How the small nation of Bhutan vaccinated 93% of its adults in just 2 weeks
Health minister credits success to health workers, the king, and a population that’s learned to trust vaccines
While many countries, including Canada, are struggling with their COVID-19 vaccine rollouts, one small Himalayan nation is knocking it out of the park.
The Kingdom of Bhutan, a country wedged between India and China, has a population of about 800,000 people, many of whom live in remote, hard-to-reach villages.
Despite those geographical challenges, 93 per cent of adults in Bhutan have received their first dose of Covishield, the Indian brand name for the AstraZeneca vaccine.
Health Minister Dasho Dechen Wangmo credited the success of the vaccination program to the leadership of King Jigme Khesar Namgyel Wangchuck, a strong health-care system and a population that learned the hard way that vaccines save lives.
Here is part of her conversation with As It Happens host Carol Off.
What's the secret to your success?
I think personally, it's the leadership of his majesty the king, the solidarity of the public and, you know, the dedication of the health workers.
You mentioned the king, but also your prime minister [Lotay Tshering] is a qualified doctor and very determined to see this vaccination program accomplished. Is that right?
Absolutely. And I think I often joke [about] this, but we have a very technocrat government highly focused on health, and a government with the biggest mandate for health. The very reason why the government was elected was the health agenda.
You didn't didn't have a large population to reach, but a difficult one in many respects. Can you just tell us what were the challenges of this campaign?
In terms of the reach, it's very diverse. We have many remote, inaccessible communities and also very hard-to-reach communities. So those were, of course, physical challenges.
But nevertheless, we also have [a] very good primary health-care system, especially for vaccination for our children. So, you know, we have achieved universal vaccination in the 1980s. So we have … a very good network of primary health-care workers across the country.
These were systems that were established a long time back. So this time, when we had to introduce [the] COVID vaccine, and given that we introduced Covishield that did not require extreme refrigeration ... we were able to use the existing system fairly well.
I think Bhutanese people realized that we, as a small nation, were under a threat and that we must all come together to achieve this goal.- Dasho Dechen Wangmo, Bhuan's health minister
Just maybe give us a sense of how you did it, how you got to those thousands of people who were in those remote villages.
We developed the Bhutan vaccine system, an online system for registration. We used the local government officials in the villages and in the districts to [organize an epidemiological spreadsheet of] every individual. And based on that data and projection, then we planned our distributions.
For many hard-to-reach places, we use helicopter services to distribute the vaccine and then we used networks of vehicles ... not just from [the] Ministry of Health, but from other sectors as well.
How much support do you have from the people of Bhutan?
Huge support. It would be fair to say unwavering support. And the credit goes to his majesty, the king — people's love for the king. And for the first time, I think Bhutanese people realized that we, as a small nation, were under a threat and that we must all come together to achieve this goal.
You mentioned love of king, but also love of public health, right? Because you have people who believe in vaccinations. What would you say to those in countries like mine, Canada, places where people are hesitant?
If you look at our immunization coverage for children, it's 97 per cent immunization coverage. Many people would know the benefit of immunization, vaccination, because, you know, at one point, we all have children dying. And then suddenly with immunization, you would actually [have] babies living healthy. We are not losing young children to preventable diseases. So people have seen, through the introduction of many immunizations and many vaccines in the past, the benefit of vaccines.
This has, over the years, built the trust and confidence of the people in the health system, especially the primary health-care system.
So what lessons do you think the rest of the world can learn from Bhutan?
I think it's, again, solidarity and collectiveness — that it is everybody's responsibility. And as [World Health Organization director-general] Dr. Tedros [Adhanom Ghebreyesus] mentioned, no one is safe unless everyone is safe. And I think really coming together for humanity, I think it's very important leaving our differences aside and trying to help the most vulnerable.
Yes, we completed our ... vaccination program in a week's time. But after the first week, we had a program designed to reach the unreached. So people who had severe disabilities, who couldn't go out of the house, we provided door-to-door services for these vulnerable populations, making sure that these services reached them.
Even at the global level, I think this is where I think the solidarity comes in, in terms of, you know, richer countries sort of helping the poorer countries get through this. And also, you know, within the country themselves, having a really … collective effort to break the chain of transmission.
Just finally, maybe a bit of politics. You got the vaccine from India, which is producing this … vaccine. India hasn't vaccinated its own population anywhere near to the degree that you have in Bhutan. Why do you think India provided you with so much vaccine?
Not just to Bhutan. I think India provided vaccines to many other countries. And it's also an expression of global solidarity. You can choose to vaccinate your population first and then to give to others, but there is a greater value in giving and sharing prior to fulfilling your own desires and needs.
So this is really an exemplary expression of solidarity, a regional solidarity.
But isn't it also the case that India would like to increase its influence in Bhutan, and especially since China is trying to spread its influence in your country? Do you think that that's part of the reason why India was so keen to help you?
No. Again, like I said earlier, it's really India's generosity, and not just towards Bhutan, but towards many countries in the world.
I remember our prime minister saying, you know, at this point in the face of the pandemic, vaccines have become more precious than gold. Yet here's a country that is sharing these resources with the rest of the world. And to us, you know, leaving politics aside, this is truly a humanitarian gesture and a very commendable humanitarian gesture, I must say, as a Bhutanese and part of the global community.
Written by Sheena Goodyear. Interview produced by Chloe Shantz-Hilkes. Q&A has been edited for length and clarity.