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Countries Face A Variety Of Obstacles In Getting Vaccines In Their Citizens' Arms

MARY LOUISE KELLY, HOST:

Here in the U.S., the COVID-19 vaccine rollout is finally mostly humming along. More than 60 million people have now gotten at least one dose. That is nearly a quarter of adults in the U.S. Elsewhere in the world, though, things are not going so smoothly. Some countries are facing supply problems. Others are grappling with logistical hurdles and powerful vaccine disinformation. We're going to check in now with three of our correspondents around the world. Julie McCarthy covers the Philippines. Diaa Hadid joins us from Islamabad. And Ruth Sherlock is in Beirut.

Hello, hello, hello. Welcome, all three of you.

DIAA HADID, BYLINE: Hello.

JULIE MCCARTHY, BYLINE: Hello, Mary Louise.

RUTH SHERLOCK, BYLINE: Hi.

KELLY: Julie, you start. The Philippines is getting a significant number of its vaccines from China. Let's start there. How's it going?

MCCARTHY: Well, the Philippines has just over a million vaccine doses. Five hundred thousand are from AstraZeneca, and 600,000 are from the Chinese vaccine-maker Sinovac - a donation from China. And the Philippine health care workers are finally getting vaccinated. But Dr. Maaliddin Biruar with the National Kidney and Transplant Institute told me he took the Sinovac shot out of desperation. Ninety-five percent of doctors, Mary Louise, at the country's biggest hospital said they're wary of Sinovacs (ph) and how much protection it provides. Trials show strikingly different results, but Biruar says he read the data. He's convinced that Sinovacs was safe to use, and he'll take his chances on efficacy. So Biruar decided for a vaccine that won't harm him against a virus that could. Here he is.

MAALIDDIN BIRUAR: What's at stake - it's your life. So for me, I didn't want to gamble with my health and my life, so I decided to take it. It's not really like saying I trust the government. It's just that's the only thing you can give me right now, so I have no choice.

MCCARTHY: The Philippines has secured Western vaccines, but they haven't arrived. China really has stolen the march in distributing vaccines there.

KELLY: Diaa, hop in here because Pakistan's also gotten a bunch of vaccine from China. Is that right? Are you seeing or hearing the same distrust there?

HADID: Yeah, we do get a sense of that here, Mary Louise. Consider a recent poll of more than 500 doctors found only 9% were willing to take Sinopharm.

KELLY: Nine percent. Wow.

HADID: Yeah, 9%. And it's a different Chinese vaccine than the one that's being offered in the Philippines, but the sentiment is broadly similar. Doctors say it's because Pakistanis see Chinese products as shoddy. But it's the only vaccine presently available because the Chinese government donated half a million batches. But even a month after frontline health workers began being vaccinated, only about half that supply has been used.

Government health officials do say the rollout is going on smoothly. But consider this - health ministers of Pakistan's two largest provinces have had to threaten their health workers to get jabbed. And so experts say if that's what it's like for health workers, vaccinating the public is going to be an even bigger challenge. And that's not just because the available vaccine here is Chinese, but because COVID hasn't really hit Pakistan very hard. And so there isn't a sense of urgency.

KELLY: I want to circle back to these questions about how the rollout to the general public might go. But Ruth Sherlock, let me bring you in. What is the general situation in Lebanon right now?

SHERLOCK: So Lebanon got a $34 million loan from the World Bank to buy its first tranche of the vaccines. It's the Pfizer vaccine. It's the first country to be given this kind of loan. So, you know, keen to make it all work, the World Bank tried to make Lebanon promise that there would be no wasta, or favoritism, in how these vaccines get distributed. They even tasked the Red Cross to monitor the process.

KELLY: And did it work, or was there wasta - people jumping the line?

SHERLOCK: Well, they have been. And you know, it's people right at the very top, including the president. So just days after the vaccination campaign started, a group of politicians ordered up a van full of vaccines to Parliament, where they got it off the books, apparently without the monitors looking. The president is in his 80s, so at least he's old enough to qualify for those eligible for this round of vaccines. But others weren't. And the health minister was quoted as trying to justify this by saying it was a move to boost politicians' morales. But you know, lots of Lebanese mocked him scornfully for that comment, pointing out that it's health care workers that have been going through hell in this pandemic. And the health minister's comment also seems especially tone-deaf, given that Lebanon is going through a catastrophic economic crisis that experts agree is largely brought on by the government, by corruption and by ineptitude.

KELLY: Speaking of presidents in your part of the world, Ruth, I saw the news this week that Syria's president, Bashar al-Assad, has tested positive. I know you - you're not in Syria, obviously, but you cover Syria quite closely from Lebanon. And it got me thinking about just the incredible challenges of trying to pull off a vaccination program in a war zone. How's it going there?

SHERLOCK: Well, it's extremely complicated, as you say, Mary Louise. So for starters, the country is divided into different areas of control. COVAX - that's the global mechanism for getting vaccines to poorer countries - has promised a batch of vaccines to both the Syrian regime and opposition rebels. In the opposition-held areas in Idlib province, for example, one of the key problems is that these areas are so battered - you know, hospitals have been destroyed by airstrikes; doctors have been killed - that there's barely even the infrastructure to distribute these vaccines. Then you have the regime-held parts of the country. Vaccinations there are underway, though, as you noted, President Bashar al-Assad and his wife Asma have come down with COVID-19.

The real issue in this area is whether the government will play ball in making sure everybody that needs it gets the vaccine. Rights groups say there's a precedent here where the regime politicizes aids, trying to steer help from the United Nations and other aid groups or, in this case, vaccines to areas where loyalists live. The World Health Organization says the regime has promised to cooperate, but lots of aid workers I've spoken to who operate in Syria say they're skeptical.

KELLY: Let me look back to the Philippines and Pakistan because, Julia and Diaa, you were both talking about how skeptical health care workers, doctors are in these countries. What about the general public and how the rollout might play out? Julie, you first.

MCCARTHY: Well, it's going to be a big climb. There is vaccine hesitancy already built into the system, into the country over a botched anti-dengue vaccine a few years ago where children died. But the big picture now in the Philippines is public health policy colliding with foreign policy. President Rodrigo Duterte leans heavily towards China. He reviles the Western vaccines. But the public - the Philippine public is on a different page. Before the pandemic, opinion polls showed a deep distrust of China. So a negative reaction to a vaccine made in China is fairly predictable. But the Philippines now has nearly 3,000 new cases a day. It has the second-worst outbreak of COVID-19 in Southeast Asia. It needs to contain this thing. And low public confidence in vaccines is a real threat to achieving that.

KELLY: And Diaa, in Pakistan?

HADID: Well, here, health officials will be challenged to vaccinate. As I said before, there really isn't here a sense of urgency. But that's complicated by something else. Here, there are pockets of violent resistance. Militants routinely try to kill vaccinators. So experts say authorities might just end up focusing on high-priority groups like health workers, the elderly, Pakistan's large numbers of foreign workers and international students who'll likely need the vaccine to travel.

KELLY: Fascinating - a portrait of how the vaccine rollout is going or not from three corners of the world. That's NPR correspondents Diaa Hadid, Julie McCarthy and Ruth Sherlock.

Thank you all.

HADID: Thank you.

MCCARTHY: Thank you.

SHERLOCK: Thank you very much.

(SOUNDBITE OF U.S. GIRLS SONG, "NAVY AND CREAM") Transcript provided by NPR, Copyright NPR.