The Vaccine Responsibility

Context: Vesting the vaccine responsibility on central government will be the ideal way of vaccine delivery. 

Problems associated with vaccine delivery in India:

• Vaccine hesitancy and vaccine shortage: This may lead to low coverage. E.g. In the first 3 months of the COVID 19 vaccine drive, only 40 % of the 30 crore high-risk populations were vaccinated.
• Low vaccine manufacturing capacity: E.g. India’s monthly COVID vaccine manufacturing capacity was about 60-65 million doses against our final requirement of 1.45 billion doses to cover 70% adults.

Arguments in favour of vesting vaccine responsibility on the centre:

• Problems in vesting vaccine responsibility on states
  • Create interstate inequities: due to discretion by vaccine supplier (to whom and at what rate)
    • Poorer states will suffer due to poor bargaining power, and better off may pay higher rates.
  • Negative implications on other welfare programmes: because states will pay higher rates at the cost of sacrificing the already underfunded welfare programmes.
  • Poor health delivery system of some state: states like Uttar Pradesh & Bihar will have to spend an estimated 0.47% and 0.6% of the State Domestic Product (SDP) respectively for providing free vaccines. (instead of spending it on building their shattered health delivery system)
• Legal obligation on the centre to control the “interstate spread of infectious diseases”: Entry 29 of the Concurrent List under Schedule VII of the Constitution.
• Successful strategy in the past: Centre has always procured vaccines and other consumables for states under all National Infectious Disease Control Programmes.
• Economic benefits:
  • Market power will remain with the government: to obtain at highly competitive rates and ensure robust quality assurance processes & coordinate supplies based on transparent objective criteria.
  • Government can cap prices: Supervised by the National Pharmaceutical Pricing Authority (NPPA)

Way forward: Steps to be taken along with vesting vaccine responsibility on the centre.

• Stop the attempts at cartelisation:  By invoking compulsory licensing and expand production through the 18 manufacturing companies in India, boosting availability at an administered price.
• Coordinate with foreign players: Aggressively take up the demand for waiver of Intellectual Property Rights (IPR) on vaccines and help expand its availability at affordable prices.
  • This will halve the estimated expenditure of about Rs 60,000 crore and ensure more efficient utilisation of the saved funds to strengthen health systems.
• Prevent creation of monopolies and profiteering.