#BTColumn – Transparency in acquiring vaccines

The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.

by Garth Patterson

I am not a politician. I have no political aspirations, have never been a member of or affiliated with any political party, and have never voted. But, like every other global citizen, I have a vested interest in the successful implementation of the COVID-19 vaccination program, whatever form it takes.

In a paper published in May 2021 and entitled, “Enhancing public trust in COVID-19 vaccination: The role of governments”, the Organisation for Economic Co-operation and Development (“OECD”) said: “Trust in vaccination, and in the ability of governments to communicate, and to successfully deliver a vaccination programme, is critically dependent on:
• the extent to which the government can instill and maintain public confidence in the effectiveness and safety of the vaccines;
• the competence and reliability of the institutions that deliver them; and
• the principles and processes that guide government decisions and actions in vaccine procurement, distribution, prioritisation, and administration . . .”

The success or failure of the Barbados Government’s stated objective of promoting confidence in the available COVID-19 vaccines, and breaking the back of vaccine hesitancy, by an aggressive public relations and information drive, will largely depend on the extent to which it adheres to these sound principles.

It has set itself the ambitious goal of converting 50,000 reluctant souls over the course of five weeks, by education, information and moral suasion, in preference to the more direct, albeit less popular, route of mandatory vaccination.

This is laudable, and the public health imperatives dictate that we dramatically increase the ranks of the vaccinated by whatever means that are deemed effective, appropriate and necessary. We should, all of us, be deeply invested in the success of the Government’s efforts, since the pandemic continues to have a death-grip on every member of our society, regardless of vaccination status. It is, therefore, vital that we lend our full support to the initiatives of the

Government, as it grapples with the difficult choices and decisions that are inherent in battling this unprecedented challenge to public health and economic security.

Having said that, the Government (and, necessarily, the Opposition) must be careful not to undermine its own efforts by allowing politics to distort its messaging.

Doubtless, in its zeal to rapidly procure vaccines for the Island, the Government has had to consider all its options, some less savoury than others, having regard to the volatile market forces of demand and supply within the context of new, emerging and scarce vaccine technology.

Since the developed countries, for the most part, had a monopoly on the human and technological resources that were necessary for the development and production of the vaccines, citizens and residents of developed countries were always going to receive priority in the distribution process.

Undeveloped and small-island nations, like Barbados, were always going to be ignominiously relegated to competing among themselves for the vaccine scraps remaining after the needs of the developed countries had been satiated.

It was always going to be a struggle for survival, countries in the region being left to fend for themselves or else to depend on the charity of developed nations or the benevolence of global health organisations and the initiatives led by them, such as the COVAX initiative for equitable global access to COVID-19 vaccines.

In the early months following the development and approval of the vaccines, and with limited options for immediate supply through official channels, many small developing countries, including Barbados, turned to unofficial sources for the procurement of vaccines.

The resort to those sources sometimes involved the jettisoning of regular procurement policies, such as due diligence, a public competitive bidding or tender process and selection by a tenders committee, and the adoption, instead, of private back-channel discussions and direct awards.

This approach, naturally, carried with it obvious financial and reputational risks, created the opportunities for abuse and corruption and had the tendency to erode public confidence in the integrity of the process and the vaccine product.

Regarding those practices, which were not unique to Caribbean countries, the OECD observed of its member governments: “While these rapid procurement activities secured unprecedented volumes of essential supplies, the use of direct awards meant absence of competition in procurement, which is a crucial aspect in maintaining citizens’ and business’ trust in these processes.

“Without competition in the procurement process, in order to maintain the integrity of the purchasing activities, public buyers need to provide clear documentation on how they have considered and managed potential conflicts of interest or bias in their procurement decisions and actions, publish their contract awards and contracts in a timely manner, and document due diligence checks carried out on suppliers and associated parties.”

The current confusion surrounding the efforts of Barbados, St Lucia and the Bahamas to procure 1,000,000 doses of AstraZeneca vaccines in April this year through Radical Investments Ltd., a private company with no known previous track record in pharmaceuticals procurement, and Good Vibrations Entertainment LLC, an entertainment company, is a perfect illustration of what could possibly go wrong when governments depart from official channels and procedures.

The Barbados Government’s defence that, unlike St Lucia, it “has not paid a cent” to Radical Investments, entirely misses the point. The real point is that the transaction could have (or possibly has) exposed the Government to serious financial risk; and the mere revelation that vaccines were being sourced through irregular channels and were, therefore, of questionable provenance has the potential to cause (or arguably has caused) irreparable damage to the public’s trust of or confidence in the Covid vaccines generally and, by extension, the Government’s vaccination program.

Full transparency is a natural disinfectant and would go a long way in restoring public confidence and trust. Speaking to this point, the OECD said: “It is also important to ensure that government actions are open to public scrutiny, and that public institutions engage with the population, by:

• Proactively releasing timely information on vaccination strategies, modalities and accomplishments in disaggregated, userfriendly and open source formats;
• Enhancing transparent and coherent public communication to address misinformation and the “infodemic”; and
• Engaging the public when developing vaccination strategies, and in the form and content of key communications.”

According to the OECD, proactively releasing up-to-date, reliable and easy to understand information about procurement and funding of vaccines is also “crucial for people outside government to have confidence in the effectiveness of Government vaccination strategies and policies.”

This is too important an issue to be tainted by the colour of political allegiances or buried in the rhetoric of political debate.

It should not be about assigning blame or scoring political points, whatever one’s political stripes. There is a legitimate case for the Government to make full disclosure of all the arrangements that it had entered into with Radical Investments and provide full clarity about the arrangements between Radical Investments and Good Vibrations. These were not mere private matters, from which the Government might comfortably distance itself.

For example, it was reported in the press that the Barbados Government had “committed to pay US$24 per dose for 300,000 vaccines”, which would have represented a mark-up of up to 700 per cent on the price of between US$3 and US$5, the range of prices at which AstraZeneca has committed to sell its vaccine to developing countries.

If true, this would have resulted in a tremendous windfall to the middlemen suppliers to the Government (Radical and Good Vibrations), which begs full explanation.

It was not too long ago that the procurement practices of the previous administration were called into question; the Barbados public was asked by those seeking election to reject the notion that any individual was entitled to preferential consideration in the award of public contracts or should be exempt from participation in a competitive tender process. We should have no lesser expectation of the current administration.

The exigencies of the pandemic undoubtedly required a nimble response, but not at the expense of sound or transparent government. The current administration has, to date, made transparency the hallmark of its government and should not stop now.

Prime Minister must be commended for the fresh oxygen that she has infused in the political realm, for her candor and for the much-needed clarification that she has provided on this Radical procurement issue.

She has properly accepted full responsibility for the decision to go off the regular path and has offered a plausible account of the emergent conditions that precipitated the ill-fated plan. But the public does deserve to know the full details of what transpired, and the Government should lay its cards face up, if only for the purpose of restoring trust and confidence in the vaccination procurement and distribution process and enhancing the chances of defeating the menace of vaccine hesitancy and the COVID scourge itself.

And to the extent that there are legitimate, unanswered questions, the Government should encourage and embrace continued open, constructive dialogue and let the proverbial chips, if any, fall where they may.

Garth Patterson Q.C. is the Senior Partner of Lex Caribbean. He was called to the Bars of Jamaica and Barbados in 1987 and the Bars of New York and St. Lucia in 1990 and 2011 respectively.