LMD EXCLUSIVE

STAYING THE COURSE

Dr. Razia Pendse delves into the importance of immunisation in ending the pandemic and efforts to ensure equitable distribution across the world

Assuming duties as the WHO Re­presentative to Sri Lanka in May 2017, Dr. Razia Pendse has been with the global health agency since 2004, holding various positions in the organisation. She previously served at its regional office for Southeast Asia and headquarters in Geneva.

Counting more than 20 years’ experience in public health, Pendse commenced her career in the field working for NGOs in India.

The WHO has said that Sri Lanka would receive COVID-19 vaccines for around four million people (or eight million doses) under the COVAX facility – an unprecedented global effort to ensure equitable access to vaccines globally. This is led by the health agency, GAVI and the Coalition for Epidemic Preparedness Innovations (CEPI), in partnership with multilateral agencies such as the World Bank, UNICEF and Asian Development Bank (ADB).

In an exclusive interview with LMD, Pendse affirms that the facility aims to provide vaccines to 190 countries that have signed up. As part of the initiative’s Advance Market Commitment, 92 nations including Sri Lanka will receive vaccines covering 20 percent of their entire populations at no cost. This is to ensure the vaccination of priority groups, protect front line workers and the elderly, reduce global transmission and restart economies to mitigate the pandemic’s impact.

Additionally, she acknowledges that there have been issues related to obtaining vaccines as a result of high demand and limited supplies. However, the COVAX initiative already has commitments to procure two billion doses within this year; and the delivery of the vaccines could begin as soon as at the end of February or in early March.

Pendse explains: “Initially, the number of doses delivered will be low; but we expect that countries will receive the vaccines promised by the COVAX facility by the third quarter of this year as more candidate vaccines are approved and supply chains ease.”

Meanwhile, she commends Sri Lanka for its immunisation system as the Epidemiology Unit of the Ministry of Health announced that almost 140,000 people in the country were vaccinated over a period of six days following the receipt of a consignment of 500,000 doses of Oxford-AstraZeneca’s COVISHIELD from India.

And in an exclusive interview with Anushan Selvarajah on the 13 January edition of LMDtv, Pendse shed light on the pandemic response and WHO’s efforts to ensure that vaccines are distributed equitably, while stressing the need for the general public to continue practising good hand hygiene, wearing masks, maintaining physical distancing, and avoiding crowds and closed spaces among other measures.

She also reiterated the importance of community engagement using evidence-based information and solidarity across sectors in the fight against the virus.

Moreover, Pendse cited the importance of having national plans for the deployment of COVID-19 vaccines to ensure that populations are protected as countries look to achieve herd immunity and end the pandemic.

– LMD

Q: Given that new strains of the coronavirus seem to be stretching healthcare services in a number of countries, could you provide an overview of the pandemic as it stands (at the beginning of 2021)?

A: We are at a critical juncture in the pandemic response for COVID-19; and while the vaccine offers hope, we need to remember that all measures must be taken together. The vaccine is not a replacement for other precautions so we have to stay the course, do it all and do it better if we want to end the acute phase of the pandemic in 2021.

WHO has reported the emergence of new strains in the UK, South Africa and other countries. We’ve learnt that the UK’s strain is transmitted more easily, which is why we’re seeing increased surges in many countries where its presence has been observed. However, there have not been reports of increased pathogenicity – i.e. increased severity of the disease.

It’s important to note that the WHO SARS-CoV-2 Virus Evolution Work­ing Group – a group of leading researchers across many countries – is monitoring these variations. All viruses undergo changes and this coronavirus is no different.

Until recently, we observed limited impacts of these changes on transmission, severity and mortality, which is good news. But we need to continue monitoring and researching reported changes, and WHO will inform governments and the public as we learn more about the virus.

While scientists monitor and research the changes in the virus, everyone must play their role in taking all measures to prevent the spread to others – this will help us break the chains of transmission and spread of COVID-19.

Q: How is the COVAX initiative progressing?

A: COVAX is designed to guarantee safe, fair and equitable access to vaccines, as and when they become available. Ensuring that vaccines are available to all the vulnerable populations across the globe is critical to end the acute phase of the pandemic, and get back to our lives and livelihoods that have been severely disrupted.

