(Photo: Hadi Mizban/AP)
Iraq’s first delivery of COVID-19 vaccines arrived in Baghdad on March 2 amid growing public anger over why the government has been so late to initiate an inoculation programme. The 50,000 doses from Chinese manufacturer Sinopharm were a donation from the Chinese government, but health officials have pledged that millions more vaccine doses will arrive over the coming months. So how long will it take for Iraq to vaccinate enough of its population to overcome the COVID-19 epidemic?
There is no consensus among experts on what proportion of a country’s immunised population constitutes herd immunity from COVID-19. Initial estimates ranged from 60 to 70 percent, but with the emergence of more transmissible variants, many have now upgraded that figure to 80 to 90 percent.
Because of multiple factors, trying to set a target for how many Iraqis will need to be vaccinated in order to reach herd immunity is not an easy task. Firstly, half of Iraq’s population is under the age of 18 and therefore currently ineligible for inoculation because of limited data from clinical trials on minors. Secondly, a proportion of the population will already have a sufficient degree of natural immunity from the virus, although it is impossible to know exactly how many. Studies in the United States have shown that as many as 1 in 5 Americans may have already been infected with the virus. Meanwhile, other studies have reported a pre-existing immune response (known as T cell reactivity) against the virus responsible for COVID-19 in 20 to 50 percent of people with no known exposure to it.
So accounting for these variables, it would be reasonable to expect that as a minimum, 60 percent of Iraq’s adult population would need to receive a COVID-19 vaccine if the country is to stand any chance of beating this virus. That equates to 12 million people, and since most of the existing vaccines require a double dose, Iraq would need 24 million doses.
So does Iraq have a strategy for acquiring this volume of vaccines? The answer at the moment is a resounding no. Public health officials should be especially worried given the rising rate of COVID-19 infections caused by the spread of the so-called UK variant.
Even more alarming is the pattern of repeated obfuscations by health officials, an unwillingness to admit to shortcomings, and a concerted effort to mislead the public. On February 1, Health Minister Hasan al-Tamimi announced in a televised statement that Iraq’s first shipment of vaccines would arrive before the end of the month, courtesy of the COVAX facility, a global alliance co-led by the World Health Organisation (WHO) that seeks to provide equitable distribution of vaccines primarily to lower-income countries. Iraq, along with several middle-income countries, had signed up to COVAX back in September and agreed to pay for 16 million doses. At the time, it was not known which vaccines Iraq would receive, or more importantly, when it would receive them, because COVAX was still negotiating agreements with the vaccine manufacturers. Even the WHO country office in Iraq prematurely announced in October that Iraq would be among the first countries in the world to receive the COVID-19 vaccine.
Tamimi’s February 1 announcement noted that between 2.5 to 3 million doses would be delivered as a first batch by the end of February, but failed to disclose which vaccine Iraq would receive. Two days later, COVAX released an interim distribution forecast for the first half of 2021. According to the document, Iraq was scheduled to receive just over 2 million doses of the AstraZeneca vaccine, but it was expected that just 15 percent of that allocation would be delivered within the first quarter of 2021, 56 percent during the second quarter, and the remaining amount throughout the second half of the year. That meant that Iraq was only forecasted to secure around 300,000 doses by the end of March.
It is hard to believe that Tamimi could have been oblivious to these details, and the only reasonable conclusion is that he deliberately sought to mislead the public. On February 20, he doubled down on his claims, this time upgrading his own forecast to 3.4 million doses by the end of the month.
Only until February 28, when it became clear that the government was not going to meet its commitment, did Tamimi attempt to dial down the numbers. This time he said that Iraq would receive just over 1.7 million doses within a week. Clarity eventually prevailed that evening when the head of the public health department confirmed that the 1.7 million doses would be delivered over the course of the next two months, and that Iraq’s first shipment would amount to less than 200,000 doses. On March 2, COVAX released an updated forecast, confirming that Iraq would expect to receive just over 1.7 million doses during the first round of allocations from March through May.
But health officials have persisted in issuing misleading statements about vaccine rollout. Based on existing trends, there is no chance that Iraq will receive its entire COVAX allotment of 16 million doses by the end of the year. Reiterating that Iraq has secured this amount is meaningless if most Iraqis will have to wait until next year before they can be protected from COVID-19. Instead, the Iraqi government needs to be honest about managing public expectations. Iraq is a long way from overcoming this public health crisis, and offering false hope to ordinary citizens will negatively impact both the government’s ability to enforce lockdown and social distancing measures, and indeed public willingness to take the vaccine when it becomes available.
In this global climate, where every country on earth is competing to secure as many vaccines as possible, and the richest countries have already reserved the lion’s share of available doses for themselves, the Iraqi government’s mismanagement of vaccine procurement will no doubt cost lives. Iraq was one of the last countries in the MENA region to receive vaccines. By the time the first delivery of Sinopharm doses arrived in Baghdad, nearly 250 million vaccine doses had already been administered in over 120 countries around the world.
Right now, Iraq has a preliminary agreement with Pfizer for 1.5 million doses, and health officials claim that an additional 2 million doses from Sinopharm are coming soon. Assuming that this is true, Iraq stands to receive no more than 5.2 million doses over the next 3 months. That is a far cry from the roughly 24 million doses needed to protect the country from this deadly virus. Iraq’s diplomatic mission in London is currently in talks with Johnson & Johnson, whose single dose vaccine was recently approved for use in the United States, but it is unclear how many doses Iraq can expect to secure this year.
Ultimately, the only hope of ending the COVID-19 epidemic in Iraq and saving as many lives as possible lies in delivering a fast and efficient vaccination programme. So far, Iraq has failed to do so, but with greater focus and renewed leadership at the highest levels, it is not be too late to reverse course.
