Needed: Free Jabs For All

Context: Centre’s vaccination policy leaves citizens at the mercy of manufacturers, does not address shortage issues. Free shots at public health centres are the strategy it must adopt

Issues with the vaccination policy in India

• Private dependence: The entire vaccination is based on just two suppliers — the Serum Institute of India (SII) and Bharat Biotech.
• Differential price model: Suppliers are allowed to set different prices for different buyers (the Centre, states and private hospitals).
  • This is the polar opposite of the “single-payer model” in healthcare, where the government tries to get the best possible deal from drug manufacturers by acting as the single buyer.
  • The stated intention was to supplement central procurement (limited to 50% of vaccine supplies) with a vaccine market where each manufacturer would charge transparently declared prices.
  • It also allows private hospitals to set their own prices for vaccination, and the prices are to be monitored and not controlled, creating an environment of exorbitant price demand.
• Inequitable distribution: In the private market, on the other hand, scarce vaccines are distributed according to their ability to pay: leaving behind the poor.
  • The problem gets worse when private provision degenerates into an extortionate black market, as might happen in a situation of vaccine scarcity.
• Does not ease the shortage of vaccine: It just shifts some of the financial burdens from the central government to private buyers and increases the bargaining power of the private manufacturers:

Moving away from liberalised vaccination policy: Instead of liberalising the vaccine market, the government should interfere. This is because of the following arguments -

• Centre has enough financial leeway: Even if the price paid by the central government were to be raised from Rs 150 to (say) Rs 300 per dose, buying two doses for two-thirds of India’s adult population of 850 million or so would cost Rs 34,000 crore, much less than already allocated for COVID vaccination in the budget.
• It will ensure equitable distribution: A reasonably equitable system where vaccination can be provided free of charge to everyone in expanding priority categories such as health workers, the elderly, everyone above age 45, and so on.
• Better state capacity: This has been well demonstrated in earlier vaccination programmes, including some that involved 100 million shots in a single day.

Conclusion: In the public interest, free vaccination at public health centres is a much better strategy. Any proposed departure from it should be examined “not only with the most scrupulous but with the most suspicious attention” as Adam Smith wisely advised us to consider business-sponsored proposals.