Key Takeaways

A surge in new cases of the coronavirus disease (COVID-19) in the middle of 2021 has again highlighted the need to speed and scale up vaccination programs in Asia and the Pacific.

Many of the new wave of infections involve the highly contagious Delta variant of COVID-19 and medical experts have warned that, without greater vaccine coverage, even more virulent strains could emerge, threatening the efficacy of existing vaccines.

By contrast, the US, UK, and countries in the European Union, all of which have ample access to vaccines and high coverage rates, have seen a decline in hospitalizations and deaths, allowing them to ease containment measures and start to reopen their economies.

“There are several key priorities to promote equitable access to COVID-19 vaccines. First, we need to ensure that the available vaccine supply is prioritized for those at the highest risk of COVID-19.”

Patrick Osewe
Chief of ADB’s Health Sector Group

Meeting Regional Vaccine Needs through APVAX

These sharp variations in coverage rates highlight the inequitable distribution of vaccines, with many poorer countries, including in Asia and the Pacific, unable to source sufficient doses because developed economies have already purchased available supplies.

The Asian Development Bank (ADB) is working closely with its developing member countries (DMCs) to ensure they can access vaccines and effectively store and distribute them to carry out inoculation programs.

A health worker preparing to extract a dose of vaccine from a vial.
A health worker preparing to extract a dose of vaccine from a vial.

The key vehicle for this support is the Asia Pacific Vaccine Access Facility, or APVAX, which was launched in December 2020. This $9 billion mechanism has a rapid response component financing the initial procurement and transport of vaccines and a project investment component funding in-country distribution and administration, as well as supporting community outreach and surveillance activities.

Vaccines financed by APVAX must meet one of these three criteria: (i) be procured via COVAX, the global vaccine distribution vehicle; (ii) be approved for emergency use by a stringent regulatory authority, or (iii) receive WHO emergency use listing.

“There are several key priorities to promote equitable access to COVID-19 vaccines. First, we need to ensure that the available vaccine supply is prioritized for those at the highest risk of COVID-19,” said Patrick Osewe, Chief of ADB’s Health Sector Group. “The second is to ensure there’s an efficient and effective vaccine distribution system, third is to have sufficient numbers of vaccinators who can provide the vaccines in the hardest to reach areas, and lastly is the need to put in place pharmacovigilance systems to monitor any adverse events following immunization.”

The facility is supporting a number of countries that have seen a sharp rise in new cases in recent months, including Bangladesh and Indonesia.

In Indonesia, infection rates in May 2021 were at their lowest level since the beginning of the pandemic last year. But, by late June, the country was seeing record caseloads as the Delta strain took hold. Bangladesh also recorded its highest ever daily case count ahead of a 1 July 2021 nationwide lockdown.

  In late June 2021, ADB approved a loan of $940 million under the APVAX facility for the Government of Bangladesh to purchase an estimated 44.7 million vaccine doses which will be administered to more than 20 million Bangladeshis by 2024. This follows earlier ADB assistance to help the country respond to the pandemic, including a $250 million loan to strengthen social protection and resilience programs and a $500 million loan in May 2020 for expanding social safety nets for vulnerable groups and to support critical labor-intensive industries and small and medium-sized enterprises.
  In Indonesia, a $450 million loan will help Bio Farma a state-owned vaccine supplier, to purchase and deliver at least 65 million vaccine doses for priority groups. The project will also help the Government of Indonesia and Bio Farma improve logistics management to deliver doses more effectively.

Complementing APVAX is a $500 million Vaccine Import Facility under ADB’s Trade and Supply Chain Finance Program, which provides guarantees to mitigate payment risks for imports of vaccines and related goods by DMCs, while additional technical assistance has been made available to establish systems to effectively and equitably distribute vaccines within countries.

ADB has also recently teamed up with leading public health experts, vaccine regulators, and policy makers to create an advisory group that will provide DMCs with technical and scientific advice on the quality, safety, and effectiveness of vaccines for COVID-19. This support has become increasingly important given widespread public misperceptions that have circulated about the safety and efficacy of vaccines, undermining efforts to increase vaccination rates.

The inaugural meeting of the Regional Vaccine Advisory Group on 1 July 2021 focused on how to increase the supply of COVID-19 vaccines across Asia and the Pacific. The group’s forthcoming recommendations will help find ways to connect global and local supply chains and overcome vaccine supply barriers facing the region.

Along with its financial and knowledge support, ADB has sought to tap ideas from the wider community that can lead to more effective vaccination programs in countries with limited resources. Through its COVID-19 Vaccine Challenge Series, ADB has found a number of innovative solutions from civil society, including the use of digital technologies to improve the tracking of vaccine stocks, alert patients about vaccine programs, provide reminders on follow-up doses, and monitor both mild and adverse reactions following inoculation.

APVAX, Philippines. Distribution and vaccination in Taguig Lakeshore Mega Vaccination Hub.
APVAX, Philippines. Distribution and vaccination in Taguig Lakeshore Mega Vaccination Hub.

Growth Prospects for Asia and the Pacific Amid Surge in Infections

In its latest economic forecast for developing Asia, ADB projected a slight moderation in gross domestic product growth for 2021 to 7.2% from a previous projection in April of 7.3%, amid the new wave of COVID-19 infections. Overall, however, ADB remains guardedly optimistic about the region’s prospects and has upgraded its growth forecast for 2022 to 5.4% from 5.3%.

“Asia and the Pacific’s recovery from the COVID-19 pandemic continues, although the path remains precarious amid renewed outbreaks, new virus variants, and an uneven vaccine rollout,” said ADB Chief Economist Yasuyuki Sawada in the 2021 Asian Development Outlook Supplement.

There are significant subregional differences in the outlook, with the latest outbreaks of COVID-19 forcing growth projections to be revised down in South and Southeast Asia. In the Pacific, the growth outlook has also been reduced amid a sharp rise in cases in Fiji and Papua New Guinea, whose containment actions will weigh on their economies. East Asia, by contrast, has the pandemic largely under control and, as a consequence, has had its growth forecast revised up. The growth projection for Central Asia has also been revised up.

The stakes for the region from scaled-up vaccination programs could not be higher. Without adequate coverage, the pandemic will remain an ongoing drag on health systems and economies, undermining recent development gains and draining precious fiscal resources needed to address other pressing issues.