Could COVID-19 provide an opportunity to invest for the future?

By Dr Stephanie Williams, Australia’s Ambassador for Regional Health Security

As Australia steps up to meet a sudden upsurge in COVID-19 cases in neighbouring countries, Ambassador for Regional Health Security, Stephanie Williams, argues the pandemic might be a once in a lifetime opportunity to invest in better health outcomes for the region.

Australia is supporting its neighbours during their time of need.

In recent days, it has responded to the sudden and significant surge in COVID-19 cases in Indonesia with a comprehensive package of rapid antigen tests, $12 million for oxygen-related and other medical equipment plus 2.5 million Australian-manufactured vaccine doses to be delivered this year. This comes on top of an existing $101.9 million package to support vaccine access for Indonesian citizens, in addition to economic support measures.

And last Wednesday, the government announced it will provide Vietnam with 1.5 million vaccine doses in 2021. This is in addition to a $40 million vaccine access package including funding for additional doses to be procured through Australia’s agreement with UNICEF.

Australia’s comprehensive and responsive health assistance during the pandemic has been driven by our long-standing recognition that infectious disease threats had the potential to cause social and economic harms on a national, regional or global scale.

That’s why the Australian Government worked closely with partner governments in planning the $300 million Health Security Initiative, launched in October 2017. While the Indo-Pacific Centre for Health Security was originally conceived to fund epidemic preparedness and target the endemic diseases of the region, such as malaria, tuberculosis and HIV/AIDS, in early 2020 its focus very quickly expanded to support for the COVID-19 pandemic response.

During the initial phase of the pandemic, Australia was able to leverage long-standing health partnerships that it had built with The Pacific Community, World Health Organization, The Global Fund to Fight AIDS, TB and Malaria and other United Nations agencies to ensure countries could access health assistance they needed to protect their populations. Our support included technical assistance and in-country deployments; provision of personal and protective equipment (PPE); laboratory equipment and COVID-19 testing kits; medical equipment (including ventilators); and infrastructure for quarantine and isolation facilities.

Ventilators given to Indonesia
Deputy Head of Mission Allaster Cox presents Indonesia with 100 ventilators as part of a AUD 2 million package to support Indonesia's COVID-19 response - July 24, 2020. Image credit: Australian Embassy Jakarta, Flickr.

As it became clear that effective national vaccination campaigns would be crucial to the recovery of the region, we began conversations in earnest about the readiness of each nation and the support Australia could offer. We developed tailored plans in partnership with 18 regional countries based on a solid understanding of their vaccine delivery support needs.

The Australian Government announced the $523 million three-year regional Vaccine and Health Security Initiative (VAHSI) last October. The Initiative provides end-to-end support for comprehensive COVID-19 vaccine coverage in the Pacific and Timor-Leste, and makes a significant contribution to meeting the needs of the larger populations of Southeast Asia. Our world-class technical experts are delivering end-to-end assistance from supply of vaccines, to regulatory assistance, and risk communications products that drive vaccine demand.

For example, Dr. Sarah Sheridan, a public health physician with expertise in applied epidemiology and vaccine preventable disease control, is assisting Timor-Leste by working closely with their Ministry of Health under a National Centre for Immunisation Research and Surveillance deployment. Working with international partners, Dr Sheridan has trained staff both in the capital, Dili, and provinces to administer the AstraZeneca vaccine.

As of 18 July, 33 percent of the adult population of Timor-Leste had already received their first dose according to the Ministry of Health. Despite the floods and responding to a serious COVID-19 outbreak while launching the vaccination campaign, the Timor-Leste Health Department’s comprehensive preparation allowed the team to exceed the government’s targets of 10,000 vaccinations a day.

In Papua New Guinea, the Therapeutic Goods Administration (TGA) has supported the vaccine approval process in an ongoing program of training and exchange.

Getting accurate information out about the disease and vaccines is critical, and targeted and inclusive health campaigns are key. Australia is already funding UNICEF to support vaccine uptake in various countries across our region.

