD 50.
If Bhutan buys the Oxford-AstraZeneca vaccine from SII through the GoI then Bhutan could get it at Nu 400 to Nu 500 for two doses as the Indian government itself may be getting it at around Nu 200 to Nu 300.
If the vaccine is directly purchased from SII then it would cost around Nu 1,000 for two doses or USD 15.
Lyonpo said that the vaccines may cost Bhutan a few million dollars but saving money is not the priority right now.
The minister said that even if Bhutan does not get the full 1 mn doses of the Oxford-AstraZeneca vaccine and it got around 100,000 to 200,000 then it would vaccinate people in phases as per the vaccine protocol with frontline workers getting priority first.
He said if Bhutan got a larger number like 500,000 then it can give the first dose and then give the second dose when the second batch comes later.
On the safety of vaccines, the minister said that the Ministry of Health has carefully studied the the data released by Oxford-AstraZeneca and no major side effects were found in the trials. Lyonpo said that Bhutan has a system to report any adverse side effects of the vaccines.
The technology used in this vaccine is also well know which is like in other vaccines. In most other vaccines a weakened form or a dead virus is injected to create an immune response.
He said that in the case of the Pfizer and Moderna vaccines the technology is new and so the long term impact is not very well known.
Lyonpo said that Bhutan is also pursuing the COVAX facility which aims to give vaccines to 20 percent of a country’s population. However, he said that it looks like COVAX will take some time.
In fact, COVAX is supposed to get around 300 mn doses of the Oxford-AstraZeneca from SII.
Pfizer and Moderna is nowhere in sight given that they are already committed to supply to richer countries.
Lyonpo said the hope is that something should happen in Bhutan in terms of vaccines by the first quarter of March and something happening even before that also cannot be ruled out.
When asked if Bhutan could go down the priority list with India given India’s own huge demand. Here the minister said that he does not think that will happen and Bhutan as assured would get vaccines as and when they are also rolled out in India, given the special relationship between the two countries.
Lyonpo said that for Bhutan the disadvantage is that it is a small country and hence a small market for vaccine companies, but the advantage at the same time is that Bhutan’s requirements are not very much.
On 3rd January Drug Controller General of India granted emergency approval to two COVID-19 vaccines which are Serum Institute’s Covishield (Oxford-AstraZeneca) and Bharat Biotech’s Covaxin.
Serum Institute of India already has 50 mn doses of Covishield with ability to ramp it up to 100 mn doses per month within a month’s time.
India is currently in the process of carrying out dry runs or practice runs for delivery of the vaccines to its states and districts.
The central hub of distribution will be the Indian city of Pune in western India from where it will go to 41 points across the country. Kolkata will be a regional hub for eastern India while there will be a smaller hub for North-East India.
According to Indian media outlets the distribution of vaccines to these 41 points will started by 8th January 2021.
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