Why Thailand stayed out of the WHO-led Covax project

If it participates in the project the government has to spend money, but it cannot choose a vaccine or negotiate, NVI director Dr Nakorn Premsri said.

Covax is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations, and WHO. Its aim is to accelerate the development and manufacture of Covid-19 vaccines, and to guarantee fair and equitable access to every country in the world

In Asean, Cambodia, Indonesia, Laos, Myanmar, the Philippines and Vietnam will receive the free vaccine, while Thailand, Brunei, Singapore and Malaysia are not eligible. To join the project, money must be spent to participate in the Covid-19 vaccine procurement, he said. Thailand had plans to co-supply the Covid-19 vaccine with Covax from the beginning and had sent a letter of intent to join from the beginning of the project, he said.

The Ministry of Public Health has established a dedicated working group consisting of experts in many areas. It is a collaboration between many parties both inside and outside the Ministry of Public Health whether in the academic, legal and financial field, to consider an agreement with Covax, he said.

Nakorn added that the agreement to reserve the Covid-19 vaccine, either through the Covax facility or a direct contract with the manufacturer, needs to consider multiple data and contexts together. Due to the decision to agree to reserve a vaccine at that time, all companies of the Covid-19 vaccine are still under development. It is not known which vaccines will be successful and there is not enough information on the vaccine’s efficacy and safety. After paying for the reservation, the vaccine may not be accepted if the development fails, he said.

The decision to make the deal is based on weighing the benefits and risks a country will experience if it books a vaccine.

When considering the conditions for booking a vaccine through Covax, it found that making a reservation would be subjected to a processing fee charged in addition to the vaccine price.

In the case of reserving with a selected manufacturer, there is no charge of US$1.6 per dose. If a country chooses its own manufacturer, it will be additionally charged $3.5 per dose (including fee $1.6 per dose and risk management fee $0.4 per dose. However, there is no real freedom of choice. Covax will allow buyers to make two decisions: Covax will offer a list of contracted suppliers in the first round, not a list of all the world manufacturers. If the buyer is not interested in the manufacturers in the proposed plan, they will have to wait for the announcement of options in the next round. If the manufacturer named in the list is selected, Covax will use the buyer’s money to book the vaccine with the manufacturer. Then the buyer will have the right to decide whether to sign a contract with that manufacturer or not.

If the buyer decides not to make a contract for any reason, they must incur all expenses in advance. There is no refund even if the agreement was terminated due to unsuccessful development of the vaccine, he said. Additionally, the vaccine must be purchased at the manufacturer’s actual price by agreeing to all conditions. There is no bargaining power of any kind and there are also other related expenses such as vaccine transportation, domestic vaccine registration costs and taxes, etc, he explained.

“The agreement to buy the Covid-19 vaccine directly from the manufacturer offers more flexibility. We can decide how many vaccines to buy and can negotiate the price. If you buy in bulk, the price will be lower, and conditions can still be negotiated, " he said.

"If we decide to purchase through the Covax facility, a minimum amount to cover 10 per cent of the population is required. If the vaccine is needed quickly, the buyer must accept the manufacturer’s terms and conditions. However, Thailand continues to negotiate with Covax. If the conditions are adjusted, and the country will benefit from it, there may be an agreement through Covax,” said Nakorn.