Injecting Confusion

Context: Vaccine policy must be based on principle. Currently, it is a Centre vs state vs private sector mess

Issues with the Indian Vaccination Policy:

• Arbitrary and irrational: The Supreme Court has lamented the vaccination policy as it has fragmented demand, expanded eligibility when supply is severely restricted, allowed suppliers to fix prices and quotas to control sales.
  • It neither fits into any known economic theory nor substantiating a principle, be it equity, competition or choice.
• Impact on Centre-state relations:
  • It witnessed an embarrassing charade of states running around suppliers, competing against each other and the private sector as if we are many countries and not one.
  • Politically, the central government has arrogated to itself the power to allocate quantities to be supplied to competing entities, and the companies are not obliged to inform states on delivery of stocks, creating distrust between states and the companies.
• Favouring few conglomerates: There was a reluctance on the part of the Centre to use its sovereign power of compulsory licensing.
  • In destroying a well laid down public health universal immunisation programme that is the envy of the world, the government is endangering peoples’ right to health security.

Challenges of the third wave: The Covid caseload is falling, but a third wave is expected to hit us around September, giving us four months to prepare.

• Not enough vaccinations: Currently, an estimated 12% population has received one dose of the vaccine and about 4% the second dose.
  • The recent Public Health England study found that AstraZeneca (Covishield) vaccine’s first dose is only 33 per cent efficacious against the strain B.1.617.2, the dominant strain in India.
• Need for more research: Since 90% of our vaccination is Covishield, we need to use our data to study its impact on different age groups/duration of vaccination to arrive at the right policy.

Way Forward:

• Centralise procurement: To speed up placing of orders and accessing vaccines; notify vaccines under the Drug Price Control Order and have the NPPA declare the base price. Affordability must be assured.
• Make the vaccine available free to all: So as to check black marketing, siphoning, price gouging etc.
• Undertake data analysis to base policy on evidence: Prioritisation must be based on epidemiological data; State-level sero-surveillance studies, as done in Kerala, could be immensely useful.
• Invest in ramping up production: Place full orders to incentivise it without compromising on quality.
• Launch campaigns, particularly in rural areas, to remove vaccine hesitancy.
• Let CoWIN be an option, not a mandatory requirement, as more than half the population has no access to smartphones or technology.

Conclusion: The GoI must heed the sound advice of the Supreme Court and review its policy so as to make it sustainable, based on the principle of fairness and justice.