22 January 2021

 

Full Report: Pakistan

Predictions

  • Regulatory approvals and Sinopharm procurement deal will allow first phase of vaccine rollout to begin in coming weeks
  • Major logistical obstacles and vaccine scepticism will mean wider public rollout, targeting 70% of population, is protracted
  • Imminent beginning of vaccination programme will ensure government remains unwilling to impose major restrictions

 

Event

The government announced it had granted emergency use approval (EUA) for the coronavirus (COVID-19) vaccine developed by AstraZeneca and Oxford University on 16 January. Two days later, the Drug Regulatory Authority approved a second vaccine, developed by the Chinese state-owned manufacturer Sinopharm. Meanwhile, Foreign Minister Shah Mehmood Qureshi said on 21 January that China had agreed to provide half a million doses of the Sinopharm vaccine to Pakistan as a gift by the end of the month. Qureshi said the government intended to import 1.1 million doses of the Sinopharm vaccine by the end of February, in support of its goal of inoculating 70% of the population.

Context

Pakistan’s approval of the two vaccines comes just over two weeks after the UK regulator approved the Oxford-AstraZeneca candidate on 30 December. The following day Chinese regulators also approved the Sinopharm vaccine for general use, having granted it early approval in August. Islamabad’s own authorisations also come in the wake of a slight rise in domestic case rates over recent weeks, with the seven-day average of confirmed new cases rising from 2,092 on 31 December to 2,280 on 20 January. The government will be relying on a widespread vaccine rollout to reduce these numbers, given its low testing rates, limited contact tracing and reluctance to introduce harsh restrictions to limit the virus’ spread. The new deal with Sinopharm will therefore be a welcome first step towards the planned vaccination programme.

Source: Gallup poll of 26,759 individuals across 32 countries

Analysis

The government will be eager to begin the vaccine rollout, not only to ease the strain on hospitals and mitigate the major economic damage wrought by the pandemic last year, but also to counter opposition claims that the administration has been slow in responding to the outbreak. This is especially pressing amid mounting criticism of the administration from the opposition Pakistan Democratic Movement alliance, which is seeking to oust Prime Minister Khan through an ongoing series of protests. This explains the large supply deal it has struck with Sinopharm, whose vaccine is in far lower global demand than AstraZeneca’s and will thus likely be quicker to procure at scale.

Outlook

The approval of the two vaccines will give the government momentum to push for more bilateral procurement deals in the coming weeks. It will also rely on the WHO’s COVAX Facility – which is expected to begin distributing doses this quarter – to bolster its initial Sinopharm rollout. The beginning of the vaccination programme will help ease pressure on the healthcare sector, as the government will initially prioritise frontline health workers and the extremely clinically vulnerable. However, the wider rollout will be protracted and Islamabad’s target of inoculating 70% of the population – providing two doses to over 152 million people – will face major challenges. The vaccine will need to be distributed to Pakistan’s rural majority, and while this will be aided by the fact that neither AstraZeneca nor Sinopharm vaccines have extensive cold-chain requirements, it will prove more logistically complex than distribution in countries with larger urban populations. Moreover, vaccine scepticism is widespread, with a Gallup poll in early December showing up to 40% of respondents would be unwilling to accept the inoculation, and this will further hinder the rollout. Even so, the government will be highly unlikely to impose any major restrictions to limit the virus’ spread once distribution has begun, given its reluctance to do so to date.

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