Is Bangladesh ready to distribute a Covid-19 vaccine?

Bangladesh may get a suitable Covid-19 vaccine next year, no matter what hurdles there are. But the question remains whether the country is ready to properly preserve and distribute it. Experts say challenges are there, as it requires complex logistics.

They think a high-profile committee should be formed and a well-designed plan and policy need to be put in place immediately to have the necessary work done before procuring the vaccine.

Experts suggested to the government to improve the capacity of the existing cold chain and ensure other required logistic support so that the vaccine can be delivered to the upazila level for fair distribution.

Vaccine policy crucial

Talking to UNB, Dr Abu Jamil Faisel, a member of the public health expert team for the eight divisions formed by the government, said Bangladesh must take necessary preparations in advance for procuring the vaccine, its preservation and distribution.

"As I know, three expert teams formed by the Health Ministry have been working out a plan and policy in this regard," he said.

Dr Faisel said it is certain that the government will not be able to provide the vaccine to the country's people at the same time, no matter how many doses it receives: "That's why we need a priority list and a vaccine policy to avoid chaos."

He said a vaccine distribution policy should be formed immediately and people need to be informed about it. "The government must communicate with people and prepare them to accept the reality by giving them proper information and presenting the real scenario before them."

Or else, the experts said, when some vaccine doses will arrive in the country, people may create a chaotic situation in hospitals and vaccine distribution centres. "So, we need to tell people in advance who may get it first and its reasons."

Preparing cold chain

Dr Faisel said Bangladesh needs to procure a vaccine which is affordable and preservable in the country's cold chain. "So, we must have a plan for the preservation of the vaccine," he said.

He said a large part of the country's current vaccine cold chain is occupied with anti-measles 'Measles-Rubella (MR) vaccine.

A total of 3.40 crore children, aged between nine months to under 10, was supposed to be given the MR vaccine in March last, but this campaign was not held due to the coronavirus outbreak.

"If we can't vacate the cold chain by giving the MR vaccine to the children, where will we keep the new vaccine? So, we need to have a plan about the preservation of the vaccine maintaining its quality," Dr Faisel said.

Public health expert MH Chowdhury (Lenin), chairman of the medicine department at the Health and Hope Hospital, said Bangladesh does not have the capacity of preserving 3 crore doses of the coronavirus vaccine at a time.

"We should first assess how many doses of vaccine can be preserved in our existing cold chain. Then we can hire private cold storages to enhance our capacity.  We can also take steps for making makeshift storages in different districts as we'll have to send the vaccine there."

Monitoring team needed

Dr Faisel said the quality of the vaccine will degrade if the doses are not properly preserved, transported, distributed and vaccinated. "That's why we need a monitoring team."

"We'll send the vaccine doses to different places across the country. We must do it properly to maintain the quality. The monitoring team will oversee whether the vaccine is transported properly and preserved everywhere maintaining the right temperature," he said.

The expert said the team will also examine whether there are any reactions or side effects of the vaccine on people since there has been no trial of any vaccine in Bangladesh.

Forming high-powered body

Dr Lenin said a high-powered committee, incorporating capable people, should be formed immediately to make appropriate plans and a policy and ensure their execution. "It won't be possible to do it by the Health Ministry alone."

"Making a vaccine policy and its implementation are such important tasks that the UK has appointed a minister to do that job. Our Health Ministry and its different bodies who still couldn't ensure adequate tests, contract tracing, encourage people to wear masks and maintain health safety rules, ensure treatment for the corona-infected people are making a vaccine policy and plans. How can we keep confidence in them?" he asked.

Dr Lenin said it will be a daunting task to distribute the vaccine fairly and maintain transparency once it arrives in Bangladesh, no matter how many plans and policies the Health Ministry makes.

"We fear people who exercise power will try to have the vaccine at the initial stage as we saw when PPE and other safety gears were procured, different administrative officials roaming here and there wearing those before getting them to the doctors. Such an anarchic situation may create over the vaccine," he warned.

Dr Be-Nazir Ahmed, former director (disease control) of the DGHS, said the committee should be formed and led by a high-official from the Prime Minister's Office.

"This committee will have to take many crucial decisions, regarding selecting a vaccine, collecting funds to procure it and other logistics support, and rightly preserve and distribute the vaccine by checking irregularities," he observed.

China and Russia's vaccines cannot be ignored 

Dr Lenin said Bangladesh may face difficulties in procuring an effective Covid-19 vaccine since it is highly dependent on AstraZeneca's one.

"It's uncertain when this vaccine may get approval due to controversy over its recent trial results. On the other hand, two American vaccines that seem to be effective are not suitable for us due to the preservation problem," he said.

Under the situation, Lenin said Bangladesh should intensify its diplomatic efforts to get the vaccine developed by Russia and China and others. "China and Russia started using their vaccines locally. But our media doesn't highlight the two vaccines. I personally think we should take steps to procure the vaccines from Russia and China."

Dr Be-Nazir said the vaccines from China and Russia have huge potential as they are also technologically very sound. "We should maintain regular contact with China and Russia so that we can get their vaccines if WHO approves them."