Across more than 128 countries,
we know that many countries are ready in terms
of the coordination and management of the deployment,
in terms of even some of the cold chain infrastructure,
the financing, the regulatory bit.
But there are some gaps.
Today on Expert Answers, we're checking in
with Dr. Muhammad Pate once more,
asking him about the COVID-19 vaccine rollout.
Specifically, we're asking him about how ready
developing countries are to begin vaccinating their people,
what are some of the key obstacles standing in their way,
and how are those obstacles being overcome
and so that they can mount a safe
and effective vaccination campaign.
So Dr. Pate, thank you so much for being here.
Here in the past few weeks since the last time
we've spoken, vaccines have started to roll out
across the developed world.
Can you fill us in a little bit
about what the vaccine situation is like
in the developing countries?
Has the vaccine started to roll out
across the developing world yet?
-Thank you, Paul.
I think it's good to see that vaccines are now
being delivered to several developing countries
over the last couple of weeks.
I think that's offering a light
at the end of a long tunnel of the pandemic.
And this is happening in an unprecedented manner as well,
given that within a year from the pandemic,
we have vaccines that have been approved
and have been administered.
Unfortunately, the gap between the high-income countries
and the low-income countries couldn't be reduced
more than what it has turned out to be.
But still, I think many countries are beginning
to vaccinate and more to come.
-And we've talked in the past about some of these obstacles
to rolling out the vaccine more quickly, more widespread,
but for folks maybe who haven't caught those episodes,
can you remind us a little bit?
What are some of the key challenges
to getting the vaccine out there further and faster?
-Buying the vaccines is an important one.
Developing them, innovating them, manufacturing them,
delivering them to countries is an important piece.
But we know that the other half of the challenge
is to ensure in fact that the vaccines reach the people
who will benefit from them.
So over the last couple of months, I think we focused
as the World Bank together with WHO, UNICEF,
Gavi, Global Fund, on an effort to help countries get ready
to deploy the vaccines, to understand where they are,
to assess their readiness, to be able to deploy
those vaccines efficiently, effectively,
as well as equitably.
Based on that assessment, over the last couple of months,
across more than 128 countries,
we know that many countries are ready
in terms of the coordination and management
of the deployment, in terms of even some
of the cold chain infrastructure,
the financing, the regulatory bit.
But there are some gaps.
-And you're laying down there all the different
puzzle pieces that have to come together
so that you can get this vaccine out to people.
And it sounds like an incredibly complicated undertaking.
Talk to me a little bit about the work
that your team and the World Bank
and its partners are doing to help countries
understand all the puzzle pieces that need to come together
and get ready to effectively distribute the vaccine.
-You know Paul, you see this is an unprecedented
deployment of vaccines in ways
that we've never done it before.
Not only are the vaccines new,
but they're also been administered
under what is called emergency use authorization
or emergency use listing in the middle of a pandemic.
And the vaccines have been administered also to adults,
to elderly, to those who have comorbidities,
and there are limited doses available.
So there's a lot of rationing going on.
The systems that are in place in many countries
to deliver to children are not sufficient necessarily
to actually deliver vaccination
for large cohort of adults that would require vaccination.
So a bit of fresh thinking is needed
in terms of designing how to deliver those vaccines.
-So just to make sure we're understanding
what you're saying is we have a lot of experience,
that the international community has a lot
of experience in vaccinating children,
but it's a whole another undertaking
to vaccinate widespread adult populations.
-Exactly.
And that means that we have to be thoughtful
in terms of how we organize this in such a way
that doesn't also undermine other essential services
that need to be delivered.
For instance, COVID vaccines are one vaccines
but also you need measles vaccines.
You need children to continue to be immunized against pneumonia
and other childhood preventable ailments.
So if you look at the bank's additional financing
the way we framed it,
it’s – support the COVID vaccine deployment
but while doing so also have the external benefit
in terms of strengthening national health systems
for other conditions that people also suffer from.
-Some sort of co-benefits there.
You mentioned a few minutes ago the readiness assessments,
and to the layman like myself,
they're kind of like a report card
that you and your team and the World Bank
and its partners have been creating
to help countries understand the pieces of the puzzle
that they need to put into place
to get the vaccine out safely and effectively.
When you've taken these readiness assessments back
to the countries, how have the countries reacted?
How are governments sort of taking up your assessments?
-You see, at the end of the day,
the responsibility for administering the vaccines lies
on the governments in the countries.
Our approach has been how to organize ourselves
as excellent partners to governments
and let the governments then be supported
to undertake those assessments.
Now, the regular assessments across the 10 domains
that I mentioned identify critical gaps,
and those get fed into their vaccine deployment plans,
which then are financed either through the bank's financing
or their domestic financing, or other external financing.
So at the end of the day,
our approach is one that we don't go
and do things to countries.
We support countries to do what they need to do
to deliver the services to their people.
-What are some of the big trends?
Where are governments needing more of that support?
Where do they have sort of things covered?
-I think in terms of the coordination and management,
the arrangements around it,
I think that's pretty much developed in many countries.
In terms of the identification of the target populations,
many countries have a clear idea
depending on their populations
what proportions they will like to prioritize over time.
The cold chain infrastructure,
they have a minimum level of it, but it can be stretched.
And that is informing how they allocate types of vaccines
for instance around urban areas or rural areas.
I think the information systems – trying to have platforms
to track let's say who gets called when,
and then to be able to go into
I think digital platforms are also imagined to be an important element in there.
I think the areas that would need a lot more attention –
it would be in the safety and surveillance
of post-administration,
that is in the pharmacovigilance to ensure
that if there are adverse events,
some of which may be unrelated to the vaccines,
that they are picked up and addressed.
Issues of communication to the communities,
because there's a lot of tendencies
towards resistant or hesitancy, vaccine hesitancy
that has to be countered by really effective,
trustworthy communication channels,
so that people understand that these vaccines
have been shown to be safe,
they are efficacious, and all the wild conspiracy theories
that are out there in way be debunked.
-And Mohammed, just as we wrap up here,
talk to me about how all of this work
could benefit countries and people further down the road
long after this current public health crisis has ended.
-As we invest these billions of dollars in supporting
our client countries to deploy the COVID-19 vaccines,
we should be also focused on what benefit
that would remain post this phase of the pandemic
that strengthens their ability to deliver basic services.
Whether it's enhanced, capable, trained health workers,
whether it's how the health workers are managed,
because of good information systems,
whether the infrastructure to deliver services,
whether the surveillance systems, that will serve us well.
On the global level, what is very clear,
and what we learned from looking at Ebola
and other previous threats,
is a globally coordinated response is key.
-One issue would be that kind
of variants could form in developing countries
that aren't immunized that could then essentially
get passed the vaccine in the developed world.
So there's an interest, a self-interest,
in every country to sort of cooperate globally.
-Yes, it's in everyone's enlightened self-interest
to invest in the global public goods
to ensure that everyone is protected.
-Well, Dr. Muhammad Pate,
thank you so much for taking the time to talk to us today.
-Thank you Paul.
Always good to be with you.
A huge thanks to Dr. Muhammad Pate for his time.
If you want to learn more about the World Bank Group
and our work in helping countries
recover from the COVID-19 pandemic,
head on over to worldbank.org/coronavirus.
You can also join us on April 9th
for a special event on vaccines
as part of the World Bank Group IMF Spring Meetings.
You can find all the details for that
at live.worldbank.org.
You can also email me and the rest of the team.
We'd love to hear your feedback,
expertanswers@worldbank.org.
Until next time, goodbye.