There is a global network of people and organizations called Innovation for Change (I4C). The purpose of I4C is to defend and strengthen civic space and overcome restrictions to our fundamental freedoms of assembly, association, and expression. The East Asian hub of this network initiated and cooperated with Khoo Ying Hooi, an Associate Professor and the Head of the Department of International and Strategic Studies at Universiti Malaya, to conduct “Vaccine Transparency and Accountability in Asia: Realities and Dilemmas” research and produced a very interesting and important regional synthesis report.

This research precisely examined vaccine equity, openness to procurement and distribution, and the social and political impact of Chinese and other vaccines in the region. The report contains research data from 11 countries across three subregions of Asia: Cambodia, Indonesia, Philippines, Thailand, and Timor-Leste from Southeast Asia, Afghanistan, Bangladesh, India, and Nepal from South Asia, and Kazakhstan and Mongolia from Central Asia.

When I read the report, I felt that humankind has fought and is still fighting not only against coronavirus but also each other’s’ moral pandemic.

The report shows how politicians make decisions under tough situations, how those decisions affect society, and how all of this is linked together at the regional and global level. In other words, COVID stripped away “the blanket” of these countries and has taken a big moral test through the society including decision makers. Let me highlight some of the analysis. 

Chinese influence

All research focus countries, except India, relied on China to vaccinate their citizens. India did not meet its commitment to work with the US, Australia, and Japan (QUAD) to address the global vaccine shortage. On the other hand, China has played a major role in geopolitics and geostrategy by consistently supplying South East, East, and Central Asian countries with domestically produced vaccines during the pandemic.

Although some of research focus countries were involved in the COVAX program run by UNICEF and the World Health Organization, the vaccination has really become a strategic and political commodity rather than a global public good. Mongolia sent live sheep flock to China when its neighboring country had a tough situation. In return, China sent back its traditional tea package to Mongolians. It is said that Mongolia has successfully carried out vaccine diplomacy during the COVID time. In conclusion, China has successfully demonstrated soft power policy and how one country can increase its political influence over others and gain strategic leverage in the region during unexpected situations.

Information asymmetry

There were no research focus countries that had integrated, transparent, and accessible vaccine related information. The amount of procured vaccine doses, the actual required dose of those countries, the unit price of vaccines, the breakdown of the vaccine costs such as import, logistics, and distribution related costs, the expiration dates, the vaccine registration numbers, and the information on the people who got vaccinated have not still been fully disclosed.

Media companies demanded information transparency and accessibility but there was no full success. The emergency situation was take advantage of resulting in, a waste of public funds, inefficient spending, corruption, and bribery. All these illegal and unethical issues arose from the information asymmetry and gap. Due to this situation and poor management, many countries are running out of vaccines. On the other hand, the Philippines ordered 50 million more doses than actually required, 44 million of which expired before they could be used. This is because of poor management caused by information asymmetry, non-transparency, and unethical actions. Eventually, the vaccination became political in many countries. It is unacceptable to taxpayers for politicians to use public health, the pandemic, and vaccine equity to increase their popularity!

Access to information technology

All 11 research focus countries used information technology to disseminate information to the public. But there is a big question mark whether the information technology infrastructure was accessible and user friendly to the people. In addition to social groups that do not have access to the Internet, there have been cases of people who have not been vaccinated due to incomplete information in the country's state registration system such as immigrants and minority groups. As a result, misinformation and disinformation about vaccines have been widely disseminated in societies, both intentionally and unintentionally. In other words, the pandemic has exposed the huge digital divide within the countries.


Distrust of vaccines was common in all 11 research focus countries. For example, Indians did not trust their own vaccine, while the Filipinos were still confused by the previous Dengvaxia cases involved in the drug. In the case of Mongolia, Nepal, Cambodia, and East Timor, there were many rumors and both traditional and social media scandals about the Chinese vaccine. In countries where produce the vaccines, tons of misinformation and disinformation about the vaccine itself went viral. Misinformation included messages such as; there is no need for vaccines at all, and the vaccine is poison and should not be injected into human body etc.… This phenomenon has divided society and created two very different but extreme stakeholders in these countries. Due to this distrust caused by the knowledge and information gap, the first stage vaccination rate was not high in Mongolia. In terms of historical, political, and economic relations with neighboring countries, Kazakhstan which is fairly dependent on China and Russia, is in the crosshairs of geopolitical games.

At the beginning of the pandemic, Kazakh citizens had options to get vaccines only from Russia and China. Only one was approved by the World Health Organization officially. Although they made their own vaccine called QazVac, they faced disbelief from international scientists as well as from their own citizens. Therefore, using their political, religious, and social connections, Kazakhstan organized special vaccination trips to the United Arab Emirates, Turkey, Croatia, and Bulgaria. Plus, they received vaccines from neighboring country Uzbekistan to fill the supply gap. All this shows the inequality level of the country, and uneven public health services. Not everyone can travel abroad and get vaccinated.

Moral dilemmas

When I was reading the research report, the films "Noah", "The day after tomorrow", and "Greenland" immediately came to my mind. Even a former minister of Mongolia said that "Once the virus spreads, there is no difference between politicians and “ordinary” people". In other words, it is not crystal clear how the countries defined or identified the citizens and social groups to be vaccinated as a priority. We have heard of cases where decision-makers and people close to the information were unfairly named on the priority vaccination list! This is a classic moral dilemma case!

