In May, we examined the possibility of Southeast Asian countries working together to create a regional COVID-19 Vaccination Certification (CVC) system. We posited that CVCs present unprecedented collaboration challenges, especially that of coordination and trust. We suggested that the EU’s Digital COVID Certificate (formerly called Digital Green Certificate) approach provided an example of how regional blocs can address such challenges.
In July 2021, the EU Digital COVID Certificate was launched across 27 nations, with all countries so far fully participating. The system has generally lived up to all it promised, so much so that the EU is allowing non-EU countries to be gradually added to the infrastructure (to date, 16 non-EU countries and territories have joined).
But how far have Southeast Asian countries come in their CVC efforts? What form can certificates take and how can their authenticity be verified, given the limitations in infrastructure and capacity? Will mutual recognition of CVCs be possible when the type of vaccines and their doses differ significantly across countries in the region? We explore these questions, summarizing the discussions of a recent webinar on this very topic.
Vaccinations continue in earnest amidst a mutating virus
Southeast Asian countries such as Cambodia, Lao PDR, Thailand, and Vietnam, as well as the People’s Republic of China (PRC), have made remarkable efforts in ramping up vaccination coverage. According to the latest data, Cambodia has fully vaccinated at least 78 percent of its population, while Thailand, Lao PDR, and Vietnam have reached 23 percent, 26 percent, and 9 percent respectively.
Yet, all these countries continue their daily battle with COVID-19 and are not yet seeing light at the end of the tunnel. They are not only working to roll out the original two shots per person, but also beginning to think about booster shots and the possibility of mixing vaccines. And as they manage the vaccine rollout, authorities are also busy creating and implementing the CVC architecture to ensure citizens can prove they have been vaccinated, and start to ‘normalize’ their lives, including for cross-border travel.
CVC progress in Southeast Asia
Governments are keen to harness CVCs, recognizing their importance to reopening economies and supporting livelihoods. Different countries in the region have approached the issue differently:
Cambodia currently uses both online and offline certification systems, and its digital database system can handle over 300,000 records per day.
In Lao PDR, the vaccination card includes a cryptographic verifiable QR code to check the authenticity of certificates, but the card is not yet inter-operable with other countries’ systems.
Lao PDR: Paper and Digital CVC with QR Code
Thailand plans to provide digital health passes through a mobile application, Mor Prom, which features an integrated vaccination scheduling system and tracks vaccination and health status. The government has also instituted the ‘Phuket Sandbox’ which enables vaccinated, certified visitors to Phuket, a major tourist destination, to forgo quarantine.
PRC has used digital technologies to track vaccine transportation, real-time temperature monitoring, setting digital appointments for vaccination, and sharing digital information and recording systems.
In Vietnam, the vaccine management platform consists of four components: a mobile application for electronic health records and patient management, a vaccine certification system, a reporting service command center, and a health information portal for the public.
Challenges of digital CVCs and regionalization
Southeast Asian countries have shown ingenuity under challenging circumstances. All have rapidly put systems in place which allow for a certain level of verification and importantly, all are open to a common trust framework. However, several major obstacles stand in the way of digital CVCs being built to scale and functioning perfectly on a regional level.
The first challenge is insufficient resources for the appropriate hardware and software. Given the evolving nature of the pandemic, issuing a CVC is only the first step towards normalization. Countries need to set up and maintain a digital infrastructure such as open-source digital credentialing platforms, electronic registries and cloud enabled services, and over the long run, allocate a share of the health budget accordingly to ensure their sustainability.
The second is limited capacity to run these systems, supported by appropriate policies and regulations. To ensure that CVCs include the most vulnerable populations such as migrant laborers, and are fit-for-purpose as both a mechanism of proof as well as a tool for ensuring continuity of care, countries will need multiple modes of delivery (paper and digital) and verification (online and offline). This will require investment in administrative and technical capacity across multiple ministries and agencies, with the support of the global development community. Multilateral development banks and multilateral organizations can facilitate cross-ministerial policy dialogue, research and academic institutions can provide CVC expertise, and NGOs can support community awareness for the end products.
These two national challenges are compounded when accounting for cross-border issues—the third challenge. From seemingly ‘simple’ problems such as synchronizing local and international languages to much more complex ones such as data sharing protocols, countries are keen to ensure regional harmonization and compliance with global standards (which are still a work in progress). Further, it will be important to assess risks and benefits of data collection, and governments must protect data privacy especially when used across ministries and countries. Given the multitude of systems already in motion, collaboration will be increasingly important. Without, a likely scenario is that a ‘leader’ will emerge amidst the bloc, creating the rules, standards, and systems with minimal consultation, for others to follow.
A way forward
COVID-19 has pushed many countries to accelerate their overall digital transformations, and vaccination systems have served as a litmus test for how prepared countries are. For the countries showcased here, digital CVCs has enabled a leapfrog into the digital era, while still acknowledging the importance of parallel paper-based systems. As Southeast Asian countries scale up the successful rollout of COVID-19 vaccines, a trusted and verifiable credential will become increasingly important to reopen their economies, especially to boost trade and tourism. Regional coordination will be key to ensure mutual recognition of CVCs. Many of these countries already have good experiences working cross-border issues for communicable disease control, and are well placed to build on these past relations and available infrastructure. However, certain design principles surrounding digitalization, including equity, accessibility, and data confidentiality, will be especially important for a regional CVC system. Given the limitations of infrastructure and capacity, issuing a trusted CVC credential will require both resources and technical support from the global development community. Learning from the experiences of those who have already rolled out regional systems, like the EU, will be valuable as Southeast Asian countries work to stem the tide of the pandemic and return to normal. But this is the beginning of a long road, and much work still remains to be done.