Asia Needs Fleets of Buses to Get Vaccines to the World’s Most Populous Region

Employees of enterprises stand in line to get vaccinated in front of a vaccination vehicle in Lingang Area, Shanghai, east PRC, March 26, 2021. Photo: Wang Xiang, Xinhua.

The PRC has shown how buses can be used to dramatically increase the number of people vaccinated against COVID-19. The region should follow their example. 

They look like sleek, bright tour buses, some vaguely insect-like with long-necked rearview mirrors. But the people lined up outside them in the PRC aren’t sightseers.

From Beijing in the north to Haikou in the southern island of Hainan; from Shanghai on the east coast to Xidu, Hunan and Wuhan, Chongqing, and Wuxi in the interior; and in many other towns and cities, the buses bring COVID-19 vaccinations to people who can’t easily make the trip to sometimes inaccessible vaccination centers.

It’s not just people living in remote mountainous areas such as Ouhai in Wenzhou, Zhejiang who benefit but also urban office workers, who don’t have to take time off to get their shots, and the elderly and handicapped. 

The buses are kitted out with vaccination stations, smart medical refrigerators that keep temperatures at 2–8°C and send an alert to the Chinese Center for Disease Control and Prevention if they deviate, and first-aid facilities in case of an adverse reaction. Vaccinated people are screened, registered, inoculated, and observed afterward. Regulators can monitor the information remotely.

A health worker takes COVID-19 vaccines out of the cooler in a mobile COVID-19 vaccination vehicle near Xidan business area in downtown Beijing, capital of the PRC, April 7, 2021. Photo: Zhang Yuwei, Xinhua.

The buses speed up inoculation, efficiently bringing millions of doses to downtown neighborhoods and more remote locales. The PRC has reason to make haste. Its population of about 1.4 billion is spread across more than 9.3 million square kilometers, including coasts and mountains and everything in between and some regions that are harder to get to than others.

In April, Nature reported that the country was vaccinating about 5 million people a day on average. In June, for more than a week, that number swelled to 20 million a day on average. As of 6 June, the journal stated, 778 million doses had been administered.

In the first week of October, according to Reuters, the average daily number of doses administered was about 1.42 million. A total of at least 2,218,826,000 doses, enough for about 79.4% of the population, have been administered.

A resident receives a dose of vaccine in a mobile COVID-19 vaccination vehicle near Xidan business area in downtown Beijing, capital of the PRC, April 7, 2021. Photo: Li Xin, Xinhua.

The news outlet said that the country has had 96,374 infections and 4,636 COVID-19–related deaths since the pandemic began in late 2019. New infections reportedly average 24 a day, or 1% of the highest daily average reported in February 2021.

The remarkable feat of vaccinating more than a billion people in less than two years was made possible by the decision to produce its own vaccines rather than rely on other countries and by getting the vaccines to its people efficiently. The vaccination buses are part of this logistically extraordinary achievement.

Health facilities have often been stretched to capacity, transport can be inefficient, and vaccination centers can be difficult to reach and expensive to build.

The buses speed up inoculation, efficiently bringing millions of doses to downtown neighborhoods and more remote locales.

Some other parts of Asia have been using vans and buses for health work. In the Philippines, for example, mobile x-ray machines serve tuberculosis patients, family-planning caravans have delivered contraception to communities, and now mobile clinics bring COVID-19 vaccination to cities and villages. 

In September, Thailand rolled out its first vaccination bus, in Bangkok, which needs only six people to operate it and to inoculate 1,000 people a day. Pekanbaru, Indonesia launched its vaccination buses on 1 June and doubled their number to 10 within 2 weeks.

People wait in front of a coronavirus disease (COVID-19) mobile vaccination bus set-up to serve the elderly and disabled groups in Bangkok, Thailand, September 8, 2021. Photo: Juarawee Kittisilpa, Reuters.

In July, the Cambodia government delivered 10 vaccination vans to the defense ministry, which was already inoculating people, and promised one or two vans each to the provinces, depending on their population.

In India, the Karnataka government and the private sector launched the 4–6-month Vaccination on Wheels in August. In Fiji, Rights, Empowerment and Cohesion for Rural and Urban Fijians (REACH) Project buses started bringing vaccines to communities in early 2020.

Some of the least developed countries might not have the high technology that the PRC does, but they use the technology on hand to get the job done. Health workers can use cellphones to inform residents of mobile clinic arrivals, register vaccinees, remind them of vaccination schedules, and transmit information to government agencies. Smart refrigerators might not always be an option, but solar panels can keep the cold chain going.

The World Health Organization and United Nations Secretary-General António Guterres appealed to the leaders attending the 76th UN General Assembly, held in September, to ensure that poor and rich countries have equitable access to COVID-19 vaccines. An impassioned secretary-general called vaccine equity “the biggest moral test before the global community.”

Continuing imbalanced access means not only that not enough vaccines are reaching the least developed countries but also that their health systems are deficient. Even if the countries were to receive more vaccines than they are, of what use would they be if they expire in warehouses or at ports because they cannot be distributed? Or, in the case of one brand, if they cannot be kept at minus 70°C? 

To reach levels of success seen in the PRC, other countries need stronger health systems, more vaccines, and greater vaccine outreach.

