Covid-19 Vaccines
for Malaysia:
A Call for
Transparency in Registration & Purchasing
Citizens’
Health Initiative
citizenhealthinitiative@gmail.com
December 28, 2020
With
the exception of the People’s Republic of China and a few other countries like
New Zealand, Vietnam, Cuba, Senegal, and Kerala state in India, which seem to
have largely brought Covid-19 under control without the help of vaccines, most
countries are struggling with succeeding waves of the pandemic and a likely
global spread of a more contagious mutant of SARS-CoV-2.
The collateral damage to
economic and social well-being worldwide has been unprecedented, and it underscores
the urgently felt need for vaccines and a return to some semblance of normalcy.
Despite
a major lapse with a 16,000 plus person religious gathering which erupted into
several clusters locally and in the region (March 2020), Malaysia had performed
creditably earlier.
Sources of Current Outbreaks
Unfortunately,
since October 2020, a resurgence of clusters emerged from non-compliant
returnees from abroad, and porous Sabah state border controls, exacerbated by
lax enforcement of SOPs during the September 2020 Sabah state elections.
Immigration
and health authorities were not sufficiently pro-active to prevent its further
spread in the peninsula, resulting in numerous outbreaks, especially among
workers in congested accommodations and workplaces, and in prisons and detention
centres.
Unlike Singapore’s
experience with outbreaks in migrant dormitory complexes, we in Malaysia are
additionally reaping the consequences of decades of corrupt mismanagement of
labor migration, viz. a persistently large pool of undocumented
migrant workers (currently estimated at 1.2-1.5 million) who have strong
incentives to avoid contact with government agencies.
Senior Minister Ismail
Sabri’s disastrous U-turn in going after undocumented migrants (after initially
promising them sanctuary and no arrests and deportation during the pandemic)
greatly complicated pandemic control efforts, in particular the crucially
important contact tracing.
As generally younger
daily-paid workers, more likely to ride out the milder symptoms of Covid-19
infection, they are now even less inclined to cooperate in testing and
isolation, given the risks of arrest, detention and deportation.
We thus face the prospect
of protracted and repeated seeding of the general population by the
asymptomatic or mildly symptomatic, especially undocumented workers reluctant
to seek treatment unless severely ill. (We should also note that active
avoidance of contact tracing and testing involves others disinclined to divulge
network contacts or contact history, e.g. underworld elements, drug and sexual
encounters, etc).
As in many other
countries, many Malaysians support efforts to secure vaccines to enhance
pandemic control efforts.
Procuring Vaccines for
Malaysia
The minister for Science,
Technology, and Innovation Khairy Jamaluddin has announced commitments to
purchase
a basket of Covid-19 vaccines, and options for further
orders.
Khairy Jamaluddin needs
to be transparent about the technical rationales, criteria, and pricing for his
ministry’s purchasing decisions. In
particular, he needs to respond to very pertinent points raised by the Covid
Research Centre (KL),
chest specialist Dr Jeyakumar Devaraj,
and others, which include the following:
·
there is currently little
information on long-term safety beyond 2 months or on durability of protection,
for all candidate or approved vaccines (any late-manifesting adverse effects
will only be detected by conscientious follow-up surveillance, monitoring, and
reporting systems). This is especially
pertinent for novel mRNA vaccines, in comparison with
the more familiar inactivated whole-virus vaccines with which we have decades
of experience
·
the
decision by the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA)
to grant immunity to Pfizer from legal liability for late-manifesting adverse
effects, and the Pfizer CEO declining to be among the early vaccinees (claiming
selflessness in prioritising those more vulnerable, in contrast to some vaccine
researchers who vaccinated themselves even before phase 1 human trials) perhaps
reflects the true risk perception or assessment of the pharmaceutical
corporations (whose profitable research and development work has been highly
subsidised by governments for ‘vaccine nationalist’ reasons)
·
stringent logistic
requirements (deep-freeze or ultra-low temperature facilities) for the mass
deployment of mRNA vaccines to under-served remote areas
·
one additional advantage
of the inactivated whole-virus vaccine is that the host immune response is
mounted against a spectrum of antigens from the whole virus, rather than
against a much more limited array of antigenic sub-components of say, the spike
protein. This could provide some
insurance against mutations, say in the coding sequences for the spike protein,
which might render vaccines directed solely against the spike protein wholly or
partially ineffective.
Beyond the immediate
urgency of securing access to adequate quantities of safe, efficacious and
affordable vaccines, the larger question of our continuing dependency on
foreign vaccine developers, producers and suppliers remains unaddressed.
National Capabilities in Production
of Medicines and Vaccines
Consider Cuba, a nation
of 12 million citizens hamstrung by a 60-year economic blockade by the US,
which has invested in human and material resources to become a biotech
power-house: recombinant hepatitis B
vaccines, synthetic polysaccharide vaccine against Haemophilus influenzae
type B,
CIMAvax vaccine against lung cancer,
and innovative treatment of diabetic foot ulcers.
Cuba’s repeated offers of
scientific collaboration in R&D, and joint ventures to position Malaysia as
a regional production and distribution platform for Southeast Asia,
have elicited only a lukewarm response.
Tan Sri Dr Abu Bakar Suleiman, the retired Director General of Health,
has shown greater foresight and entrepreneurial verve as chairman of Bioven,
which is shepherding CIMAvax through US-FDA and UK phase 3 clinical trials.
It is not too late to
make the necessary strategic decisions for a promising growth area
(pharmaceuticals and vaccines) in the national and regional economies of the
newly launched RCEP.
for more
information/clarifications, please contact:
Chan Chee Khoon cheekhoon50@gmail.com
Chee Heng Leng cheehengleng@gmail.com
Endorsers
Aliran
Citizens’ Health Initiative
Freedom
Kuala Lumpur & Selangor Chinese Assembly Hall (KLSCAH)
North South Initiative
Pengguna Pahang
Parti Sosialis Malaysia (PSM)
Pergerakan Tenaga Akademik Malaysia (GERAK)
Suara Rakyat Malaysia (SUARAM)
