Context: Critical analysis of India’s vaccination strategy and an overview of necessary changes to be initiated.
Issues with India’s vaccination strategy
Failed to effectively contain virus spread: Daily cases exceeding 261,000 and reported shortages of hospital beds, essential medicines and even oxygen.
Limitations of the highly centralised system: While the Central government remains the sole authorised buyer of vaccines, it fixes price and places all orders, limiting its timely distribution.
Serum Institute of India’s vials could not be exported because of the ban, hitting their expiry date.
Failure to agree on a price: Government’s offer price was lower than the price for vaccines delivered to World Health Organization’s Covax programme for distribution in the poorest countries.
This limits the scope to ramp up production capacity, thereby resulting into prolonged delays.
Failure to recognise the role of private sector vaccine producers: No alternative marketing options.
Added complexities: As more vaccines with different properties and costs are joining the drive.
Way forward: Necessary changes to look into -
Move to a dual market system: Where 65% of vaccine production is allotted to the government at a negotiated price for public vaccination programme and the rest sold domestically in the free market.
Ensure a reasonable pricing framework: Transparent institutional methodologies taking into account discounts for bulk purchases.
Allow an export window: That substantiates India’s credibility as a pharmacy of the world.
Planning and ordering in advance: Vaccinating 70% of India’s population (excluding children and pregnant women) by the end of 2021 will require covering 680 million people.
Institute differentiated buying: Government could plan to cover 480 million through public free vaccination programme while remaining 200 million could be drawn from the market.
Ensuring affordability while raising prices: Even if the cost per dose rises significantly (currently Rs 250/dose in the private and Rs 150/dose in public), it would still be affordable to upper-income groups.
Moreover, the Confederation of Indian Industry has stated that its members will join the vaccination effort, bearing the cost of vaccinating all employees their families.
Ensure transparency: In placing firm orders with domestic suppliers, publish resulting supply commitments from different companies, mechanisms of vaccine distribution to states etc.
Enlarge scope for imported vaccines: Free market shall be put in place as imported vaccines are expensive and require storage at low temperatures, which public hospitals will not be able to provide.
It will also encourage the companies that have developed them to engage in licensed production in the country for the domestic market and for supply to other countries.
It would also be a concrete step towards the kind of vaccine cooperation that was talked about in the recent Quad summit.