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SINGAPORE – Many things about the coronavirus were still unknown in the first half of the year, but Singapore knew that it had to act quickly to secure the Covid-19 vaccine doses for its people.
This was despite the fact that some solutions were as novel as the pathogen itself: some candidate vaccines were being developed with new technologies that have not been used in any other vaccine on the market.
The data was limited, so risks and bets had to be taken after careful analysis of the available information. They all paid off on Monday night (December 21), when Singapore became the first nation in Asia to receive doses of the Pfizer-BioNTech Covid-19 vaccine. This, a few weeks after Britain and the United States received theirs.
Professor Benjamin Seet, who oversees the expert panel providing advice to the Singapore government on Covid-19 vaccines and therapies, said during a press conference on Monday that advance purchase agreements depended on many factors, including safety and security. Disponibility.
“If we want to buy it, will it be available? Because the doses could be bought by larger jurisdictions – for example, we have seen in the global media, the United States, the European Union, many of the largest economies have bought huge chunks,” he said Professor Seet, who is Deputy Executive Director of the Education and Research Group at the National Healthcare Group.
“Basically, even to put ourselves in the pre-order book, we have to make decisions as soon as possible. And that’s why we have pre-purchase agreements,” he explained.
Singapore signed its first advance purchase agreement in June with Moderna, the American biotech company behind one of the early leaders in the Covid-19 vaccine, to purchase its vaccine. A down payment was made to secure the deal.
Since then, at least two other agreements have been signed with vaccine developers Pfizer-BioNTech and Sinovac, and efforts are underway to select and procure other candidate vaccines as part of Singapore’s plan to secure a diverse portfolio of Covid-19 vaccines. .
Earlier this month, Prime Minister Lee Hsien Loong had said that if all goes according to plan, Singapore will have enough vaccines for everyone here by the third quarter of 2021.
Leo Yip, head of the civil service and chairman of the planning group on vaccines and therapeutics, said that the 11 months that passed since Covid-19 reached the shores of Singapore until the Republic received its first shipment of vaccines was no accident.
He said: “This was due to significant advances in vaccine technology. But it was also due to the dozens of public officials who worked tirelessly and quietly behind the scenes during this period to ensure that Singapore had early access to vaccines.”
Step 1: identify
Knowledge is power, or so the saying goes. But this is limited when it comes to a new pathogen never before seen by the world.
So in April, Singapore took steps to ensure it had access to all available information. The nation’s first step was to form the panel of experts on therapies and vaccines, which is led by Professor Seet.
The panel consisted of 18 scientists and physicians from the public and private sectors, who analyzed data on potential drugs to treat the disease, as well as more than 35 vaccine candidates. Their goal was to identify the most promising ones and assess which ones were safe and effective for Singapore to acquire.
There are currently 56 Covid-19 vaccine candidates in clinical trials, and many of them take advantage of different technologies such as inactivated virus vaccines, viral vector vaccines, or even DNA / RNA vaccines. They all work in different ways, and Professor Seet said the panel considered them all.
Traditional vaccines, such as inactivated virus vaccines and live attenuated vaccines, work by injecting whole but inactive viruses into patients to stimulate an immune reaction.
“But ultimately we looked at RNA vaccines with much more interest, particularly because they were easier to manufacture. And therefore they could enter clinical trials earlier and be available globally in the large quantities needed,” Professor Seet said.
“So it was interesting from the point of view that it can be obtained quickly. And it can be obtained in a timely manner. And more data can be obtained about it very soon,” he added.
The Pfizer-BioNTech vaccine approved for use in Singapore, for example, is an RNA vaccine. So is the Modern socket, which was recently approved for use in the United States.
RNA vaccines work by injecting fragments of the viral genetic code so that a patient’s body generates a protective response without actually being exposed to all of the virus.
Data from late-stage clinical trials published last month by Pfizer-BioNTech and Moderna showed high success rates; both were shown to be more than 90 percent effective in preventing Covid-19.
But hindsight is always 20/20. In the first few months, Singapore had to find other ways to get the information it needed to make a decision about which vaccines to buy.
Step 2: Research
Singapore’s next step in late April was to form another group to make “strategic bets” on some of the candidate vaccines recommended by the panel of experts, Yip said.
This planning group was chaired by Mr. Yip, and its mission was to secure and support the development of promising therapies, as well as to ensure early access to vaccines for Singapore. This group was based on the scientific evaluations made by the scientific panel.
“We rely on EDB officials to establish contact with a wide range of vaccine manufacturers,” said Mr. Yip, referring to the Economic Development Board. “We take advantage of the strong relationships created between EDB Singapore and pharmaceutical companies like Pfizer, as well as biotech companies like Moderna and BioNTech.”
Non-disclosure agreements were also signed with several of the companies, it added, giving Singapore access to confidential data on the progress of vaccines.
Typically, data from clinical trials are made public when they are published in scientific journals. But the peer review process can take some time.
Professor Seet said that Singapore signed about 40 confidentiality agreements. “This allows us to access data that is not available in the published literature, to get it early and we can find out more about the teams that actually developed the drugs,” he said.
None of these agreements was contractual, he clarified. This means that Singapore was not obliged to buy any vaccine from the company with which it signed the confidentiality agreements.
Generally speaking, Singapore’s approach to ensuring vaccines reflected how the country ensured access to other vital resources such as food and energy: diversification.
Yip said it was important for Singapore to select a portfolio of vaccine candidates, as there was no certainty that even the most promising ones would eventually succeed.
The first vaccines may have made their way to Singapore, but this strategy remains one that the nation holds firmly to.
Step 3: negotiate
More than a billion dollars has been set aside to support Singapore’s search for vaccines.
Dr. Lisa Ooi, vice president of health care and wellness at EDB, said that in addition to the procurement of vaccine doses, this budget also includes funds for other related purposes.
This includes Singapore’s involvement in the Covax multilateral facility initiative aimed at ensuring equitable access to vaccines around the world, as well as supporting local development efforts in terms of therapies and vaccines, and supporting the companies that would make vaccines here long term.
The EDB would not be based on the cost of each dose of the vaccine, citing confidentiality reasons.
When asked if Singapore’s relatively small order affected its bargaining power with pharmaceutical companies, EDB Senior Vice President and Health and Wellness Director Goh Wan Yee said that many pharmaceutical companies recognize the state of Singapore as a hub. Asia’s leading biomedical.
“So I think that position, plus the fact that many companies are based in Singapore, puts us on a good basis to negotiate and work with them on access to vaccines,” Ms Goh said. “So despite our small market size, I think companies are still interested in having their products launched and used in Singapore.”
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