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YAB Prime Minister,
YB Minister in charge, Special Committee on Covid-19 Vaccine Supply (JKJAV),

Over the past weeks, we have seen the ramp-up of vaccinations nationwide. We are
heartened by the government’s moves to increase the number of mega vaccination centres,
as well as to the increase in the number of GP clinics who will be providing vaccinations to
the public.

However, there will always be a segment of the population who will be difficult to
access; and in turn face difficulties in trying to access vaccination – often termed in project
management as ‘last-mile delivery challenges’.. These include vulnerable groups;
underprivileged, those living in remote rural areas and those from the lowest socioeconomic groups.

Among the challenges these individuals and communities will face in getting
vaccinated will be issues of transport and logistics, language barriers, financial burden, lack
of health and even general literacy in understanding the need to vaccinate among others.
The issues surrounding successful ‘last-mile delivery’ are myriad; and added to this mix is
the ‘powder-keg’ of fake news which has further worsened suspicion and distrust among
quite significant numbers of our communities.

We represent long-standing, long-serving Civil Society Organisations (CSO)s working
on the ground would like to offer our services and assistance to the government especially
with the purpose to tackle the last mile delivery challenges in vaccination and ensure that all our communities are equitably and completely vaccinated so that we can return to some
semblance of normalcy.

Why CSOs will be beneficial in ‘last-mile delivery’?

Our CSOs have the experience of working specifically with communities at the
ground level for many years, if not decades. They understand the workings of these
communities and in many instances, already have very effective and successful partnerships with them in terms of programmes and services.

What is more important is that these organisations enjoy strong relationships and
trust with community members – trust that is needed to be leveraged on to overcome the
trust deficit which seems to be prevalent and driving issues of vaccine hesitancy.

Rather than listening to some WhatsApp video of some unknown expert persuading
them of the benefits of taking the Covid-19 vaccine, what is needed is the trusted
community partner who has worked with them for many years providing individual level
explanations and, if needed, even one-to-one counselling that will enable individuals to
register and subsequently be guided through the vaccination process.

CSOs will also be extremely beneficial to the process because they draw upon a
different reservoir of human resources not from the Ministry of Health. Our news pages and
social media pages are filled with stories of how our clinical colleagues in MOH and MOE are
swamped with issues of managing the continuing burden of Covid-19. They are busy
treating, contact-tracing, swabbing and containing the disease spread – and spread quite
thinly at that.

CSOs can alleviate this burden somewhat, bringing in external manpower and able to
work across both the public/private divide. CSOs also have a strong base of volunteers and
capabilities to maximise the use of limited resources to be able to deliver. These will enable
delivery to be done using highly cost-effective means.

How will CSOs carry out ‘last mile’ delivery?

CSOs can work together with MOH at the ground level, within sub-districts and
districts to take on the load of vaccination across many different states. They can be used to deploy in either small teams; or via mobile vehicles to quickly and efficiently reach multiple areas- especially those that have multiple branches and state/district level organisations.

CSOs will also be able to carry out counselling, structured health education and
outreach in multiple languages within a diverse range of communities and groups. This is
critical to convince individuals to overcome their hesitation and accept vaccination.
Additionally, CSOs will also be able to provide transport and overcome other logistics
barriers that different individuals and communities may face.

How do we engage CSOs into the vaccination effort and what will they need ?

The entire premise of this effort is based on the idea that CSOs are ready and wiling
to go. Many of us have been continuously engaged since the Covid-19 pandemic in various
initiatives including working hand-in-hand with government agencies. We are no strangers
to the system and can begin work immediately.

What we need is i) the approval and willingness of government to utilise us in the
vaccination effort- this is why we are appealing to the YAB Prime Minister and YB Minister
directly; and ii) integration into the overall vaccination effort- via supply of vaccines and
direction on geographical distribution of tasks.

Countries like Bhutan managed to vaccinate their entire population entirely based
on the strength of volunteers. We, the Malaysian CSOs are ready and willing to serve our
nation during this time of dire need and play a role in relieving the burden of our strained
public healthcare services. All we need is the green light…. so we can finally all see the light
at the end of the Covid-19 tunnel.

DR MURALLITHARAN M, NATIONAL CANCER SOCIETY OF MALAYSIA (NCSM)
DATIN SERI SUNITA RAJAKUMAR, YAYASAN MYNADI.
ROSLIZAWATI MD ALI, MALAYSIAN WOMEN’S ACTION FOR TOBACCO CONTROL AND
HEALTH (MYWATCH).

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