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WHO Envoys call for a two-track approach to defeat the pandemic
Being vaccinated does not mean that we can throw caution to the wind and put ourselves and others at risk, warns Dr. Palitha Abeykoon, the WHO Director-General’s Special Envoy for South-East Asia
by Randima Attygalle
Calling for a ‘two-track approach’ where governments and vaccine manufacturers support all WHO Member States in their accelerated efforts to create vaccine manufacturing capacity and vaccinate their most vulnerable populations and where individuals and communities maintain a steely focus on continuing essential public health measures to break transmission chains, WHO Director General’s Special Envoys for COVID-19 in their latest communiqué make a case for a ‘renewed commitment to a comprehensive approach to defeat this pandemic.’
Reiterating that ‘no one is safe until everyone is safe’ the Special Envoys underscore that the global solidarity is essential for stopping the emergence of new variants. Moreover, they urge countries to support WHO’s call to vaccinate at least 10% of the population of every country by September, and a “drive to December” to vaccinate 40% by the end of 2021. Achieving the September goal means 250 million more people in low and middle-income countries must be vaccinated in just four months, prioritizing all health workers and the most at-risk groups to save lives.
“This is to set an achievable global target and to highlight the need for the world to move together because that has not happened and in fact the vaccine inequity is getting worse,” Dr. Palitha Abeykoon, WHO Director-General’s Special Envoy for South-East Asia, told the Sunday Island. Citing the ‘unacceptable reality’ of 10 to 15 countries having already vaccinated far more than these targets and holding 75% of the global vaccine supply and are talking of a third booster dose, Dr. Abeykoon remarked that, “sucking up the vaccine in the high income countries is condemning millions to death.” A few countries in Africa have just recently administered their first dose, he added. He remarks that COVID-19 “should not be a pandemic of the poor and the unvaccinated.”
The problem in the Serum Institute of India, with the raging pandemic there, left many in the lurch without the second dose. Now there is renewed hope with a sizeable quantity of the vaccine expected to arrive in the island this weekend, sufficient to cover all those who got the first dose. says Dr. Abeykoon.
Several more countries are in the same predicament as we with the shortfall of the Astra Zeneca second dose and a few of them had given an mRNA vaccine (a new vaccine teaching the body how to make a protein that will trigger an immune response without using a live virus) as the second dose.
“The WHO has not yet recommended mixing vaccines but that is being done. Research work is going on to determine the best combinations of vaccines that could be mixed,” Dr. Abeykoon noted.
In terms of the ‘two-track’ approach mooted by the WHO, what is seen here at home is a ‘mixed situation’ observes the senior consultant. “The President’s target of administering at least one dose per person over 30-years by end of September, though on the face of it seems ambitious, can be achieved if we could get adequate supplies of vaccines.” Although it’s likely that the vaccine supplies through the COVAX facility and bilateral channels could meet these needs, the vaccine situation in the world is still unpredictable due to many factors, he warns.
“The world has to see this as a global issue and not through a narrow nationalistic prism. In any event we need to ensure that the most vulnerable groups get vaccinated as a priority.” He also points out that our daily vaccination rates these days are much better than regional counterparts. “Our track record in vaccination has always been excellent and vaccine hesitancy is not an issue.”
Being vaccinated does not mean that we can throw caution to the winds and put ourselves and others at risk, warns Dr. Abeykoon. Although both doses of a vaccine provides protection and prevent death and serious illness and complications, vaccines do not prevent infection per se. There are reported instances and some evidence from a few countries that the Delta variant particularly is able to resist some vaccines. “We need to get more data on this to be certain but our policy on choice of vaccines should take this information into consideration.”
The ‘second track’, where the people should be convinced to maintain a ‘steely focus’ on continuing essential public health measures is right now crucially important and until we reach a high level of immunity in the country, and globally, these measures have to be observed, explains the WHO envoy, adding that, our narrative of the second track could have been much better.
“Until the holiday season last April when the relaxation of the public health measures helped to trigger the third wave, we had observed the basic public health and social measures quite well and hence contained the infection reasonably successfully. The surge from May until end June reversed many of the gains we had made and the re-imposition of more stringent public health and social measures early this month helped to contain the spread to a large extent. The advent of the Delta variant of concern has added another significant variable. Vaccines will certainly be a very important measure but at the same time strictly observing basic public health measures will be essential to prevent its spread.”
A carefully calibrated exit strategy from the public health and social restrictions also need to be worked out says Dr. Abeykoon who notes that relaxing public health interventions should be done cautiously and with careful attention to those who remain unvaccinated.
The pandemic is nowhere near finished and in fact the worst may be yet to come, he remarks. WHO’s findings on the current global situation are applicable to Sri Lanka as well. These include variants of concern that are emerging, inconsistent application of public health and social measures, increased social mobility and large number of people who remain susceptible to COVID-19 infection as a res ult of inequitable vaccine distribution around the world. “Regular, consistent communication of the above risk factors and the desirable behaviour with clear messages and engaging the public in the overall response is the key.”
Reiterating the need to come out of the pandemic with a stronger public health system, Dr. Abeykoon remarks that the improvements in our surveillance system, capacity for diagnostics and sequencing are significant. In terms of our potential for vaccine development, he points out that these are hi-tech and expensive interventions.
“Sri Lanka can be a desired site for clinical trials and there are some ongoing discussions. Of course if we can invest in partnerships with either development agencies or the private sector vaccine manufactures, it is certainly feasible. For example Thailand recently started production of Astra Zeneca in the country and plan to produce other vaccines.”