By PATRICK JARAMOGI
KAMPALA- |SHIFTMEDIA| The hopes for the Covid19 vaccine among Ugandans is high, but new revelations indicate the wait may be longer due to procurement challenges.
Cabinet in a seating last week approved the purchase of 18 million doses of the COVID-19 vaccine developed by AstraZeneca.
The procurement of the 18 million doses of vaccine will be implemented by the Ministry of Health and the National Medicines Stores (NMS).
But the procurement process of these vaccines remains unclear, especially regarding the selection of the Serum Institute of India to supply the Astra Zeneca doses worth USD$ 126 million (Ugx 460 billion).
While addressing the nation on February 4 2021, President Yoweri Museveni said the doses would be used to vaccinate people above 50 years of age, as well as people with underlying health conditions, frontline health workers, security personnel, teachers and other essential social service providers.
Each person will receive two doses separated by 28 days.
High prices raise queries
Already ‘hairs’ have been raised regarding the exorbitant price of the vaccines. Insiders within the Ministry of Health and National Medical Stores intimated to this reporter the way “top” health officials negotiated their way out into the deal to siphon taxpayers money.
Contrary to other countries such as South Africa that have purchased similar vaccines at just $5.25 (Ugx19,170), and Europe at $2.16 (Ugx7,900), Uganda is to set to purchase the drugs at $7 per dose, two doses at $14 (Ugx 51,100) plus an additional shipping fee of $3 (10,950).
In total, tax payers will fork out Ugx62,050 ($17) to meet vaccines for the first 9 million Ugandans. Simple mathematics points that if proper bidding process is followed, with limited chances to corrupt officials having leeway, the nation would only spend USD$ 94.5m(Ugx 345b) instead of the USD 126m (Ugx460b), thus saving USD31.5m (Ugx115b)
The way these 9 million Ugandans will be selected remains another puzzle all together.
Though the Ministry of Health has assured Ugandans that the Covid 19 vaccine will be offered free of charge, however, talks within the ‘corridors’ indicate that some “wealthy” Ugandans will have to pay for the jabs.
Emmanuel Ainebyona the Ministry of Health publicist said talks are on with the private sector to ensure those who can afford it (vaccines) can obtain it at a minimal price.
“If they (government) subjected us to pay for the Covid 19 tests, how sure are you that they won’t ask us to pay for the vaccines,” said a worried Juliet Nankya, a business woman.
There is out-rage among Ugandans regarding plans to charge them for the vaccines given government plans to procure new Members of Parliament brand new cars valued at over Ugx300m.
“I would rather die of Covid 19 than pay that $14. These are tax payers money, that we and our grandchildren shall pay. How do I pay for vaccine yet MPs are getting shs300m for vehicles,” said Kirunda Alex a driver.
On top of the Astra Zeneca doses, the country expects to get the first batch of over 3.5 million doses of the AstraZeneca vaccine from the Covax facility early next month (March) to immunize another 1.78 million Ugandans.
What is rather interesting is that fact that some “shrewd” Ugandan officials, who think they are always smart are up to their games of siphoning tax payers money regarding public procurement.
The same happened during the procurement of the Covid 19 relief food, the Covid face masks as well as the purchase of double Cabin pickups by the Covid 19 National Task Force. But that is a story for another day.
Our findings unearthed that though these “fishy’ officials already gave a report to the President and cabinet regarding prices, the supplier Serum Institute of India revealed that they are yet to decide on the exact pricing.
The Serum Institute Spokesman told Reuters News Agency that the institute has not yet signed any deal with Uganda. “While discussions are ongoing, there has been no finalization of price or volumes,” the spokesman said.
What we need to expose here is the disparity in vaccine prices supplied by the same firm.
The Serum Institute is supplying the same doses of the vaccine to South Africa, Saudi Arabia and Brazil at $5.25 (Ugx19,170) per dose, why is Uganda being charged $7 (Ugx25,600) per dose?
An official from the Serum Institute said: “We can only start formal talks after we receive the first down payment of US$ 5 million (Ugx 18.3b).”
How effective is AstraZeneca?
As the ‘shrewd’ ignite means to steal from tax payers money, there is worry regarding the effectiveness of the AstraZeneca vaccine being procured.
Uganda has so far registered over 39,000 COVID-19 cases and 325 deaths. But amidst the hopes of vaccine, Africa is already bracing for the third wave of Covid.
South Africa had to halt the use of the AstraZeneca vaccine last week after tests indicated that the jabs were “ineffective”. The halting of the immunization left many South Africans crestfallen.
According to medics, the AstraZeneca brand proved a high-efficacy rate against the Covid-19 variant found in South Africa. The new variant has already been reported in 40 countries globally, throwing a spanner in the grand works of the vaccine manufacturing.
The trial was carried out by researchers at the University of the Witwatersrand in South Africa and the UK’s Oxford University but has not yet been peer-reviewed.
The trial’s chief investigator, Prof Shabir Madhi, said it showed that “unfortunately, the AstraZeneca vaccine does not work against mild and moderate illness”.
But the World Health Organization (WHO) warned against jumping to conclusions about the efficacy of Covid vaccines.
