The United Nations High Commissioner for Refugees sounded the alarm at the beginning of this month on the rapidly deteriorating circumstances of refugees and asylum seekers in Asia. As outbreaks surge following the spread of the new Delta strain first detected in India, displaced persons across the region are at a very high risk of contracting the deadly virus—not least because of a dearth of coronavirus vaccines throughout the Asia-Pacific. The UNHCR is renewing its appeal to countries with prior pharmaceutical agreements and successful vaccination programmes to urgently donate surplus vaccines to the besieged countries.
But even if these wealthier countries redirect their doses to Asia via the COVAX facility, these nations—with their warm climates, insufficient medical infrastructure and remotely situated residents— are largely ill-equipped to store and distribute the precious vials of the most effective vaccines currently on the market, due to their refrigeration requirements. Equitable access to vaccines will remain a pipe dream for Asia unless new solutions are lighted upon fast. Now, however, new vaccine technologies look set to turn the page on vaccine inequality in coming months.
Asia’s growing catastrophe
The town of Cox’s Bazar in Bangladesh houses approximately 900,000 Rohingya refugees and asylum seekers, making it the largest settlement of its kind in the world. In the past months, these settlements have seen over 1,100 coronavirus cases—a statistic that is shocking but hardly surprising given the cramped living conditions and poor sanitation in the camp. What’s more, a lack of vaccines in the country means that not a single person in these encampments has been inoculated.
And Bangladesh is not the only country struggling to keep the disease at bay among vulnerable groups of asylum seekers and refugees, with Nepal, Iran, Pakistan, Thailand, Malaysia and Indonesia all experiencing similar crises. Even though these nations have all agreed to vaccinate refugees and asylum seekers within their borders, the scarcity of vaccines in general means that these disenfranchised groups come last on the waiting list.
But although the Asia-Pacific region has recorded the largest global increase in Covid-19 deaths, Western vaccine nationalism means that the life-saving doses are in short supply across the continent. To make matters worse, the recent coronavirus crisis in India has not only had a major impact on the region’s Covid-19 cases but also on global vaccine distribution as India was an important vaccine production hub. UNHCR’s plea to distribute vaccine supplies more equitably was levelled at refugees in particular, but the unequal status quo leaves all citizens in the region susceptible to the virus.
Could second-generation vaccines turbocharge Asia’s vaccine drive?
Soon, however, second generation vaccines could recalibrate the currently Western-oriented supply chain and provide Asia with more flexibility on national vaccination campaigns. Relying on the latest medical technology to succeed where vaccine diplomacy is failing would avoid a situation in which, as Gordon Brown said, wealthier countries attempt to “tackle this through whip-rounds or treating this like a charity fundraiser”. In order to ensure that the world finally defeats Covid-19 altogether, it is clear that more vaccines are required. After the first spate of vaccine approvals at the beginning of this year, a slew of new vaccines will not only bolster global supply, thereby improving access, but also offer an improvement on extant vaccines.
One such second-generation vaccine, produced by US-based Akston Biosciences, is especially well-suited for hot regions such as ASEAN because it doesn’t require the same particular handling as first-generation vaccines like Pfizer and Moderna. In fact, Akston’s AKS-452 remains effective for a week up to 37ºC and shelf-stable for four months at 25ºC – a critical advantage in areas where refrigeration infrastructure is limited.
With the vaccine candidate already in Phase II of clinical trials in the Netherlands since mid-April, AKS-452 could be approved this year. Encouragingly, Akston’s vaccine could be rapidly scaled up, with a single 2,000-liter production line capable of producing over one billion doses each year. It’s precisely the kind of medical advance which has the potential to turn the tide on the sluggish global rollout caused by “vaccine nationalism, limited production capacity and lack of funding.”
Breaking the Gordian knot of vaccine distribution
Indeed, the state of affairs in Asia is currently so lamentable, with only 23 doses having been delivered per 100 people in the Asia-Pacific, that Vietnam is accelerating plans to purchase vaccine production technology to produce Russia’s Sputnik V vaccine themselves. Meanwhile, lack of supplies and infrastructural complications meant Thailand only began mass vaccination this week—and is producing the less-effective AstraZeneca vaccines using an inexperienced company owned by the King.
As the virus and its variants sweep through masses of vulnerable individuals in the Asia-Pacific, vaccine diplomacy must be expedited with immediate effect. But in the longer-term, investments in a second generation of more flexible vaccines could fix the grievous imbalance once and for all.
