Public Health, not Private Profit

Context: Government must ensure sufficient monitoring and safeguards as private entities are drawn into the vaccination drive.

Concerns with allowing private administration of vaccines:

• Chargeable nature of vaccination: eligible individuals will have to pay Rs 250 per dose at private centres while it is free at government facilities.
• Ethical concerns: With charging for a vaccine that has been allowed for only restricted emergency use based on limited data.
• Weak monitoring: in reporting Adverse Events Following Immunisation (AEFIs).
  • Insufficient screening: about known cases of serious adverse events (SAEs) and deaths.
  • Lack of diligence and lapses at the state level: leading to a significant lag in the National AEFI Committee’s causality assessments of SAEs.

Positives steps by the government:

• Increasing government centres: by enlisting private hospitals empanelled in the Ayushman Bharat-PMJAY, CGHS, state-level insurance schemes.
• Low Cap on the price for vaccination (250/dose): sends an early signal of the feasible drop in vaccine prices to the global community.
• Retained control of the supply and distribution of vaccines:
  • Ensures uninterrupted supply for domestic vaccination programme while balancing commitments to the COVAX facility and other international demands.
  • Enables prioritised distribution: in the event of upsurge of cases in parts of the country or the spread of variants.
• Upheld the principle of equity: in donating doses and facilitating exports.

Way forward:

• Ensure free-of-cost vaccination: to beneficiaries while scaling up vaccination by engaging private institutions on a model of fair and reasonable remuneration for services.
  • Enable competitive pricing and ensure that procurement prices are within a reasonable realm of the costs of production.
• Strengthen protocols and systems for monitoring and reporting of AEFIs: essential for building public confidence and reducing vaccine hesitancy.
• Act in global solidarity and demonstrate leadership by sharing affordable vaccines, especially when poor nations fall perilously short of doses.