Lithuania’s chance for more vaccines is in the hands of individuals, but they are also tied

With the first two shipments, 20 thousand tons arrived in Lithuania. 475 doses of vaccines manufactured by BioNTech and Pfizer. The third shipment our country received on Monday.

Due to the limited number of vaccines, the vaccine purchased under the state budget will be vaccinated in the near future only by people belonging to risk groups approved by order of the Minister of Health who are at higher risk of COVID-19. disease and / or develop a severe form of this disease. Meanwhile, private medical institutions in Lithuania are already receiving inquiries about the possibility of vaccination, paying for the vaccination with personal funds.

However, it seems that that possibility will not yet exist: Lithuania, like other European Union (EU) countries, purchases COVID-19 vaccines centrally, so national initiatives are limited. Although participation in centralized European procurement does not preclude private initiative, people looking to buy vaccines can face difficult challenges.

Centralized procurement

As Lukas Savickas, advisor to the then outgoing prime minister, explained, the procurement of PCR tests and protective equipment during the first coronavirus wave, it is important to understand that Lithuania, like all EU countries, has opted for centralized procurement of the European Union.

“National initiatives are incompatible with this procurement. In this case, the emphasis shifts to the fact that action should focus not so much on national initiatives as on representing the national interest in the European Commission (EC) and promoting action by the EC so that the supply is faster, more efficient and faster. It is important to understand that there are certain limiting aspects “, he explained.

Gytis Andrulionis, director of the State Drug Control Service (IWC), which represents Lithuania before the EC, assured that participation in centralized European procurement dictates a very clear procedure according to which states must act. While centralized procurement takes place, EU Member States cannot individually consult the vaccine manufacturers with whom the EC negotiates and consults.

“While the contracting is taking place, the country that participates in the EC contracting cannot negotiate separately with the producers with whom the EU is negotiating. This is to avoid so-called” vaccine nationalism. “In others In other words, if Lithuania concludes agreements with Pfizer and BioNTech, it is now only operating together with other Member States through the EC. We cannot carry out our own individual negotiations so as not to try to leave other countries in a worse situation. After the conclusion from the negotiations and the conclusion of the agreements, Lithuania and how the state could talk with the vaccine manufacturers in accordance with European regulations ”, explained G. Andrulionis.

Centralized purchasing: a European lesson (less) learned?

Aurelijus Veryga, who served as Minister of Health and Head of Operations in the spring, recalled that with the first wave of coronavirus in Europe, European countries acted separately in the purchase of tools and tests. At the European level, there was little coordination at the beginning, and if there was, it was delayed.

“In the spring, we announced how much we ordered for artificial lung ventilators and other joint purchasing equipment. But even though we ordered something, we bought it ourselves because it was clear that it would take a long time and that it was a complex process. Of course, in each In any case, you run a lot of risks: you don’t know the manufacturers, you don’t know if everything will be fine with those tools, if they will come or if someone will buy them. There have been all kinds of stories, and certainly some, that have turned many hairs on the head gray. of a lot of people.

The situation with vaccines is very different. First of all, the difference is that the acquisition process itself is absolutely centralized, unlike the acquisition of instruments. The EC has now taken the initiative both in negotiation and in contracting and at other times. In this case, the parties were told rigorously enough that they could not take their own initiative and negotiate individual supplies with the same producers with whom the EC has a contract. If this is the case, it is clearly established that the party can simply abandon the joint purchase, ”explained A. Veryga.

Such centralized purchasing guarantees, he said, were introduced so as not to tempt member states, and in particular large EU countries such as Germany and France, which could produce vaccines themselves. It’s like an attempt to learn the lessons of spring when we saw during the first quarantine that countries had banned the export of personal protective equipment and other things for some time.

“At that time, there was a strong reaction from the EC, saying that it cannot be done to make it a common economic space and countries cannot just take it and close it. It was an attempt to learn this lesson, but that attempt comes with a lot of question marks. We see that the UK has already registered another vaccine, the AstraZeneca vaccine, and is already starting vaccination. We see the numbers of the United Kingdom, Israel and the United States, and at the same time we see that Europe is losing the fight against time ”, assured A. Veryga.

When asked why Europe continues to lose the battle against time, the outgoing Health Minister stressed that it was difficult to pin down the exact reasons. Officially, we hear explanations that he thinks seem logical, especially given concerns about the quality of vaccines and the knowledge that Europe is very precise and strict about the quality of vaccines. According to Veryga, this argument would be convincing if we compare Europe with Russia or with third world countries.

“When we see that the United States or the United Kingdom, which have really serious agencies, are faster, it means that something is wrong with us. If we look at the same AstraZeneca vaccine, we will see that the British were able to register it faster than the EU. Pfizer or Moderna vaccines are based on certain modern technologies, these vaccines may have more safety questions and may be more difficult to evaluate. The AstraZeneca vaccine is based on conventional technology, so it is not clear why it cannot be registered in a month and why the saying that it will probably not be registered in January, when the British not only registered it, but also the vaccine, it’s not clear, “said A. Veryga.

The possibility of private initiatives remains

According to G. Andrulionis, if private networks or private institutions wanted to buy the vaccine, there would be no restriction. According to the Director of IWT, the activities of individuals are not restricted in any way, as follows from the EC Regulation.

“The issue of individuals is not regulated in any way in this process. This is a business relationship between, say, a health care facility or network and a vaccine manufacturer. It’s about individuals and private relationships, ”he explained.

However, even with such a possibility of private relationships, according to the IWT director, it is practically impossible to implement it. “It just came to our attention then. Absolutely everything that is produced that I know of is immediately included in the states or even in their regions. Everything is done centrally and for a private company to buy from a manufacturer, even now it has not been heard, ”he said.

The outgoing Health Minister, A. Veryga, emphasized that when considering the possibilities of private initiatives, it is necessary to take into account a number of certain nuances, which could provoke a very negative reaction from the EC.

“Companies are likely to be uncomfortable taking private initiatives. Let’s not forget that Europe has given producers more than € 2 billion. For the sole purpose of developing a vaccine. It is a lot of public money that has been allocated under certain conditions, that is, once the vaccine has been developed, the supply will be guaranteed to ensure that the parties will receive the vaccine, ”said Mr. Veryga.

However, in theory, according to the outgoing Health Minister, additional purchases of the vaccine could arise because “it is not just the seven vaccines that Europe has decided to develop and other vaccines besides Russia or China.”

“Another option is to obtain vaccines from other countries, but that is highly unlikely. The only thing our government did was when no vaccine had yet been approved, and adherence meant that those six or seven vaccines would have to be purchased, discussions were already being held with the Eastern Partnership countries about what would happen if the vaccines remained. But it is not about February or March, in theory such a situation could occur in late autumn or even next year, “he explained.