WHO and the UN are right to be alarmed. Only 47.7% of the world’s population has received at least one dose of the COVID-19 vaccine but only 2.5% of people in low-income countries.

Vaccination buses are just one solution and an effective one. They do traverse some countries, but not enough of them and in not enough countries. Imagine what fleets of them could do.

 Najibullah Habib

Najibullah Habib

Senior Health Specialist, East Asia Department, ADB

This blog is reproduced from Asian Development Blog.

In the People’s Republic of China, Helping Women Will Help the Environment

Skies in the People’s Republic of China have been clearer than usual during the pandemic. Photo: Zhang Kaiyv.

Gender equality needs to be at the forefront to make environmental policies more effective and to speed the full recovery from COVID-19.

Lockdown measures to reduce transmission of COVID-19 in 2020 have exposed the extent of human impact on nature. As people were required to stay inside and work from home and air travel and industrial output dropped significantly, we saw pollution decline and nature bounce back.

In the People’s Republic of China, the decrease in carbon dioxide (CO2) emissions during the first quarter of 2020 has been estimated at 11% compared with the same period in 2019. Mobility and economic activity were drastically reduced during this time.

The return of a blue sky in big cities revealed the seriousness of pollution. It also signaled the need for urgent human action to veer toward sustainable consumption and production given that this year’s decrease in global CO2 emissions (estimated at 7%) will hardly affect overall atmospheric concentrations.

This will require environmentally sustainable policies as well as changes in individual behavior, which is challenging, as demonstrated by the need for recent policies on fireworks prohibition, waste segregation, and wildlife protection. As a Chinese saying goes, “it’s easy to change mountains and rivers, but it’s difficult to change people’s habits.”

This led us to dig deeper into the environmental awareness, attitudes, and behaviors of different social groups and explore the links between sustainable consumption and gender in the People’s Republic of China. We conducted a survey based using the Chinese Family Panel Study and the Chinese General Social Survey. We found that women exhibit higher pro-environmental preferences and behaviors than men in numerous cases, but not always.

Overall, data indicate that women exhibit greener living and working habits than men. Women tend to smoke less, eat less meat and prefer cleaner cooking fuels, such as gas and electricity, instead of coal and firewood. Women tend to put more effort and time toward environmental protection through garbage sorting, recycling, and using reusable shopping bags rather than disposable ones.

Regardless of income and age, women’s transportation choices are more likely to be carbon free. This includes walking, cycling, and public transportation. Women and men hold equally strong awareness about the need for harmony between humanity and nature.

Data also showed improving trends across time and age groups, but young generations appear to have higher environmental awareness and pro-environmental preferences than older generations.

Although science is increasing the odds of overcoming COVID-19, it is more urgent than ever to accelerate action towards sustainable living.

Although we find women are more willing to invest time and physical effort on green actions, we also identified three conflicts that policymakers should note to unleash women’s positive contributions to environmental solutions.

The first conflict is that women are constrained in both finances and time to take more responsibility despite their high social preference towards environmental protection. The gender wage gap is as large as 39% in the People’s Republic of China and larger for the older generation, which partly explains why women are less willing to take on financial burdens related to the environment. We also found that women on average take on more unpaid housework and care work than their male counterparts (1.3 hours more on weekends and 1.1 hours more on weekdays). The gap is even larger for rural women.

Second, women exhibit lower awareness on climate change and industrial pollution than men; despite stronger eco-friendly behaviors in daily life.

Finally, women lack enough political representation to drive the policy discussion. The People’s Republic of China ranked 95 out of 153 countries in terms of women’s political empowerment in the Global Gender Gap Report 2020.

To unleash women’s potential, a level playing field is a prerequisite, and the following actions can help.

1. Close the remaining gender gaps that limit women’s capacity to shape policy. This includes enhancing the social care system to reduce the time poverty of women, promote equal education opportunities, especially for rural women, set up wage transparency mechanisms to promote equal payment, and address gender stereotypes in leadership, politics, and participation in decision-making on green development.

2. Include a gender perspective in the design of sustainable consumption and production policies. We recommend integrating gender analysis into the existing policy agenda of sustainable consumption and production; specifically, policy makers need to ask whether gender differences in information access and decision-making about resources will contribute to the varying impact on men and women.

3. Continue investing in environmental education and awareness of the impact of consumption choices. Action is based on awareness, but we have identified a general “threshold of indifference.” This means that despite efforts at education and improvements over time, still a significant share of the population, regardless of gender or age, continues to have low awareness about environmental processes. Promoting more informed decision making of consumers is needed, including making the origin of products more transparent, developing labeling and certification systems, and adopting product traceability technology.

Although science is increasing the odds of overcoming COVID-19, it is more urgent than ever to accelerate action towards sustainable living. Gender equality needs to be at the forefront to make environmental policies more effective. As Chairman Mao Tse Tung famously stated, “women hold up half the sky”. With women’s enhanced participation and the effort of both men and women, we will eventually hold up the whole sky, making the world better, greener and safer.

 Veronica Mendizabal Joffre

Veronica Mendizabal Joffre

Social Development Specialist, East Asia Department, ADB

Fan Li

Fan Li


This blog is reproduced from Asian Development Blog.

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