A nurse shows the Sinovac Covid-19 vaccine to the media during a ceremonial vaccination program held inside a sports stadium in Marikina City, east of Manila, Philippines on March 2, 2021. Photo: NurPhoto/George Calvelo

MANILA – The Philippines has finally kicked off its Covid-19 vaccine rollout with much-publicized donations from China but rising controversies around the rollout will prevent Beijing from declaring a “vaccine diplomacy” win.

China recently delivered 600,000 doses of the vaccine developed by the Beijing-based company Sinovac Biotech and frontliners across the country are set to be among the primary beneficiaries. The drive kicks off as the Philippines grapples with one of the region’s worst outbreaks and steepest economic recessions caused by extended lockdowns. 

Top Philippine officials, including the former military chief and vaccine czar Carlito Galvez Jr, were also among those who received the first batch of Chinese-made vaccines in a bid to reassure the public about their safety and effectiveness. 

They were joined by leading public health experts, including Philippine General Hospital (PGH) director Dr Gerardo “Gap” Legaspi, Food and Drug Administration director-general Eric Domingo and director of the Institute of Molecular Biology and Biotechnology, Dr Edsel Salvana.  

But there is still deep skepticism about the safety and efficacy of the Chinese-made vaccines, not to mention allegations of massive corruption and overpricing that have intensified public opposition against the jabs.

It hasn’t helped that no less than the country’s Health Secretary Francisco Duque III, as well as Beijing-friendly President Rodrigo Duterte, have refused to take the Chinese vaccine, citing among other things age considerations. 

For months, the Duterte administration had come under fire for its failure to obtain vaccines. Last year, the president passed on the opportunity to acquire millions of vaccines from Western pharmaceutical companies, placing his faith instead in vaccine donations from strategic patrons in China and Russia. 

Philippine President Rodrigo Duterte (2nd L) looking at a vial of the Sinovac vaccine after the first batch arrived aboard a Chinese air force plane on February 28, 2021. Photo: AFP/Presidential Communications Operations Office

‘Just be patient’

“I made a plea to Chinese President Xi Jinping that if they have the vaccine, can they allow us to be one of the first? Or if it is needed, if we have to buy it, that we will be granted credit so that we will normalize as fast as possible,” claimed Duterte in a national address mid-2020, just as he repeatedly spurned Western pharmaceutical companies’ offers. 

“If you can endure until December … China is first [in the vaccine race] … That’s why I salute the Chinese,” he added. “Let’s just wait for a vaccine. Let’s wait till December if we can just be patient … We are not going back to a ‘new normal’. It’s going to be normal again,” Duterte insisted. 

Beijing responded in kind, with Chinese Foreign Ministry spokesman Wang Wenbin stating: “We are willing to give priority to the vaccine request made by China’s friendly neighbor the Philippines.”

So enthusiastic was Duterte with Chinese vaccines that his presidential security detail reportedly “smuggled” in limited doses by September last year, months before full approval was given by both Chinese and Filipino regulatory authorities. 

Much to Duterte’s embarrassment, however, it was Indonesia rather than the Philippines that received millions of Chinese vaccines. In fact, sub-Saharan African nations from Zimbabwe to Senegal managed to receive Chinese vaccine donations ahead of the Southeast Asian country, seen by some Filipinos as a reflection of the low priority the Philippines is accorded in Beijing’s strategic calculus. 

Aside from the months-long delays, the greater concern now is the price and safety of Chinese-made vaccines. As early as January, there was widespread public outrage over the alleged overpricing of Chinese vaccines, reportedly amounting to as much as 16.8 billion pesos (US$350 million).

A government worker disinfects a high school amid concerns about the spread of the Covid-19 novel coronavirus in Manila, March 9, 2020. Photo: AFP/Maria Tan

Pricing controversy

In response, the Philippine Senate launched a days-long special inquiry, which revealed major anomalies in initial government contracts with Chinese vaccine companies. 

In a privilege speech following the inquiry, leading Senator Panfilo Lacson warned of massive corruption in the absence of public scrutiny of vaccine procurement. 

