COVID-19

Ex-general presents military-enabled COVID-19 vaccine plan for PH

Pia Ranada

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Ex-general presents military-enabled COVID-19 vaccine plan for PH

IATF Chief Implementer Secretary Carlito Galvez Jr. on October 20, 2020.

Photo by Darren Langit/Rappler

The sought-after vaccines will be transported by the military and kept in their camps, says vaccine czar Carlito Galvez Jr

Former military chief Carlito Galvez Jr admitted being nervous about the complex and critical task he has before him: distributing a COVID-19 vaccine to at least a 5th of the Philippine population.

But the day after Philippine President Rodrigo Duterte named him vaccine czar, Galvez was ready with a presentation on his proposed “Philippine National Vaccine Roadmap.”

Sa totoo lang po, I feel so nervous dahil alam ko napakalaki ng responsibilidad na nasa aking mga balikat,” he said on Tuesday, November 3, before his presentation.

(To be honest, I feel so nervous because I know a great responsibility is on my shoulders.)

The plan, which would be submitted to Duterte for approval on Thursday, involves phases of studying and approving safe and effective COVID-19 vaccines by a panel of experts and doctors. This is followed by an “implementation” phase where the military forms the backbone of vaccine distribution.

Galvez has his work cut out for him.

The most promising COVID-19 vaccine candidates like those of Moderna and Pfizer may require storage in ultracold temperatures of -70 degrees Celsius, a kind of cold chain never before deployed in a massive scale in the 3rd world country.

The Philippine archipelago is composed of over 7,000 islands in the tropics. Some of the poorest households live in remote or conflict-ridden areas.

Then there’s the suspicion of many poor Filipinos against vaccines in general, which was exacerbated by the dengvaxia controversy in 2018. Fear of the dengue vaccine led to a drop in the immunization rate the following year, directly resulting in a measles outbreak.

Duterte himself does not make the job any easier. While the Department of Health and his spokesmen spoke of providing free COVID-19 immunization to only 20 million to 60 million Filipinos, Duterte has promised to shoulder the vaccination of all 107 million Filipinos.

The populist president has other exacting edicts: the military will distribute because local government officials can’t be trusted, only government-to-government vaccine procurement, no payment of a “reservation fee” for “Western” vaccines.

The plan

Galvez’s plan depends on government health experts’ optimistic projection that a COVID-19 vaccine being developed abroad would be approved and available to the Philippines by April to June 2021.

Based on this, the first half of the plan involves the following activities from November to December:

  • Formation of vaccine panel of experts;
  • Start of clinical trials of vaccine candidates assessed by panel;
  • Assessment and selection of COVID-19 vaccines;
  • Approval of procurement of said vaccines;
  • bilateral and multilateral agreements of completed.

The second half, from January to March 2021, involves:

  • Procurement of vaccines;
  • Production, shipment, and storage;
  • Early planning on distribution, deployment.
Military-enabled

Duterte, who had described the military and police as the “backbone” of his administration, is again relying on soldiers to implement COVID-19 vaccination.

Soldiers will primarily be in charge of logistics – or transporting and storing the vaccines in different parts of the country.

“The military has logistics for air, naval, and land. Same with the PNP and the uniformed service like the Coast Guard,” said Galvez in Filipino.

Galvez said the vaccines would be kept in military camps and warehouses. Nurses and health workers would still administer doses. Identifying recipients and mobilizing them to vaccination booths would be the job of the local government.

Galvez says it’s this heavy involvement of the military that made him a good fit for the job, given his experience as a former military chief. Before his retirement from active service, Duterte tapped him to serve as Armed Forces chief of staff from April to December 2018.

“My being a military chief makes it easier for me to coordinate with the PNP and AFP,” he said.

Military training, in general, prepared him for complicated large-scale logistical tasks like a vaccination program, said Galvez.

“One major training for us in the military is on being integrators and catalysts. We are able to integrate efforts of agencies… We are good at logistics, at the same time, the deployment and redeployment of resources,” he added.

Malacañang said the same when asked to explain why Duterte had appointed a former general, and not a doctor or medical expert, as vaccine czar.

“Because the vaccine operation will entail logistics. You really need managerial skills and someone used to management processes,” said Presidential Spokesman Harry Roque in the same press conference.

Roque had also said Duterte had named Galvez vaccine czar “many months ago” but because the President had not announced it, the Palace refrained from doing so.

The 57-year-old Galvez is just one of the retired generals who are leading Duterte’s pandemic efforts. Defense Secretary Delfin Lorenzana is National Task Force vs COVID-19 chairman. His second-in-command, Interior Secretary Eduardo Año, was, like Galvez, a former military chief under Duterte.

Environment Secretary Roy Cimatu, a military chief during the Arroyo administration, was put in charge of Cebu City’s pandemic response.

Impossible to leave out LGU

Last July 31, Duterte said he didn’t trust local government officials to distribute the COVID-19 vaccines fairly, hence his decision to give the job to the military.

Ibigay ko sa barangay barangay captain, ‘O, halikayo.’… Mamulitika unahanin niya… ‘Di yung mga kalaban niya sa politika, hindi mabigyan. Iyong ayaw niya, hindi mabigyan,” he aid.

(I’ll give it to the barangay captain, ‘Come here.’.. He will put politics first… He won’t give [the vaccine to] his political opponents. His enemies, he won’t give to them either.)

But Galvez, on Monday, admitted it would be impossible to leave LGU chiefs out, even when it came to selecting those to be given the vaccines.

“We cannot do without the LGU,” said the vaccine czar.

“It’s the LGU that has all the information, so the profiling and segmentation of society, determining who will be the priority will be done by the LGU together with the DOH,” he added.

Asked how he would address Duterte’s concern on politicization of vaccination, Galvez said this “bias” would be eliminated or suppressed because LGUs would be working with other agencies.

He likened COVID-19 vaccination to national elections, a massive operation that required the involvement of local governments.

Cold chain plan

Galvez already has ideas for how to create a cold chain throughout the country.

He said he is already in talks with pharmaceutical companies like Zuellig Pharma and UniLab who have experienced setting up such facilities. These companies have assisted the Department of Health before in previous vaccination efforts.

The plan is to coordinate with the private consortium of such companies so that the government will no longer have to build its own facilities.

It could then take months to finish the inoculation of millions of Filipinos.

Dr Jaime Montoya, an official involved in vaccine clinical trials here, said a COVID-19 vaccine would likely have to be administered twice to an individual, with the second dose given 21 to 28 days after the first.

Even if the target population is reached, there’s no certainty how quickly the vaccinations will lead to a drop in COVID-19 cases significant enough for quarantine rules, mask-wearing and physical distancing requirements to be lifted.

It would still depend on how effective the vaccine is and how much of the population gets it.

If the vaccine is effective and all Filipinos are inoculated, a significant reduction in transmissions would be observed in a “few months,” Switzerland-based vaccine expert Dr Melvin Sanicas told Rappler.

“But the worst-case scenario is a vacine thats not as effective as we expect, let’s say 30% to 40% effective, and only, let’s say, half of the population gets it,” he said.

It’s these factors and more that would determine how successful Galvez’s plan will be, a plan that the President and millions of Filipinos are depending on. – Rappler.com

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Pia Ranada

Pia Ranada is Rappler’s Community Lead, in charge of linking our journalism with communities for impact.