The Vaccine Responsibility

The Indian Express     27th April 2021     Save    

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.