“Again, when there is an attempt at overpricing, isn’t it also logical to think [that somebody would make a lot of money]?” he said, revealing that initial data by the Philippine Department of Health showed two doses of Chinese Sinovac vaccine came with a whopping price tag of 3,629 pesos ($38), several times higher than vaccines from other global pharmaceutical companies.  

“Imagine this … if this Sinovac controversy was not tackled in the Senate, and assuming that the deal for the original price of 3,629 pesos or $38 for two doses, or 1,814 pesos equivalent to $19 per shot, against the $5 in Thailand, easily the price difference of 25 million doses would fetch $350 million or P16.8 billion,” he added, just as the government clarified that the vaccine prices were reduced by 60% to around 650 pesos per dose ($14) in subsequent negotiations. 

Duterte’s spokesman, Harry Roque, later revealed that the price of Chinese vaccines were primarily driven by geopolitics rather than market conditions. 

“Unlike in capitalist countries where the price is dictated by the market, China can change the price of its vaccines. They don’t care. It depends on which country is buying,” the presidential spokesman admitted, claiming the Philippines was lucky to receive discounted “BFF [Best Friends Forever]” rates. 

Chinese vaccines are not only hounded by corruption allegations. Early on, leading experts such as Anthony Leachon, the former president of the Philippine College of Physicians and a former consultant to the government’s Covid-19 Task Force, raised fears over the safety of Chinese vaccines. 

A man works in the packaging facility of Chinese vaccine maker Sinovac Biotech. Photo: AFP

‘Other options’

“Yes, a vaccine might be available by December [2020] but I prefer to explore other options other than the Chinese vaccine … [such as] Moderna, Pfizer, Oxford, Astra Zeneca,” the top Philippine expert said in response to Duterte’s preferred reliance on Chinese vaccines last year. 

“China is not an established reference country for quality products. Reference countries based on US FDA (Food and Drug Administration) standards are USA, EU, Canada, Australia. So multiple options would be ideal,” Leachon added, who incidentally served at Pfizer Philippines’ medical director for 16 years.

Filipinos are also concerned about the safety of Chinese vaccines, with studies showing Sinovac’s effectivity rate dropped to 50% in some clinical trials in Brazil, while Indonesia reported an efficacy rate of only 65%, well below the at least 90% efficacy rates of vaccines developed by more established pharmaceutical companies like Pfizer.  

Latest surveys show that as many as 46% of Filipino adults are unwilling to take vaccines, with 35% undecided, underscoring the importance of public trust in the efficacy and safety of available vaccines.

Amid the vaccine scare, bureaucratic corruption and erratic leadership, The Economist Intelligence Unit projects that the Philippines will be among the last countries to achieve a semblance of herd immunity, which requires vaccinations of 70% or more of the entire population. 

In a sign of the Southeast Asian country’s growing desperation to secure safe and effective vaccines, the Duterte administration recently contemplated a controversial “vaccine for nurses” deal, which provoked outrage among the country’s medical front-line workers.

Philippine nurses raise thier right hand during a mass oathtaking ceremony for nurses who passed the July 2010 nursing licensure examination, at a convention center in Manila on September 20, 2010. Photo: AFP/Noel Celis

Nurses for vaccines

In 2019, almost 17,000 Filipino nurses signed overseas work contracts but last year the Philippine government placed restrictions on their deployment abroad to deal with one of the worst Covid-19 outbreaks in Asia. 

Last month, Alice Visperas, director of the Philippine Department of Labor and Employment’s (DOLE) international affairs bureau, said the Duterte administration was open to relaxing health worker deployments to countries such as Britain and Germany in exchange for vaccines. 

“We are considering the request to lift the deployment cap, subject to agreement,” Visperas said. Both the British and German governments demurred from the proposed controversial barter deal. 

“We are disgusted [with] how nurses and health care workers are being treated by the government as commodities or export products,” said Jocelyn Andamo, secretary-general of Filipino Nurses United, echoing rising public anger over the government’s perceived ill-treatment of those on the pandemic’s front line.