Case for Private Sector Involvement in Covid-19 Vaccine Rollout

Adewale Okoya
It is certain that humanity will not forget in a hurry the devastating impact of the coronavirus pandemic or Covid-19 on its social and economic life.
Today, the pandemic remains the most potent threat to the continued existence of humanity in modern times.

Apart from putting the lives of tens of millions of people at risk and actually being responsible for the deaths of millions of others, the Covid-19 pandemic has threatened the livelihoods of tens of millions more.

A joint statement by ILO, FAO, IFAD and WHO, in October 2020 said, “Tens of millions of people are at risk of falling into extreme poverty, while the number of undernourished people, currently estimated at nearly 690 million, could increase by up to 132 million by the end of the year.”

To be sure, the fear of the pandemic is palpable and governments across the globe are rising to the challenge to ensure a return to normal living, even if it will be a compromised one.
The silver lining has been the unprecedented speed in the development of a vaccine to turn the tide in the spread of the pandemic. The development of vaccines means that the end of the coronavirus pandemic is in sight.

In December 2020, the United States US pioneered the rollout of the Covid-19 vaccines and other countries soon followed in its footsteps. Nigeria was not left out in the exercise. According to Nigeria’s Minister of Health, Dr. Osagie Ehanire, between 80 and 85 million doses of vaccines are guaranteed for the country based on its arrangements with the African Export-Import (Afrexim) Bank.
The country commenced the vaccination exercise on March 2, 2021, after receiving the first batch of 3.9 million doses of AstraZeneca’s Covid-19 vaccine as part of the COVAX facility arrangement, spearheaded by GAVI and the World Health Organisation (WHO). The vaccines were then allocated by the National Primary Health Care Development Agency (NPHCDA) to all the states in Nigeria. However, the rollout in Nigeria has not been a smooth one.

Overall, the most important battlefield is vaccine distribution. There is simply nothing that matters more right now than optimal execution of the vaccination programme. Nagging issues on how to properly manage and speed up the immunisation campaign continue to agitate the minds of various stakeholders in the country’s healthcare sector.

Their concerns revolve around the low uptake of the vaccine among healthcare workers and the need to involve the private sector in the vaccine rollout. More worrying is the continued burden of distributing the vaccine entirely free by the federal government, which from an economic standpoint is not sustainable. There is no doubt that adding the huge cost of procurement and distribution of the vaccine to the country’s already mounting debt burden is not the way to go.

Going by the recent experiences in the countries with the largest outbreaks demonstrate that private sector capacity can play a crucial role in the response effort.
In several of the developed countries such as the United States, Europe, and South Africa to name a few, the power of the private sector has been harnessed to help decentralise and accelerate vaccinations among the populace.

To effectively address the Covid-19 vaccine rollout, it is essential for the federal government to partner with and leverage the competencies available in the private sector, including not- and for-profit organisations.

Although one cannot ignore the experience of the public sector in the handling of vaccination exercises in this country, the sheer magnitude and significance of the task at hand demands a different approach, especially putting into consideration the extra edge which private sector operators possess in delivering services.

According to the NPHCDA, approximately 965,000 people have been vaccinated as of April 6th, representing 48.0 percent of the targeted population to be vaccinated in this first phase.
It must be stated that every country in the world has a routine childhood immunisation program. However, not all countries are well situated to deliver vaccines to adults, particularly to the elderly and the most vulnerable.

By allowing the participation of the private sector, a higher success rate will be assured while provision of essential health services in various government hospitals and centres will not be neglected.

The private sector represents an important means of providing surge capacity in responding to massive number of Nigerians who are queuing up to receive the Covid 19 vaccine and to help ensure that even routine health services continue to be provided by government healthcare workers.
Speaking at an emergency stakeholder meeting on the Covid-19 vaccine rollout hosted by the Healthcare Federation of Nigeria (HFN) this month, Founding Partner of the Anadach Group, health specialist for the WHO in the Middle East and North Africa and East Asia regions, Dr. Egbe Osifo-Dawodu, equally observed that “It is only with the involvement of private sector can Nigeria accelerate the vaccination programme.”

One could not help but agree with the resolutions at the HFN session that the government should partner with the private sector to scale up sensitisation and awareness on the Covid-19 vaccination programme and ensure an active and up to date Covid-19 vaccination website where information is published daily. Speakers at the session also advised the government to consider allowing Covid-19 vaccines to be delivered to large hospitals/healthcare facilities with over 250 workers.
The views of the Chairman of the Nigerian Economic Summit Group (NESG), Mr. Asue Ighodalu, who made a few remarks at the HFN session were also to the point.

He advocated that the private sector should be allowed to participate in the vaccine administration process using a similar template to that was used for the Covid-19 testing programme in Lagos State, during which private sector players were permitted to charge a controlled price.
His advice to the government to explore other vaccine options and to grant licenses to qualified private sector organisations to procure vaccines to complement those supplied by the government should be given close attention because this will allow the government to focus more on regulation of the vaccination programme.

Considering the pent-up demand for the Covid-19 vaccine by the people, if reports of people offering money to be vaccinated are to be believed, the suggestion by HFN’s Financial Secretary, Mr. Adeyemi Adewole, that out-of-pocket payment for the Covid-19 vaccine should be encouraged for people who can afford it as it is being done in countries such as in Dubai and India, will be a welcome idea.
It is heartwarming to note that several top government officials have also indicated their support for the involvement of the private sector in the procurement and administration of Covid-19 the vaccine.

The Commissioner for Health in Cross River State and the National Chairman of Nigeria Commissioners for Health Forum, Dr. Betta Edu, is on record for saying that, “We need to open the space and allow the private sector to come in. The number one thing that will bring efficiency into the health sector is to open it up to other key stakeholders.”

The challenges enumerated by Anambra State Commissioner for Health, Dr Vincent Okpala, in getting the vaccine to go round in the state makes a compelling case for the involvement of the private sector.
Okpala said, “If you look at what happened with Covid-19 testing, not using public resources to do travel testing makes sense. There is a growing efficiency that also came into that. Looking at that as a test case, one can argue for addressing the vaccine situation with the same principle.” It is obvious that an important path to victory in vaccine distribution is to renew the public-private partnership approach that was adopted at the outbreak of the pandemic.
The government must once again work closely with the business community in order to accelerate the country’s fledgling economic recovery.

The private sector must also demonstrate the commitment and competence required from them when called upon to take part in the effort to ensure efficient vaccine distribution. The private sector must get ready to move forward together with the government so that the country can return to the normalcy we all crave for.

It is important to establish an efficient vaccine distribution programme and to encourage everyone to get the vaccine. Nonetheless, it is apparent that a PPP approach can help in amplifying that message.
Okoya, a former newspaper editor and social commentator writes from Lagos