Despite being Southeast Asia’s manufacturing hub of AstraZeneca’s COVID-19 vaccine, Thailand is struggling with a severe shortage of jabs for its own population. The situation is so serious that the government decided to go ahead with the world’s first Sinovac-AstraZeneca mixed inoculation program in spite of loud public complaint.

False assurances?   

Earlier this year, the government dismissed criticism that its vaccination plan was inadequate given it had reserved just 26 million doses of AstraZeneca. The deal included knowledge transfer to allow royally-owned pharmaceutical firm Siam Bioscience to produce the vaccine in Thailand. The government then began importing Sinovac jabs from China to tackle the second wave of infections and announced it had ordered another 35 million AstraZeneca doses.

In early June, Disease Control Department (DCD) director-general Dr Opart Karnkawinpong described the deal for 61 million AstraZeneca jabs as the core of Thailand’s plan to procure 100 million doses before year-end.

Health authorities promised that from mid-2021 AstraZeneca would start delivering about 10 million doses every month, and called on all Thais to register for their jab.

However, shortly after mass vaccination launched on June 7, millions of Thais found their bookings cancelled. The authorities then changed their tune, saying AstraZeneca could set the volume for each delivery but would definitely supply all 61 million doses by year-end.

The promises and assurances from the government continued in this vein until a doctor anonymously leaked a letter apparently sent from AstraZeneca to Public Health Minister Anutin Charnvirakul last week. Dated June 25, the letter showed that AstraZeneca had offered no guaranteed timeframe for the delivery of all 61 million jabs.

What does the leak reveal?

According to the letter, Thailand signed the contract for 26 million doses in January this year and for 35 million more doses in May.

Given that the amount accounted for 34.93 per cent of total doses ordered by Southeast Asia, AstraZeneca planned to supply 5 to 6 million doses per month – or about a third of its production capacity in Thailand – to the Thai government. The company also pointed out that this amount was nearly double the supply Thailand had said it would need during discussions with AstraZeneca last September.

This leak appeared to confirm Deputy Public Health Minister Sathit Pitutecha’s recent announcement that AstraZeneca had said it would deliver all 61 million doses by May next year.

Authorities’ explanation

On July 18, Opart told the media that the 3 million doses mentioned in the discussion on September 7last year referred to the number of doses the country could administer per month according to data at the time. “But we later informed AstraZeneca that if there was enough supply, we could administer up to 10 million doses a month,” he said.

When asked about the timeframe for deliveries by AstraZeneca, Opart said parties to the contract would need to negotiate further based on demand and supply.

“Since the contract was prepared before actual production began, we did not know exactly how much could be expected each month. Thus, we didn’t go into those details in the contract,” he said.

He added that DCD did tell AstraZeneca later that it would need 6 million doses in June, 10 million per month from July to November and 5 million more in December.

Opart also revealed that the contract for 26 million doses was signed last November. Between January and March this year, the government made moves to procure another 35 million doses. DCD then amended the contract to cover the additional doses and sent it to AstraZeneca on March 25. However, the response from AstraZeneca only arrived on May 4, Opart claimed.

“We will negotiate further with AstraZeneca to push for supplies,” he said. “AstraZeneca has not officially said the last batch will arrive in May next year. This also depends on its production capacity here, which is in the process of being boosted.”

As of July 16, AstraZeneca had delivered 8.19 million doses to Thailand.

Thailand wants to limit export of locally-produced AstraZeneca vaccine

Thailand’s Ministry of Public Health is to go ahead with a temporary restriction on the export of locally-produced AstraZeneca vaccine, to ensure sufficient supply for domestic use, in the wake of the relentless spread of COVID-19 in the country.

Is the contract unfair?

Social critic Sarinee Achavanuntakul says the contract appears to place Thailand at a disadvantage. Writing on Facebook, she said it gives the country little chance of receiving more than what AstraZeneca plans to provide.

“It seems like Thais have been deceived into believing that 61 million doses of the AstraZeneca vaccine will be available this year,” Sarinee said.

Vaccine delays elsewhere too

Thailand is not the only country hit by vaccine shortages. Several countries in Europe and Asia, notably Taiwan and Malaysia, are experiencing the same problem.

The European Union (EU) was so incensed that it decided to sue AstraZeneca over delayed deliveries. The Anglo-Swedish company developed its vaccine in collaboration with Oxford University and is providing the shots at no profit during the pandemic.

However, the EU lost its battle to force AstraZeneca to deliver 120 million doses by the end of June. A Belgian court ruled that the pharmaceutical company only had to deliver 80 million doses by September – significantly fewer than the amount the EU was demanding. AstraZeneca also escaped without a fine.

Emerging information suggests that Thailand, like the EU, signed a contract with a clause stipulating that AstraZeneca will make its “best effort” to meet orders, rather than a guarantee.

Can Thailand afford to export jabs?

National Vaccine Institute director Dr Nakorn Premsri said the National Vaccine Committee had approved in principle the idea of a ministerial order to limit export of vaccines made by Siam Bioscience. The export cap is deemed necessary as the COVID-19 crisis has flared up with more than 10,000 new infections daily and around 100 deaths per day.

Four months ago, India temporarily halted the export of AstraZeneca at the height of its COVID-19 outbreak. In Thailand, Public Health Minister Anutin has voiced support for temporarily halting vaccine exports.

Vaccines from other makers

Anutin said the Thai Food and Drug Administration will seek a meeting this week with representatives of all makers of COVID-19 vaccine registered in Thailand.

“We will try to procure more vaccines, especially the mRNA type that people want,” he said.

By Thai PBS World’s General Desk