(ATF) Malaysia’s science, technology and innovation minister, Khairy Jamaluddin, recently wrote on social media that 2021 would be the country's "year of vaccination".
As Singapore and Indonesia kickstarted their vaccination programmes earlier this month, Malaysia has invested 3 billion ringgit ($743 million) in three major Covid-19 vaccines to cover at least 40% of the population by the end of 2021.
According to publicly available data, Malaysia procured 12.8 million doses of the Pfizer-BioNTech vaccine for 6.4 million people after the World Health Organization (WHO) issued emergency use authorisation of the US-German vaccine. The remaining 12.8 million doses are from AstraZeneca-Oxford and the WHO’s COVAX initiative.
“This is an unprecedented immunisation effort which has never been seen in recent history,” says Azrul Khalib, chief executive of Galen Centre for Health and Social Policy, a think tank. The longtime healthcare advocate has been an outspoken critic of the Malaysian government’s handling of the pandemic, especially in their failures to lower infection rates since initiating the first total lockdown last March.
A series of missteps has led to the current Lockdown 2.0. Malaysia has recorded 172,549 cases of Covid-19, with 642 deaths. At least 3,170 new cases were identified on January 22 - a one day record - with 12 more fatalities. Local media reported this week that active cases have reached 40,000, far more than the 34,000 beds available reserved for Covid-19 patients in public hospitals and quarantine centres.
Back in May 2020, law enforcement authorities rounded up and mass arrested thousands of “illegal” migrant workers and refugees, only to lock them up in detention centres in appallingly unhygienic conditions. “The advice to work out a strategy to protect vulnerable populations was not heeded and as a result, we saw massive spikes among detainees and prisoners, and later documented and undocumented migrant workers,” says Khalib.
While it is s true that Malaysia received global plaudits for doing better than most countries in their fight against Covid-19, concerns were raised early during the nationwide lockdown for forcing migrant workers to work long, gruelling hours in unsanitary conditions, particularly in rubber and glove manufacturing sectors.
According to Khalib, the crackdowns “decreased the trust of the communities in the authorities”, in that it forced undocumented migrant workers to go into hiding and flee testing and treatment.
The Malaysian government quickly shifted from writing off testing and treatment expenses for migrant workers before the rate of infections rose upwards of 3,000 from March to April in 2020 to conducting raids on the eve of Labour Day. Defence Minister Ismail Sabri Yaakob later denied allegations of “cruel” and “inhumane” treatment of migrant workers who were arrested.
LIFTING THE HEALTHCARE BURDEN
In a recent survey conducted by the health ministry, more a third of Malaysians are suspicious of the efficacy of vaccines and harmful side effects. However, echoing a number of health experts and practitioners, Khalib suggests that the first step is to eliminate online misinformation and educate the public, transparently and comprehensively, about each vaccine.
“It’s high time all parties purchasing vaccines also increase education, information and focus on protecting [vulnerable] populations, especially since Malaysia has around 1.7 million foreign workers,” Khalib says.
Even for private players that may not have relevant medical knowledge, they would be required to distribute through the federal government’s public healthcare system and the national Covid-19 immunisation programme.
During the pandemic, the government and corporations who normally go head-to-head to market for new innovative strategies have exhibited unusual collaborative efforts. For instance, proprietary tools and expertise - which is safeguarded inside the pharmaceutical enterprise - are now being exchanged to accelerate COVID-19 vaccines.
One such collaboration is between two of the largest vaccine producers in the world: UK’s GSK and France’s Sanofi. Once rivals, the GSK-Sanofi partnership is slated to support the WHO’s COVAX initiative with 200 million doses available for everyone worldwide.
In Malaysia’s case, private players teaming up with Chinese companies such as Sinovac, affiliated with state-owned China National Pharmaceutical Group, and a private biotech firm, CanSino Biologics, are roping in the government to jab an additional 33% of the population.
To Khalib, it’s likely that these “inactivated vaccines will initially constitute the majority of vaccines in the private sector” - in other words, giving priority vaccinations to employers and employees.
The single most critical issue haunting the country’s public healthcare systems is the fickle change of government policies, which include serious economic damage of lockdown measures, lack of screening and testing facilities, late treatments for undocumented migrants due to fears of repercussions and holding large-scale elections.
“Despite the high level of compliance and adherence by the Malaysian public, the earlier strategy failed to produce the single digit and low-level targets that were projected,” says Khalib, specifically referring to the aftermath of the Sabah state election, a large rural state located on the island of Borneo.
Amid political turmoil, Malaysia’s national palace declared a state of national emergency until August 1, until and unless the rate of infections is lowered. The decree gives sweeping powers to Muhyiddin Yassin, the prime minister, and his cabinet, in turn, permitting the government to pass laws without parliamentary approval.
Former prime minister Mahathir Mohamad also lamented the suspension of democracy, a first in over half a century, saying that “it is a kind of dictatorship, where people cannot protest or question (a decision).”
Concerns over power grabs and mistrust in the ruling government from opposition parties and the general public could result in a trust deficit of the vaccines if not addressed soon enough, according to Khalib.
Although it remains to be seen how the national vaccination plan will pan out after the supplies are distributed by the end of February, NGOs and health practitioners are putting out calls to restore confidence in the whole process to curb infections and register to get vaccinated.
“If the government is insistent on doing it their way and not learning from the mistakes of others ... we will be doomed to repeat the same mistakes and encounter the same problems which will delay the roll out of the vaccines to those who need it,” says Khalib.