Abstract
The research on Medication Management for COVID-19 Infectious Diseases: Problems and Obstacles to Public, Private Sector Procurement and Solutions aimed to study the problems and obstacles in procurement of COVID-19 medicines, such as vaccines. ATK, Favipiravir by government agencies and the private sector in Thailand through comparing the processes and criteria for procurement of such pharmaceuticals abroad and to study the improvement of the government's vaccine policy and management and the role of the National Vaccine Institute in providing emergency vaccines or to enhance the public and the development of a prototype vaccine, and to obtain recommendations for improving the government's vaccine policy and management in accordance with the outbreak situation. The findings revealed that 1. The COVID-19 outbreak has greatly impacted the public health, social and economic systems around the world. The virus can mutate and spread to people of all ages. As a result, the number of infected people around the world continues to increase until the end of February 2022, with more than 440 million people infected worldwide and 6 million dead. Many governments, especially high-income countries, have partnered with leading medical companies around the world to develop vaccines to stop the epidemic. The aforementioned circumstances and conditions allow high-income countries to have access to vaccines and medical supplies before poor and developing countries. High-income countries are also home to vaccine and pharmaceutical companies such as the United States, the European Community and China, as well as Russia. These countries can reserve vaccines and pharmaceuticals, in particular, Vector vaccines of AstraZeneca and mRNA of Pfizer and J&J, with the exception of China and Russia that use vaccines tested and developed by their own domestic companies such as Sinovac, Sinopharm and Sputnik V vaccines. The World Health Organization has adopted a standard for vaccines that can be used in emergencies. The policy of most governments around the world is to provide vaccines as quickly and as possible for any cost. While vaccines on the global market are limited and becoming scarce. As a result, the manufacturing company becomes the authority to set the price itself. 2. Compared with the COVID-19 vaccine procurement process, the United States uses a vaccine reservation method by contributing budgets to AstraZeneca and Pfizer for trials, research and development of vaccines on the condition that: If the vaccine trial is unsuccessful, a refund is not required. Most high-income countries similar to the United States, such as Canada, can reserve vaccines at nearly five times the population of the country. Singapore is undisputed by procurement laws and is able to pre-order vaccines in large quantities and quickly, even though they are not endorsed by the Health Science Authority. The Philippines is in a similar context to Thailand because there are restrictions under procurement laws and cannot pay upfront to reserve vaccines, unless the president exercises his or her authority to approve or “unlock” from such legal restrictions. Furthermore, the participation of the private sector and local governments in vaccine procurement and distribution makes it possible to procure vaccines faster than in Thailand. In the case of Thailand, it was found that in the first phase of the epidemic, the government was unable to provide vaccine procurement easily because of the limitations of the Government Procurement and Supplies Administration Act, B.E. 2560, which was not conducive and a lack of clarity in practice. The relevant government agencies were unable to immediately purchase vaccines and medical supplies. 3. As COVID-19 is an emerging disease that still lacks knowledge as well as around the world, problems and obstacles in the procurement of vaccines and medicines in Thailand result from laws being designed to operate under normal circumstances. For example, the Government Procurement and Supplies Administration Act B.E. 2560 (2017). It is a limitation that governments and relevant agencies at the operational level cannot procure vaccines and medical supplies in a timely manner. The essence of the said law does not allow the purchase of unstocked items and the result is not guaranteed, and the exact delivery date of the vaccine must be specified. Even after The Comptroller General's Department, Office of the Ombudsman, and the NACC, as well as the Office of the Council of State have discussed guidelines for government agencies responsible for purchasing vaccines and medical supplies. It is adhering to the guidelines for the Government Procurement and Procurement Management Committee's letter, No. Kor Khor (Kor.Wor.Jor.) 0405.2/Wor 115 dated 27 March 2020 for greater flexibility and agility in operations. Suggestions 1) The government should amend the Government Procurement and Supplies Administration Act, B.E. 2560 (2017) to be more flexible. It may adjust from the material matter according to the letter of the Committee on for the Government Procurement and Procurement Management Committee's letter, No. Kor Khor (Kor.Wor.Jor.) 0405.2/Wor 115 dated 27 March 2020 to be any section or additional specific section to increase flexibility for the staff working and create transparency and accountability. 2) Adaptation of medical and public health organizations to respond to emergencies Organizations and relevant agencies should manage knowledge (KM) through lessons and experiences from this COVID-19 crisis for adaptation to support emerging diseases in the future. 3) The government should prioritize on the National Vaccine Institute as a research and development agency and to coordinate and seek cooperation with agencies, international organizations to ensure Thailand's vaccine security to have enough potential to develop a prototype vaccine for use in case of emerging disease in the future. 4) The government should address the crisis when emerging medical diseases still lack knowledge, prevention and treatment methods by basing the safety and benefits of the people as the base of "educating academics leading to politics" and enhance transparency and confidence among the people through the concept of Open data, Open Government.
