Push inoculation, plagued by limitations and red tape, makes doses available to those who can afford them. In a world where the economy is struggling, most do not.
ISLAMABAD, Pakistan - The coronavirus was traversing Pakistan, and Muhammad Nasir Chaudhry was concerned. Long lines and solid objects attacked the government's free vaccination campaign. Newspapers were full of reports of well-connected people jumping in line for free.
Mr. Chaudhry, a 35-year-old government coordinator, found that he could pay to complete this long route himself. He has registered to take two doses of Russian-made Sputnik V vaccine for about $ 80 at a private hospital. That is a lot of money in a country where the average worker makes about $ 110 a month, but Mr. Chaudhry was willing to make a commitment.
Critics have attacked private trade in Pakistan and around the world, claiming to make inoccines available only to the rich. But in Pakistan, as elsewhere, solid goods have thwarted such efforts. Private hospitals have no supplies, and Mr Chaudhry has not yet been vaccinated.
"I'm willing to pay double the price of the vaccine, but I don't want to wait any longer," Mr Chaudhry said.
The discovery of the coronavirus vaccine has highlighted the global inequalities. The United States and other rich countries are buying more and more world vaccines to protect their people, leaving millions of doses stored and in some places unused. The less developed countries are arguing over what is left.
To speed up vaccination, some countries have allowed doses to be sold privately. However, those campaigns have been plagued by complaints about complaints and complaints about land grabbing.
"Pakistan's example is a small glimpse of what has gone wrong with the global response - where only wealth is well-established who gets it," said Zain Rizvi, a pharmacologist at the Public Citizen, Washington, DC, email team. "Ending this epidemic will require the international community to do more than that."
India sells drugs to private hospitals, although they are busy getting treatment as the epidemic is so big. Kenya authorized the sale of private drugs, and then banned them for fear that counterfeit vaccines would be sold. In the United States, some well-connected companies, such as Bloomberg, have acquired employee ratings.
Indonesia on Tuesday allowed companies to buy drugs from the government to inject workers and family members for free. The only approved vaccine for that program to date has been developed by Sinopharm.
Pakistan says an independent system could make free firearms available to low-income people. By purchasing doses of Russian-made Sputnik 5 vaccine, the world's richest people will not need to get free doses, made by China's Sinopharm. Some people may prefer to be vaccinated in a private hospital because it is widely believed that they are extremely well-organized and work better than full-fledged government institutions.
The demand for Pakistan is growing. The world of nearly 220 million people reports more than 2,500 cases a day, but its low diagnostic standards suggest that some cases remain undetected. The government tightened borders and restricted social cohesion.
But the government's vaccination campaign is declining. It started offering prices to over 40 people this month. Young people may have to wait a few months.
Solid earth assets must be blamed, "said Chaudhry Fawad Hussain, Pakistan's information minister. In addition to the Sputnik and Sinopharm vaccines, Pakistan earlier this month received 1.3 million doses of the AstraZeneca vaccine from Covax, an international vaccine organization, and is expected to receive 3.5 million doses of the Sinovac vaccine from China by the end of May.
Private trade has sparked a heated debate in a country where the economy has been hit by the epidemic and on long-term issues such as the lack of foreign investment and huge government debt. Critics say the decision will deepen divisions within the country, where the majority of the population lives below the poverty line.
"The government was not thinking about the plight of the poor while allowing importers to sell vaccines," said Dr Mirza Ali Azhar, leader of the Pakistan Medical Association, an association of medical professionals nationwide. "Such discriminatory policies will exacerbate the feeling of deprivation of poor young people, especially those with weakened immune systems."
Mr Chaudhry, the information minister, slammed the price issue, saying private drugs could not address the needs of the community at all.
Step into another problem: Hospitals can't afford to buy vaccines. The need was strong. The government is setting a price tag but has been embroiled in controversy with private importers over how much it should cost.
In April, in the city of Karachi, long queues were being built as two private hospitals began selling the Sputnik V vaccine for entry. Private hospitals in Islamabad, the capital, and Lahore have experienced similar public upheavals and disappeared within days. Metropolitan hospitals have now stopped taking walk-ins, and online registration has also been suspended.
Sputnik V is not the only vaccine the government allows to be sold in secret. A single-dose shot made by China's CanSino Biologics costs about $ 28. Demand has been weakened by public confidence in Russia's vaccine. However, the goods were sold immediately after CanSino prices began to sell last month. The government has said another 13.2 million doses will arrive in June.
"Sputnik V has received a remarkable response in Pakistan with thousands of people being vaccinated in just a few days and the highest number of registrations has been confirmed in hospitals throughout Pakistan," said Umair Mukhtar, chief executive officer of AGP Limited. He said the company had placed larger orders for more.
The price dispute in government could delay further growth. The drug regulator wants Sputnik V to be sold at a lower price. AGP won an interim court order on April 1 to sell the vaccine until the final price has been paid.
For those who can't afford the prices, frustration grows. Junaid Jahangir, a lawyer based in Islamabad, said many of his friends were receiving private treatment. He also signed up for Sputnik V's private lab but also received a text message later stating that the vaccination campaign had stopped.
"I am deprived of a good chance to fight the virus if I become infected," said Mr Jahangir. "The need is there, and I don't see what could be the cause of the inefficiency."
Some private paymasters backed up their decision by quoting media reports that some well-connected people were crossing the line to get free, public doses. In May, at least 18 lower-level health workers were suspended by authorities in Lahore for protesting people to turn a chance after a bribe.
Iffat Omar, an actor and presenter of the talk show, publicly apologized in April for crossing the front line to get vaccinated. "I'm sorry," he said on Twitter. “I'm embarrassed. I apologize from the bottom of my heart. I will repent. ”
Fiza Batool Gilani, a businessman and the daughter of former Prime Minister Yusuf Raza Gilani, said he knew of many young people who crossed the line and received free government vaccination in recent weeks.
"I was also asked to get a free vaccine, but I refused because I wanted to get a private vaccine," said Ms Gilani. Wealthy people have to pay their bills, he said, adding that his family would pay for a CanSino gun to domestic workers.
Most people, like Tehmina Sadaf, do not have that option.
Ms Sadaf, 35, lives with her husband and 7-year-old son in a working area on the outskirts of Islamabad. Her husband is a pastor in a Muslim church. He gives Quranic lessons to young children. He said the epidemic had a negative impact on the family's average income of $ 128 a month. "After paying rent and electricity, we have a lot left over," he said.
He had his doubts about the public vaccine, "but the price of a private vaccine is very high," he said. "It should have been low so that even poor people like us could afford it."
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