Dr Katherine O’Brien, the WHO’s director of immunisation, said it was very plausible that the Oxford-AstraZeneca vaccine would still have a meaningful impact on the South African variant, especially when it came to preventing hospitalisations and death.
But not all hope is gone, countries that have secured AstraZeneca doses, said that AstraZeneca vaccine was not only effective in preventing disease – but also in reducing transmission to others.
Officials defend price tag
Responding to a swell of global criticism, a senior Ugandan health official told Health Policy Watch that Uganda’s government is not paying unreasonably higher prices for its AstraZeneca vaccines, in comparison to other African countries – or Europe.
“You cannot compare prices directly between countries because there are many factors to consider. Prices have to vary anyway,” said Alfred Driwale the manager of the Uganda National Expanded Programme on Immunization (UNEPI) at the Ministry of Health.
But Driwale told Health Policy Watch that the prices countries may quote, per vaccine, vary because there are many factors to consider including overhead costs, the timing of orders; transport costs; the amounts of cash down payments or deposits, as well as economies of scale etc.
“You cannot expect a country with a big population to pay the same price, the big country will definitely have a higher bargaining power,” says Driwale while comparing the prices a country like Uganda and Nigeria may pay for the vaccine.
Uganda has some 48 million people while South Africa has nearly 60 million.
Driwale who did not want to comment on whether this sets a precedent for what Uganda might pay in the event it procures other types of vaccines saying ‘ it is still too early to have that conversation now.”
What experts say about Ivermectin
Study has shown that Ivermectin was a preferred option to AstraZeneca, though this was also rejected in South Africa where the drug is recommended for only animals.
The South Africans were warned not to use the parasiticide, Ivermectin, as a preventative or curative treatment for Covid-19.
This is after the international debate on the drug’s effectiveness against the disease reached local shores late last year.
Dr Peter Oberem, CEO of South African animal health products provider, Afrivet, said that while a number of international scientific articles supported the theory that Ivermectin could possibly prevent or cure COVID-19 infections, South Africa’s Ivermectin products “are not registered as human medicine” and “have been tested for safety in animals, not humans”.
Oberem’s stance was echoed by the South African Health Products Regulatory Authority (SAHPRA) that confirmed in a statement that Ivermectin was neither indicated nor approved by SAHPRA for use in humans.
Information provided by the Barcelona Institute for Global Health (ISGlobal) said that there were parts of the world where Ivermectin was approved to treat specific health problems in humans.
This includes in the US where it was approved for use against the parasitic roundworm, Strongyloides stercoralis, and against river blindness caused by the parasitic worm, Onchocerca volvulus.
Ivermectin was also once used in Fort Portal to treat epidemic in the 1990s, and reports show it worked.
Renown Toxicologist speaks out
According to Professor Dr Mustafa Ali Mohd-, a Clinical Pharmacologist & Toxicologist and a former member of a WHO expert panel on chemical safety, it is important to conduct at least three phases of human clinical trials, in the interest of safety, for all vaccines or drugs before they are approved for public consumption.
“But human clinical trials can take many years and we are now in an emergency situation with many people being infected with Covid-19 and dying every day. Ivermectin could be our saviour,” said.
He said Ivermectin has been used for over 30 years by many millions of people with 3.7 billion doses distributed around the world with no reported severe side effects or deaths from taking it.
“Many recent studies around the world have shown that Ivermectin is also effective for treating Covid-19 and it has already saved many lives. Contrary to what Dr Musa said, the US National Institutes of Health has on 14 January 2021, upgraded the status of Ivermectin from “against” to “neither for or against” meaning that doctors in the US are now allowed to use Ivermectin to treat Covid-19.
Pfizer experimental vaccine was approved for use in Malaysia (without human clinical trials) and in the US, under “Emergency Authorisation. So why can’t Ivermectin, which has been proven safe for more than 30 years, be approved under “Emergency Authorisation” as well? It can be used for prophylactic (prevention) purpose and for treating Covid patients. For prophylactic purpose, it can be immediately administered, focusing on public red zones and among the high infections areas first, said Dr Mustafa Ali.
Ivermectin can also be considered as an emergency drug to be used PRIOR to the arrival of vaccines from overseas (which may be delayed) as a PLAN B. The most important consideration “to make here is the safety of the medication.
“If we weigh the pro and cons, I would like to appeal for Ivermectin to be approved as soon as possible for emergency use, and it should also be used under prescription by a doctor, as an additional safety measure,” advised the Toxicologist.
India saved lives with Ivermectin
India developed a “miraculously” effective and safe COVID-19 treatment kit which costs merely $2.65 (ugx9,700) per person and has helped put the nation’s case and fatality rates in “steep decline.”
Last month, several medical experts testified before the U.S. Senate Homeland Security Committee in favor of authorizing ivermectin for early treatment of the novel coronavirus. Among them, Dr Pierre Kory, a founding member of Front Line Covid-19 Critical Care Alliance (FLCCC), explained that ivermectin, a Nobel Prize-winning anti-parasitic agent, “basically obliterates transmission of this virus,” with “miraculous effectiveness.”