How Bhutan managed to vaccinate more than half its citizens in a single week

Joe Wallen
·4-min read
A Buddhist monk receives a Covid vaccine under the watchful eye of Bhutan's King Jigme Khesar Namgyel Wangchuck - Upasana Dahal/AFP
A Buddhist monk receives a Covid vaccine under the watchful eye of Bhutan's King Jigme Khesar Namgyel Wangchuck - Upasana Dahal/AFP

As Ninda Dema folded up her sleeve and placed her hands together in prayer, she gave a nervous smile to the surrounding television cameras, aware that the entire population of the Himalayan nation of Bhutan was watching her from their homes.

On March 27, Ms Dema, a 30-year-old bureaucrat, received Bhutan’s first Covid-19 vaccine - kickstarting the world’s fastest immunisation programme. Some 62 per cent of eligible Bhutanese citizens were vaccinated in just one week, outstripping both the UK and the United States.

“Let this small step of mine today help us prevail through this illness,” said Ms Dema.

Bhutan, one of the world’s least developed countries, best known in the west for measuring progress via its unique Gross Domestic Happiness index rather than purely through economic output, is an unlikely global vaccination outlier.

By Tuesday, almost 469,664 out of its total population of 735,553 had received a single dose of vaccine - 85 per cent of its citizens, with children excluded.

Certainly, Bhutan’s small population size is a major advantage over many other countries. But its success can also be attributed to its dedicated citizen volunteers, known as "desuups", as well as robust public healthcare planning and a regional geopolitical struggle between New Delhi and Beijing.

Together, the desuups were able to deliver vaccinations to healthcare centres, ensure citizens reported for appointments and educated the Bhutanese on Covid-19 protocols, including social distancing and mask-wearing.

Their role has been invaluable in a country that had only 37 doctors and barely 3,000 full-time healthcare workers before the pandemic.

In the north-western district of Gasa, where approximately 3,000 Bhutanese live in mountainside villages, a team of four medical staff was accompanied by six desuups, working as local primary school teachers, to navigate the desolate terrain.

Wearing heavy boots usually worn by armed forces and carrying emergency medical kits, the team was able to reach six villages in six days.

And, when the snow made the journey impassable on foot, the authorities arranged helicopters to deliver doses.

“We’re really grateful for the vaccine. If not for the helicopter service, we’d have had to travel for more than five days [to get vaccinated],” Dema, a resident of the village Esuna, told Kuensel Online.

Bhutan was also able to rely upon its established “cold chain” vaccination programme, one of its “prized possessions,” according to Dasho Dechen Wangmo, the country's minister of health.

“We achieved universal immunisations in the 1990s and we have always been very successful in vaccinations,” said Mrs Wangmo.

“So the current immunisation is riding on the existing programmes, there were already a lot of systems in place and it made it very easy to introduce a new vaccine through a lot of advocacy and micro-level planning.” 

This established immunisation programme meant members of the public also trusted the authorities and there was little vaccine hesitancy.

Bhutan’s neighbour India has also played a crucial part in its rapid roll out. As part of a plan to counter growing Chinese influence in the region, the country has received 600,000 free doses of the AstraZeneca/Oxford University vaccine manufactured by the Serum Institute of India, as a gesture of goodwill.

Bhutan has also received testing kits, personal protective equipment, N95 masks and essential medicines like paracetamol from New Delhi.

"New Delhi has made Bhutan a major target of its vaccine diplomacy," explains Michael Kugelman, Senior Associate for South Asia at the Woodrow Wilson Centre.

“This effort may be grounded in humanitarian concerns, but it’s also a way to consolidate Indian influence at a moment when China’s footprint is deepening around the region.”

The Bhutanese Prime Minister, Dr Lotay Tshering, is a qualified doctor and he has been leading the country’s response.

When Bhutan detected its first Covid-19 case in an American tourist in March 2020, its borders were immediately closed - they remain so - and a mandatory quarantine was imposed on residents returning from abroad.

To date, Bhutan has only recorded 886 cases of Covid-19 and reported just one death, aided by two carefully managed lockdowns.

"From day one, we took it very seriously as in Bhutan we consider the health of the people as the most important thing. The whole country mobilised under the leadership of the King and it has been successful so far," said Bhutan's Former Ambassador to the United Nations, Lhatu Wangchuk.

"We are seeing a sense of relief among the Bhutanese people, although we cannot be too complacent until we get our second shots."

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