The government has managed to achieve a rare feat of uniting the pharmaceutical sector based on its shared experience of the government's attitude and approach to the COVID-19 vaccines.
The government is usually adept at dividing a sector whose component parts are more inclined to go their own way than work together.
The Pharmacy Guild and Pharmaceutical Society of Australia are the latest groups in the sector to publicly lament the federal government's performance on the national rollout of COVID-19 vaccines.
At all or specific stages of the pandemic, community pharmacy, wholesalers and manufacturers have been at the very pointy end of discussion on the vaccine.
Australia's rollout is beset by issues that were significantly built into the program in the early period of the pandemic when the federal government failed to act quickly and lost the race for vaccine candidates.
The government cannot be blamed for the misfortune of what happened with the University of Queensland candidate, the confusing advice on the vaccine developed by AstraZeneca and The University of Oxford and Europe's export ban.
Yet it can be faulted for taking too long, negotiating too few agreements for vaccine candidates, and other decisions related to the rollout. All of which have combined to make for a very frustrated pharmaceutical sector.
The events of this week have only made things worse with confusion over the use of vaccines in particular age groups. The federal government's confused messaging has been confounded by some of the bizarre interventions from state and territory leaders and chief health officers.
What is the public to make of what has descended into a public spat between medical experts and public health officers?
A disgraceful intervention and attempt to shift blame
In August last year, after the prime minister made the patently ridiculous claim that Australia was "at the front of the pack" for vaccines, BioPharmaDispatch published an analysis showing how the government practically lost the race in an eleven-week period from early June to mid-August during which other countries and global organisations disclosed 32 deals worth over US$10 billion for at least 5 billion doses of the investigative candidates.
Department of Health secretary Dr Brendan Murphy followed the prime minister's statement with the bizarre claim there was no such thing as a global vaccine queue and that CSL could repurpose one of its facilities in 'just a few weeks' to produce AstraZeneca's adenovirus viral vector candidate. Professor Murphy has also said the rollout 'is not a race'.
The claims over 'queues' took another twist yesterday when finance minister Simon Birmingham publicly acknowledged Australia is “at the back of the queue” for one of the mRNA vaccines. It was a disgraceful intervention given he blamed other countries and the company when, in fact, the government is entirely to blame over its inaction.
So, Australia was "at the front of the pack", then there was no queue or race, and now there is a queue and the country is "at the back".
There are limits to the reasonableness test
There must be some reasonableness in assessing the government's performance on the vaccine given the scale of the pandemic and the fact it is the first in over 100 years.
Yet it is a fine line and the fact remains the rollout - not just the lack of supply - has not been helped by some of the decisions taken. The mistakes made in 2020 have driven what often gives the impression of a 'make it up as we go' rollout strategy.
From the early period of the pandemic as the industry started the process of rapidly redeploying its R&D, product development and manufacturing capacity at vaccines, companies in Australia were confronted with a bureaucratic lack of urgency and unwillingness to engage in the context of a global race for supply.
Australian-based representatives of these companies were effectively competing with their global peers to get a place in the vaccine dose queue. Yet it was an open secret across the industry they attracted very little interest from the government until it was too late.
As the BioPharmaDisaptch analysis showed, during June, July and August, the US, UK, Japan, South Korea, Europe, China, Switzerland, Brazil, India, Indonesia, Argentina and Mexico all secured doses of vaccine candidates.
There was never a guarantee any of these vaccines would work but it made sense for governments to quickly invest 'at risk' given what was at stake.
Australia did not secure its first actual agreement until September and that was significantly reliant on the complex repurposing of a manufacturing facility in Melbourne.
The government was not just too slow in securing an advanced supply of multiple candidates.
Arguably the most curious decision was to not use its existing medicine and vaccine distribution infrastructure. This is the infrastructure the government directly supports to the tune of over $200 million every year through the PBS Community Service Obligation (CSO).
At the time the government announced a limited tender, the National Pharmaceutical Services Association (NPSA), which represents the CSO wholesalers, did not speak out over the lack of consultation.
The government announced the tender without consulting its own CSO network. It then announced the outcome of the tender without informing its own CSO network.
NPSA chair Richard Vincent recently described its frustration in an interview with BioPharmaDispatch.
"Our core point is that you have got an infrastructure that the government pays for and is invested in for another four years. And the health minister yesterday reinforced his confidence in the NPSA and the CSO wholesalers, but then when it comes to the logistics around administering a vaccine, we are not in the process," he said.
In recent days, having consistently called on the government to bring forward the involvement of community pharmacy, the Pharmacy Guild has finally lost patience with national president Trent Twomey delivering a fierce assault on the rollout.
“It is bewildering to see the Government happy to give away doses of the vaccine when it can’t even successfully organise to get the vaccine to its own people across Australia,” he said.
It has been joined by the Pharmaceutical Society of Australia. According to national president Associate Professor Chris Freeman, “Governments need a patient-centric approach to put the community first. Pharmacists need to be activated now, so that as more supply becomes available, they are already on board and can be fully utilised to vaccinate in pharmacies alongside vaccinations occurring as part of the General Practice network and vaccination hubs.”
The sector is now significantly united in its frustration with some expressing that privately and others publicly
It has been united through the shared experience of the government's attitude and approach to vaccine procurement, distribution and administration that has only contributed to the stalled and stalling rollout.
