India's Vaccination Woes

Pharmacy of the world - India hadn't held back from giving itself this title during the initial weeks of its colossal vaccination drive, which started in January 2021. Today, this very pharmacy struggles to vaccinate its people, as another 600 million doses have been added to the already overburdened distribution, with the opening of vaccination to all adults from May 1st. Sadly, only six states have been able to roll out vaccines for the 18 - 45 bracket since yesterday, and the numbers don't look quite so good for the coming days as well.

Self - reliance was the main word that floated around government press conferences since late 2020, promoting vaccines manufactured in India and barring other manufacturers from sending their vaccines to India. This produced surmounting pressure on the two main makers, Serum Institute of India and Bharat BioTech, who had little to no support from the Central government in terms of finance and raw materials. The export of raw materials was banned by the USA the Centre failed to fund them. The Serum Institute had to invest 270 million dollars of its own money, and received an additional 300 million dollars from the Bill and Melinda Gates foundation, instead of receiving money from its government. On the other hand, Bharat BioTech had to rely completely on its internal resources. It is now, several months later, with India in the grip of a devastating second wave, that the government has advanced 4500 Crores to these two makers. However, with so many lives lost already, isn't it too little too late? Moreover, these companies had contractual obligations abroad too, and the Indian government granted vaccines to other countries as well. It also had a supply commitment under the COVAX agreement. Thus, about 65 million doses have been sent to other countries by India. Not to forget that in March 2021, when vaccine shortages were visible in India, the Indian Ambassador to the United Nations bragged that they had supplied more vaccines internationally than vaccinated their population.

In early 2021, a false sense of achievement, created by the government itself, filled the nation. On January 29th, the Prime Minister announced in his speech at the Davos Forum that India had won the COVID war, which brought India acclaim from around the world. Even though experts warned about the threat of the second wave of the coronavirus, these warnings were ignored and super - spreader events like the Kumbh Mela were given the green signal. Who could forget the massive political rallies headed by the Prime Minister himself, where social distancing and even masking were proudly flouted? Wasn't it then a cruel irony that soon after such rallies, the government requested the countrymen to take the necessary safety precautions? All that remained important was the election and its campaigning.

It was very evident from the beginning that vaccination (At least 70 per cent to achieve herd immunity) was the long - term solution to defeating the coronavirus. Moreover, India entered the vaccination drive with the obvious advantages of experience of being one of the largest suppliers of vaccines in the world, and having great experience in large scale immunisation, However, like the USA, UK and EU thought ahead and pre-booked doses as early as May 2020, India placed its first order only in January 2021, that too for only 16 million doses, for a population of 1. 5 billion people.

In probably the most baffling policy turn by now, the Centre announced on 22nd April 2021, to start vaccination for all adults from May 1st. However, it was the "liberalisation" and "acceleration" policy that raised many eyebrows. According to the new rules, the Centre would receive 50 per cent of the vaccines produced by the manufacturers, which it would allocate to the states based on a wide range of factors. This lot of vaccines is meant for the age group above 45, and the rest of the vulnerable population. On the other hand, the other 50 per cent can be acquired by the States and the private hospitals, for the 18 - 45 age bracket. In a devastating emergency, the Centre has shifted responsibility onto the States and allowed vaccine makers to dictate prices in the market. This means that the States and the citizens will have to pay for the vaccination of adults between 18 and 45, and the Centre shall not. This shedding of responsibly has caused a rapid and desperate rush for the vaccines, from the already strapped stocks, as States and citizens have been left to fend for themselves.

Moreover, both Serum Institute and Bharat BioTech have mentioned that they can only ramp up their production capacity (Currently about 80 million doses monthly) by July. The Russian Sputnik V has been cleared for Emergency use, but there is no specific ruling on the quantity. The USA has sent raw materials for developing the vaccines, but there is no immediate solution to the problem. Despite this, Indian firm Biological E is aiming to produce about one billion doses of the Johnson and Johnson vaccine, approved hastily by the government, by the end of 2022. Another Indian Firm, Cadila Healthcare, also wishes to get approval for its vaccine. Again, amid rising infections and mortality rates, these don't provide immediate solutions.

On the costs, the federal government and the States have to pay different prices, with the Centre receiving Covishield for 150 rupees a dose, the States receiving for 300 rupees a dose, and the private hospitals receiving for 600 rupees a dose. Covaxin is even more detrimental for the private sector, as they would receive it for 1200 rupees per dose. On the other hand, states would receive it for 400 rupees and the Centre for 150 rupees, per dose. With such high prices for citizens, how are the poor supposed to get vaccinated? This differential pricing has rightly come under fire by the Supreme Court, and late on Sunday, a bench headed by justice Dhananjaya Y Chandrachud said that the vaccine policy was detrimental to the right to public health, under Article 21, and required to be revisited. It is also important to note that around the globe, countries have been offering vaccines to their people for free, including the USA. Indonesia was one of the few countries to allow their private sector to procure doses, but even in that case, the companies weren't allowed to make their employees pay for the vaccination.

To provide a clear picture of the poor state of the vaccination drive in India, here are some statistics. Scarcely 2 per cent of the total population of India has received both doses of the COVID - 19 vaccines. This means that only this minuscule part of the population is secure from the virus, even then maybe not. Less than 8 per cent has received one dose of the COVID - 19 vaccine, and thus, the major part of the population remains fully susceptible to the risk of the coronavirus. Now, as the government has opened up vaccination for all adults, it has made registration on the Cowin app necessary. Even though the app may be convenient, it may act as a technological barrier for the population in India not having access to the Internet or much knowledge of these applications - the poor. Even as several adults registered after numerous app crashes, they failed to get any slot. This was because the government announced that it was mere registration for the vaccination, and a slot would only be available when the doses were.

The world that had commended India on fighting the virus is now questioning it, and rightly so. With 4 lakh infections every day and a system crumbling, votes are being counted instead of the deaths. How are we to get out of this? The public deserves an answer.

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