Ramping Up Vaccinations Should Be Accorded Top Priority By India

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.