Afghanistan, the country with the largest number of people with disabilities per capita, initially did not include this vulnerable group in its list of priority vaccinations.

In addition to protecting public health, the Philippines decided to consider its economy in a balanced way by making the priority list of people to be vaccinated include the highest contributors to the GDP and representatives of companies. To this extent, many small and medium-sized companies and individual business people, who were self-employed, were mistreated by the government as compared to the employees of large corporations, and they were sacrificed indeed. In addition, in Nepal, the decision to vaccinate employees of diplomatic and media organizations before the elderly has been widely criticized by the public. It is concluded that this was a political game for voters. Due to the inequity between urban and rural areas, people in rural and remote areas, which make up 80 percent of the total population, could not get vaccinated on time. Also, the debate about whether children should be vaccinated or not is still ongoing.

The eleven research focus countries have issues related to vaccine accessibility and inequity that are rooted in gender, as well as minority groups. In particular, the issue of refugees and immigrants will be strongly highlighted. This is an issue of discrimination no doubt! Let us take the example of India in relation to gender. The study found three reasons why women are far less likely to get vaccinated than men. These were traditional lifestyles based on patriarchy that violated women's rights, limited digital usage of women or gender-based digital divide, and misinformation as well as disinformation that vaccinations have negative effects on women's menstruation and general well-being.

In neighboring country Bangladesh, street cleaners, garbage collectors, and informal migrant workers who have not received vaccinations were totally abandoned. 

In other words, indigenous people and ethnic minorities, poor and vulnerable groups, political refugees, migrant workers, people with disabilities, sexual minorities or LGBT people, and people living with HIV or AIDS have not been able to fully enjoy their rights due to social discrimination.

Bangladesh is one of the top countries in the world receiving the largest number of immigrants and refugees from other countries. In that sense, for the first time, a policy to vaccinate refugees was successfully implemented for the Rohingya nationalities. In countries such as Nepal and Cambodia, there are also good cases where religious leaders have worked successfully to actively involve religious people and ethnic minorities to get vaccinated on time. On top of all this, the voice of the civil society in these countries was very strong, and to this extent, the vulnerable groups of the society were able to protect their rights.

Vaccine distribution

Most of the research focus countries imposed a state of emergency and implemented strict centralized management during the pandemic. However, countries such as Indonesia and the Philippines have been much more effective with decentralized management with flexible governance. In these countries, in addition to the central government agencies, city, district, province, and even the smallest state administration leaders had the right to distribute and allocate vaccines and make direct decisions. Moreover, India, Indonesia, and the Philippines have provided considerable authority to their private sector and companies. 

As for Mongolia, the Trade and Development Bank announced that it would vaccinate all its customers, but this promise was never fulfilled, and its reputation was ruined. On the other hand, information system engineer from And Systems company have volunteered to help the government by creating a solution for synchronizing the spread of covid and vaccination data and displaying it directly on the mobile app.

The Indonesian Chamber of Commerce and Industry has collaborated with its government on the vaccine distribution program to create herd immunity among the public. However, this decentralization system has broken down in some countries as the private sector has shifted from public health goals to profit-oriented action. As soon as private hospitals began to charge a fee, accessibility and equity of vaccine to vulnerable groups in society was drastically reduced, thereby increasing the inequality of health services..

One thing is very clearly seen from Thailand's vaccination map. The four poorest villages in Thailand have the lowest vaccination rates. To wrap up, social and economic inequality has been seen to be a big signal to policy designers and decision-makers during and after the pandemic and throughout the vaccination process.


The research report identifies five dimensions of vaccine transparency and accountability: geography, technology, target group, legal framework, and poverty. This is not just a measure of the effectiveness of vaccine equity related to the COVID pandemic, but it shall be considered as a basic recipe for accelerating the development of the country, improving the accountability of the government, and fighting with humankind’s moral pandemic. In order to ensure vaccine equity and transparency, especially to protect the rights of people with disability and minority and vulnerable groups, the civil society and media companies of these countries have provided invaluable assistance and have been able to apply pressure to create a great positive influence on decision-makers and politicians. 

COVID-19 killed millions of people worldwide. 

This pandemic has clearly shown the flaws and gaps in our social construction system, as well as the unproductive and inefficient aspects of government institutions.

In particular, the healthcare sector has had to make significant changes to be ready for future contingencies and risks. In addition, it has become very clear that countries should develop backup plans to protect themselves without directly relying on the help of others in times of unexpected situations like COVID. The research report shows how important the free flow of fast, real-time, true, and accurate news and information is, before, during, and even after global disasters and risky situations.

If we see the bigger picture, the greater the openness and transparency of the government, the greater the responsibility and accountability. In that sense, declaring a state of emergency should be the last resort, because in this situation, the public control and accountability for the government almost disappears. Therefore, it goes without saying that it should be the ultimate mission of the governments of countries to work with the private sector, media, and civil society organizations as much as possible to come up with equal voices to policies and plans so that no one is left behind.

Last but not least, inequality and non-transparency are the evil root of all negative social phenomena, and without correcting this system, it is impossible to build a rule of law-based society to fight poverty, corruption, bribery, and injustice.

Thanks to Nathan Stoneham for editing the article.