COVID-19 vaccine: Availability vs accessibility

GENERAL SANTOS CITY — In 2009, I led a research project to assess the situation confronting senior citizens in this city. It was part of a national initiative courtesy of the Coalition of Services of the Elderly (COSE), a nongovernment organization working with and for older persons, especially the most disadvantaged ones in both urban and rural areas in the country. COSE aims to address the issues of poverty, exclusion, and invisibility so the elderly will live in dignity. They help the elderly cope with the myriad challenges associated with aging, and how they can be empowered to do certain things they can still do, despite their advanced age.

Among the findings of that situational analysis among the “seniors” in the city was the differential levels of access they had to maintenance medicines and other medications they needed for their various health problems, especially those related to their overall weakened bone structure, wobbly and creaky joints, problematic blood circulation, among a host of others. Some elderly here had to deal with mild to serious mind-related issues, like forgetfulness and dementia. I remember talking to one of them who disclosed her fears that she may no longer recognize her family members in the near future, and, for her, it was quite threatening.

Many elderly are aware that their badly needed medications are always available in drugstores in this city. But such availability does not translate to access to these medicines especially for indigent senior citizens. At that time, Republic Act No. 9994 or the Expanded Senior Citizens Act of 2010 providing cash assistance of P500 (P1,000 in some well-resourced local government units) to indigent seniors was not yet in place. Yet another source of inaccessibility to badly needed medicines is the geographical isolation of the elderly from indigenous communities. This was also the problem of senior citizens with mobility issues, who lived by themselves, and did not have the benefit of younger family members or relatives who acted as caregivers.

Fast forward to 2021. The scramble for a vaccine against COVID-19 has spawned a number of issues such as whether it can be made available at the soonest possible time, and who are the lucky and preferred ones to access it first. Now that its availability is somehow assured, the next issue is whether everyone, especially the indigent older people, can have access to it.

For my daily-wage-earner friend here, accessing the COVID-19 vaccine—wherever it will come from—is quite far-fetched. With his very limited daily income (P500-P600 a day), it would be impossible for him to buy the vaccine using his meager financial resources. He calculated that with his family of six, even with a vaccine priced at P500, he would need to work for at least more than one week in order to pay for all his family members. This also means he would not have any more money left for food for his growing family, or for purchasing much-needed vitamins to help boost their immunity to any kind of disease. Exposure to the pandemic can mean a slow death for those with limited financial resources.

If the national government is able to find the needed finances to purchase the vaccine in behalf of the country’s more than 27 million poor people, then we can say that the availability of the vaccine also translates to their access to it.

But this remains a wish for many people, especially for my daily-wage-earner friend. The General Santos City government has recently announced it is allotting P150 million to purchase COVID-19 vaccines. But it has not announced how it will be distributed, and on what basis, and who will be accessing the vaccines first before others. The vaccines may be available, but may not be accessible to the many who need them the most.

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