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Saturday Interview | ‘Vaccines are global public good’

After joining the Health, Population and Nutrition Department of the World Bank in 1987, she embarked on her stint with the WHO.

Ajita Singh | New Delhi |

Dr POONAM KHETRAPAL SINGH, who became the first woman to assume the Office of the World Health Organization (WHO) Regional Director for South-East Asia on 1 February 2014, has proved to be a strong regional voice in the global health arena.

After joining the Health, Population and Nutrition Department of the World Bank in 1987, she embarked on her stint with the WHO. She became a member of the WHO Director-General’s Cabinet to serve as WHO Deputy Regional Director for the SouthEast Asia Region from 2000 to 2013.

Prior to being its regional head, she had also been an IAS officer for over two decades and had worked in various positions including as secretary of health in Punjab. In an interview with AJITA SINGH, Dr Khetrapal Singh shared her thoughts on the Covid-19 pandemic and India and the world’s campaign to put an end to it.


Q. What is your view on the new variants of the novel coronavirus?

A. All viruses, including the virus that causes Covid-19, change over time. There have so far been hundreds of variations of this virus identified worldwide and we have been following them closely.

Viruses change as they circulate, and these changes can lead to changes in characteristics of the virus. The more we allow it to spread, the more opportunity it has to change. Hence, everyone must continue to take all actions to slow and eventually stop the spread of the virus.

Q. How potent is its new mutant variant?

A. Until now, most changes of this virus have had little to no impact on how it transmits or the severity of disease it causes. The UK and South Africa have informed WHO and the public of variants circulating in their countries that may transmit more easily, though research is still ongoing.

WHO is working with scientists and is in close contact with health officials in the UK and South Africa to understand how these changes affect the virus’s behaviour, including on whether it could cause more severe disease, or have an impact on vaccines.

Q. There are various rumours on coronavirus vaccines.Is it misinformation?

A. The recent news around vaccines has brought hope and we are starting to see a light at the end of the tunnel. The transparency shown by manufacturers and developers by publishing protocol — so you know each step and when they will occur — is very encouraging.

This has enabled scientists, regulatory agencies and WHO to be able to evaluate and compare the vaccines. This transparency also helps towards building trust with the population. However, we are aware of misinformation being circulated about Covid-19 vaccines.

Once we are closer to availability of safe and effective Covid-19 vaccines, we expect a lot of positive sentiment towards vaccination, especially given the protection and return to normal life they could represent.

Q. Your comment on India’s recent go-ahead to vaccines against Covid for emergency use?

A. WHO has guidance around the exceptional authorisation of vaccines and other products in the context of emergencies. WHO has an emergency use and listing procedure in place to assess novel products to be used in epidemic conditions and speed up access for patients.

Even while authorising emergency use of a vaccine, countries are advised to continue to collect detailed efficacy and safety data.

Q. What is you reaction on India’s Covid vaccination drive?

A. WHO welcomes the first emergency use authorisation given to Covid-19 vaccine in the WHO South-East Asia Region. This decision will help intensify and strengthen the fight against the Covid-19 pandemic in the region. The use of vaccine in prioritised populations along with continued implementation of other public health measures and community participation will be important in reducing the impact of Covid-19.

Q. Will the corona vaccine that India is developing be of any use? Will the vaccine help abate the Covid infection worldwide?

A. Currently, over 230 vaccines are at some stage of development. Of these, at least 61 candidate vaccines are in human trial. About 16 are in phase III trials. There are several others currently in phase I/II, which will enter phase III in the coming months.

We have a very robust pipeline — the more candidates, the more opportunities for success. We are already seeing vaccine roll-outs in some parts of the world. As fewer doses are expected initially, high-risk groups like older people and health workers are expected to be prioritised.

Q. How long will the Covid vaccines take to show effect? Will it be administered simultaneously globally in all populations.Else the continued spread of the disease will keep infiltrating the borders?

A. Vaccines are a global public good. This is because we benefit if others are vaccinated. It is in all countries’ interest that the vaccine is made available across the world. There will be no true global recovery unless all parts of the world are able to bring transmission under control.

One of the two objectives of the ACT-Accelerator is the fair distribution of Covid-19 tools; the other is their accelerated development. The distribution of vaccines is a very important topic that WHO is working with Member States to address. WHO has developed a Fair Allocation Framework in collaboration with ACT-Accelerator partners and Member States.

WHO advises that once a vaccine(s) is shown to be safe and effective, and authorized for use, all countries receive doses in proportion to their population size to immunise the highest priority groups. In the second phase, vaccines would continue to be deployed to all countries so that additional populations can be covered according to national priorities.

Q. Is WHO regulating the distribution of vaccines globally?

A. Within countries, national authorities will have discretion on how to use their allocated doses based upon their own situation and guidance from national policy making bodies, as well as upon recommendations and advice from the WHO Strategic Advisory Group of Experts on Immunization (SAGE).

Q. Does the WHO have any guidelines to help end the pandemic fast?

A. The fastest way to end the pandemic is to supress the transmission of the virus everywhere at the same time, by continuing actions that can contain the virus and vaccinating those at highest risk in every country. We must be cognisant that vaccines will help to end the Covid19 pandemic, however, they won’t solve everything by themselves.

As the Covid-19 crisis continues, we still need to continue to take all necessary measures — Covid-appropriate behaviour by one and all and core public health measures by the authorities — to prevent the virus from spreading and causing more disease and deaths.