DEAR Khairy, 

IN an online discussion on the topic “The Path to Herd Immunity” with the Oxford and Cambridge Society Malaysia last month, you said the country needs to become more nimble and self-sufficient in its response to Covid-19. 

You also said Covid-19 could evolve from pandemic to endemic – already the Singapore government has recognised it as such – in which case the government will have to decide on the right procurement strategy. 

And you said, Malaysia is working alongside a university in Thailand – even though we have local institutes such as Clinical Research Malaysia, Institute of Medical Research, Clinical Investigation Centre – to develop an mRNA vaccine not just for Covid-19, but other tropical infectious diseases to boost Malaysia’s end-to-end vaccine manufacturing and development capacity.

How well you prepare us for future epidemics and pandemic with mass vaccination to reduce the number of infections and deaths will be your legacy. 

No matter how well thought out your procurement strategy, as you mentioned, it will not work as evidenced by current events. The best vaccine procurement strategy will only work if the outbreak is localised and not when every other country in the world is competing with you for supply. As you said, If you have to scramble to talk to Pfizer and get in the queue, it’s going to be bad for our country.

Building our own clinical and scientific research capacity is obviously the preferred choice. Faced with a huge debt overload from the various programmes that the government has implemented over the last 15 months, it is presumed that the government would not have any excess from its already scarce resources to delve into this. 

In Malaysia, there have always been inconsistencies in the budget allocation for public research in the field of health due to the intervention of subjective judgments or political influences of various parties. Since resources are limited, it is time the government review how the private sector can contribute to clinical and scientific research for the country’s future.

Based on the responses aired publicly for the past  months, rushing to be prioritised for vaccination by various groups that contributed to the country’s economy appeared to be the number one issue. Businesses, be it manufacturing or services and for economic reasons, has reasons to believe that if their employees are vaccinated, they could continue operating their businesses albeit with strict SOPs instead of being subject to lockdowns where either they have to shut down or reduce to bare bones operations.

You could start by identifying who shall be the key stakeholders in the private sector that could be involved and what they could potentially contribute to a national immunisation programme for future pandemics followed by the determination of an optimal model of public-private engagement. 

Certain sectors benefited from this crisis and it appears that they will continue to do so in any future pandemic. In our country, the glove companies, healthcare industry,  e-commerce and logistics companies and even the financial institutions benefited from it.

Accordingly, these companies – as a starting point, let’s restrict them to the firms listed on Bursa Malaysia – shall be “persuaded” to contribute a certain percentage of the profits to a clinical and scientific research fun to develop vaccines for future viral diseases. Tax exemption should be offered as an incentive.

Those who are unable to contribute the predetermined amount may “opt in the programme”, such as those sectors that have been appealing for you to consider them for priority vaccinations . They can either make over a single minimum contribution for the next 10 years. 

The government would own the intellectual properties and the rights and patents for all discoveries. KPIs will be set for the operation of this fund and reports on funds utilisation and their progress will be made public on a half-yearly basis. Representatives from the private sector would be appointed to a supervisory board overseeing the funding and commercialisation of the vaccines developed.

For their contributions, all these companies would have immediate priority for vaccinating their employees in the event of any future pandemic and they would have first right of refusal to be distributors for the vaccines inside Malaysia while the government maintains all export rights to the vaccines developed.

What should the areas of focus in the next pandemic? The viruses that pose the greatest risk to human health, have epidemic potential and for which there is no vaccine. The main focus of the CSRF fund will be to fund Malaysian scientists and researchers – veterinary scientists, epidemiologists, public health officials, economists and ecologists – to identify and characterise new viruses rapidly so that they can start working on a vaccine for those viruses.

As you acknowledged in the discussion, there is a lot of data on various zoonotic viruses waiting to jump to the animal ecosystem to human beings. The World Health Organization has identified many diseases as having a high potential to cause future pandemics which are currently being overlooked. In the case of Covid-19, even though many of us felt like it came out of the blue, scientists have long been sounding the alarm about a potential pandemic from a coronavirus. And before that, the world already has warnings with the SARS and MERS outbreaks, both caused by coronaviruses, and both spilled over from animals into humans. 

Our country is to have been the first to detect the Nipah virus when it emerged in 1998, which remains deadlier than Covid 19. Even though we have managed to eradicate it, there are still no known vaccines or treatments for it.

According to GAVI, the vaccine alliance, the only known work in progress on the subject is a Phase 1 clinical study of a Nipah virus vaccine candidate (HeV-sG-V) which started in February 2020 and is expected to complete in September 021. The Coalition for Epidemic Preparedness Innovations invested US$25 million (RM100 million) in 2018 to start a safety study to assess the safety and efficacy of the vaccine among healthy adults aged 18-49.

As demonstrated in this crisis, it is also the responsibility of the private sector to fund research into viral diseases that could turn pandemic or endemic. We are all in this together. An outside-the-box problem necessitates an outside-the-box solution.

Hopefully, one day in the future, if the public were to ask you whether you think you can stop the next pandemic, your answer won’t be “I will try but yes”.

* FLK reads The Malaysian Insight.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.