204:oral COVID-19 vaccine procurement strategy in Thailand: political economy perspective

ObjectivesThe availability of COVID-19 vaccines is gradually changing the world, allowing countries to combat the pandemic using an offensive rather than defensive approach. The decisions to procure and manage the vaccines are influenced by a country’s health system, its economic status, international politics as well as national interests. This study looks at this dynamic in Thailand through the lens of a political economy analysis to understand the distribution and influence of power and resources in procuring vaccines for an upper-middle income country.MethodsWe conducted a document review and interviews with key stakeholders to gain insights into the health system and political economy implications of Thailand’s COVID-19 vaccine procurement strategies. The data was analysed using a framework developed by Fritz, Kaiser, and Levy in 2009 on political economy analysis focusing on structural, institutional and stakeholder-related factors.ResultsThailand had been successful in containing COVID-19, however, a proactive approach to planning and procuring COVID-19 vaccines was not employed. Thailand did not join the multi-lateral COVAX Facility, and instead relied on two manufacturers. It also pursued a vaccine security policy by supporting domestic production of a COVID-19 vaccine. As of July 2021, the country has vaccinated 5.2% of its population, which is lower than the global average. Relevant groups and stakeholders in the vaccine policy landscape include the Ministry of Public Health, the National Vaccine Institute, Government Pharmaceutical Organization, private hospitals, medical associations and the public among others. The study is at an early stage of analysis and results will be available in September 2021.ConclusionThe complexities of COVID-19 vaccine policymaking necessitate a nuanced, multidisciplinary approach. Political economy analysis can be a useful tool in informing the various stages of the policy making process such as agenda-setting, policy design, adoption, implementation and evaluation.