In Cambodia, by the end of June, UNICEF with Australia’s support had ensured every village in the country had accurate public health messaging on reducing the spread of COVID-19 by social measures and vaccination. Billboards, posters and audio messages in indigenous languages promote vaccine registration. Access to the registration process for people with disabilities is planned, even in remote areas.

Australia understands the problem of constrained vaccine supply cannot be solved without global cooperation. We were an early investor in the COVAX Advance Market Commitment (AMC), a global initiative that is procuring and delivering donor-funded COVID-19 vaccines to eligible developing countries. Australia has now contributed $130 million to the COVAX AMC.

Australia also started providing COVAX AMC with vaccine doses from our domestic supply in May. Papua New Guinea, Timor-Leste and Fiji were the first countries to receive shared doses purchased by or manufactured in Australia. In addition to vaccines, we provided additional PPE and laboratory consumables for testing, often transported by the Australian Defence Force.  Australian Medical Emergency Teams (AUSMAT) have been deployed to all three countries to support the response.

The Solomon Islands, Samoa and Tuvalu have now also received doses from Australia’s supply pipeline. In Tuvalu, Australian supplies have added to COVAX doses from New Zealand to ensure full adult vaccination coverage this year for the world’s fourth smallest country.

There is more to come. In June, Prime Minister Morrison announced at least 20 million Australian-manufactured COVID-19 vaccine doses would be shared with the Indo-Pacific region by mid-2022. Under this commitment, 2.5 million doses will be committed to Indonesia and 1.5 million doses sent to Vietnam. Up to 15 million vaccine doses will be shared with the Pacific and Timor-Leste.

Another important multilateral mechanism is the Quad Vaccine Partnership. Working with Japan, the United States and India, vaccine manufacturing supply will be strengthened to ensure continued availability. Under the partnership, Australia is committing $100 million towards ‘last mile’ delivery of doses to Southeast Asia.

Practitioners working in global health have long known that both targeted and large-scale projects are needed to improve universal health access. COVID-19 is a once in a lifetime opportunity to invest for the future.

COVID research
The CSIRO has also pledged to work with Indonesian researchers to strengthen pandemic preparedness in the region. Image credit: Eijkman Institute for Molecular Biology.

The benefit of our investments in global product development partnerships is now becoming clear. Our vaccine development partner, the Coalition of Epidemic Preparedness Innovations, known as CEPI, has clearly demonstrated its worth by the number of early COVID-19 vaccine candidates in its portfolio that are now protecting the world’s population.

Further funding to FIND, the global leader in diagnostics for developing countries, for COVID-19 testing will strengthen laboratory capacity for the detection of many other debilitating and deadly diseases in our region.

Australia is proud to support home-grown innovations that are being shared with the world. In Samoa, for example, a new electronic patient information system that will record all COVID-19 vaccinations in the country. The Tamanu paperless system is operated by nurses on hand-held mobile tablets. Information is instantly tracked by district hubs who deploy local resources to support appointments and to a national database for tracking purposes.

Such systems are the true game changers of the pandemic that will not only be able to record vaccinations and track surveillance for other diseases that benefit individuals but provide information to allow better decision-making by health policy makers.

Australia is not only helping our region to open up after the pandemic but also to deliver better health outcomes for years to come.

Dr Stephanie Williams was appointed as Australia’s Ambassador for Regional Health Security in March 2020. As Ambassador, Dr Williams guides the implementation of the $300 million Health Security Initiative and the $523 million regional Vaccine Access Initiative – two major health initiatives for the Indo-Pacific region. She is a Public Health Physician and Epidemiologist, who has been the Department of Foreign Affairs and Trade’s Principal Health Specialist since 2017.

Banner image: AustralianAid delivery of ventilators, PPE, rapid-antigen test kits, and other vital medical equipment arrives in Indonesia - July 9, 2021. Credit: Australian Embassy Jakarta, Flickr.