The COVAX facility enables the procurement of different candidate vaccines as they’re approved by regulatory authorities or listed for emergency use by WHO. These vaccines will be equitably distributed among all member countries of the scheme.

As of mid-January, 190 nations have signed up. Of these, 92 are Advance Market Commitment (AMC) countries – low and middle income nations that will be given donor funded doses with the priority being ensuring that at least 20 percent of their populations are covered.

Agreements are in place for the facility to receive two billion doses this year, of which 1.3 billion will be distributed to AMC nations.


Q: When can nations such as Sri Lanka expect to receive the vaccine?

A: A few factors impact access to vaccines through COVAX. Among them is the availability of efficacious and safe vaccines that have passed through stringent testing by regulatory authorities or been listed for emergency use by WHO.

As candidate vaccines are approved, they will be picked up by the scheme and we expect that by the end of the first quarter of this year, doses will begin to be distributed to countries that have signed up.

The readiness of countries such as Sri Lanka to roll out vaccination programmes will be important. COVAX is looking for countries to immediately deploy vaccines as soon as they’re dispatched so that there are no idle doses lying around.

Q: Could you shed light on the regulatory approval process impacting the roll out of vaccination programmes?

A: In terms of regulatory pathways, once a vaccine has been studied, and trial data regarding its efficacy and safety is available, this is submitted to the regulatory authorities of countries that want to use them.

For example, this would be the National Medicines Regulatory Authority (NMRA) in Sri Lanka. Therefore, it is up to each country to select the right tools that best fit their populations. From WHO’s perspective, what’s important is that the vaccines being rolled out meet the highest scientific and ethical standards.

Q: What is your take of the anti-vaccine lobby?

A: There is sufficient evidence indicating that vaccinations save lives and the same is true for the COVID-19 vaccines. It is one of the most important tools we have to address the pandemic.

Most anti-vaccination campaigns are driven by misinformation and disinformation. As such, it is important that the public gets clear, transparent and credible information on what vaccines can and cannot do, and why they are needed.

In the age of social media, there are many ‘infodemics’ and it’s necessary to scan information being passed around, and address myths and misconceptions. The media has a critical role to investigate misinformation and guide people towards the right information.

Q: Can herd immunity be achieved if vaccines are not administered to children below the age of 18?

A: The impact of COVID-19 is less severe in children while the mortality rate is lower. Meanwhile, the elderly and people with comorbidities are highly vulnerable with much of the severe impacts and deaths impacting these groups. So while we need to safeguard our children, it’s necessary to protect the most vulnerable.

Additionally, most vaccines that have been trialled and for which data is available have been tested on people who are 18 or older. For this reason,  children are not presently part of the COVID-19 vaccination plan.

Q: What is your take of reports that rich nations are ordering and stockpiling more vaccines than they need?

A: The availability of safe and effective vaccines is a game changer in saving lives and livelihoods. But all vulnerable people across the globe must have access to the vaccine because viruses don’t respect boundaries and we have seen that with COVID-19. Viruses are threats everywhere – especially in a globalised and interconnected world – so nobody is safe until everyone is safe.

We are looking to ensure access to all vulnerable people in all countries. In other words, some people in all countries need access to this important tool for the pandemic response. If all people in only some countries are vaccinated, we will not be able to turn the tide of the pandemic.

Global solidarity and equitable access will help us end this pandemic.

Q: Many are looking at 2021 to be the ‘year of the vaccine’ in the hope the world will be more like it was in 2019 than last year. Would you agree with this trend of thought?

A: Year 2021 has ushered in new hopes as vaccines are being approved and rolled out. If we’re looking for this year to be better than 2020, we have to stay the course and do it all better, in terms of prevention and protection measures.

If we pose as barriers to the virus moving from one person to another, this is also a potential weapon that we could have in breaking the chains of transmission while vaccinations will accelerate this process and curb the spread. Preventing transmission will also help curb the evolution and spread of variants.

If we can continue on this track and do all that is needed to prevent transmission, we should be ending 2021 on a high note.

– Compiled by Lourdes Abeyeratne

TALKING VACCINES ON LMDtv