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Friday, March 29, 2024

Vaccine checklist for local governments

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Local officials opened the new year with policy announcements that spelled out their top mission for the year: securing and distributing COVID-19 vaccines to their communities. 

From cities hit hardest by the spread of the disease, mayors across the country launched registration sites and allocated millions of pesos to ensure their residents would receive vaccines for free. 

Except for a few cities that started talks with pharmaceutical companies and only involved the national government when negotiations progressed, most local government units (LGUs) were awaiting clear guidance on how they could secure vaccine deals or what their responsibilities would be.

The Duterte government, through vaccine czar Carlito Galvez Jr., only said LGUs were given the clearance to secure deals with vaccine companies, with the oversight of the national government.

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Since the announcement of several LGU-led deals early in January, the government slowly outlined detailed procedures that local governments could follow when entering into tripartite vaccine deals. 

Tripartite format

With limited funds to procure COVID-19 vaccines, the government has identified tripartite deals as one way the country could increase its orders for vaccines and secure doses for more Filipinos.

The parties involved in tripartite vaccine agreements are the vaccine manufacturers, the national government, and either local government units or the private sector. 

The national government entered its first tripartite deal in November 2020 with AstraZeneca and a number of private groups, which pooled together nearly P700 million to purchase 2.5 million doses. 

Before the agreement with AstraZeneca was signed, the national government had no framework to follow and which it could share with LGUs. The agreement became the basis for similar deals entered into by more private firms, and later set the foundation for LGUs’ own negotiations with vaccine firms.

As more local officials sought clearance to negotiate with pharmaceutical firms, President Rodrigo Duterte finally gave blanket approval for LGUs to choose their suppliers and enter into tripartite deals. 

Despite this green light, not all LGUs will have the funds needed to buy pricey vaccines.

Galvez said the national government would still be responsible for ensuring that second- or third-class municipalities would receive vaccines for their communities, along with prioritizing distribution across the country. 

The government’s tasks

In the recent Senate hearings on vaccines, Galvez detailed a process that interested LGUs could follow when ordering vaccines: 

LGUs consolidate orders at the provincial or regional level.

The National Task Force (NTF) on COVID-19 processes these orders. 

NTF, through Galvez, endorses orders to vaccine manufacturers for further negotiations.

According to Undersecretary Epimaco Densing, the Department of the Interior and Local Government (DILG) was considering limiting the number of vaccines an LGU may procure to up to 50% of their population only.

He told the House of Representatives the cap would be placed to ensure LGUs did not spend all their funds on COVID-19 vaccines, as resources were still needed for other pandemic or emergency response measures. 

Galvez said the national government would take care of supplying the remaining doses for LGUs to ensure herd immunity would be reached in the different localities. Scientists currently estimate about 70% of a population needs to be vaccinated against COVID-19 to reach herd immunity.

For this subsidy for LGUs, the national government will source doses from those it has secured through direct purchase agreements or from quantities donated by the private sector. 

What LGUs need to do

In the case of deals with AstraZeneca, which has so far been the only vaccine company involved in tripartite deals, the obligations are the following: 

LGUs will need to commit a portion of their available budget for the purchase of vaccine doses. 

LGUs will shoulder a “purchase price” set during negotiations and ensure prompt payment is given following schedules listed in signed agreements. 

LGUs will need to reimburse AstraZeneca for “all costs associated with delivery, distribution, storage, and destruction” if needed prior to the delivery of vaccines to their final destinations. The reimbursement will include “foreign exchange losses incurred by AstraZeneca” during the term of agreements. 

LGUs will need to develop a local vaccination plan that is in line with the national government’s distribution and deployment plan. 

LGUs will need to follow the prioritization list of vaccines laid out by the national government though the Department of Health (DOH).

LGUs will need to craft COVID-19 vaccine plans that do not compromise the implementation of regular vaccination activities under the National Immunization Program.

Galvez said only AstraZeneca, Moderna, and Novavax so far were willing to enter into tripartite agreements. Discussions on adopting this setup is ongoing with Pfizer, Johnson & Johnson, Gamaleya, and Sinovac. 

Galvez said all doses ordered by local officials will be transferred to their respective LGUs, unlike deals entered into by the private sector, which required them to donate doses to the national government. 

In the case of LGUs, the national government will only handle receiving these vaccines from manufacturers once they arrive in the Philippines. 

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