Written by Anil K Antony
India’s vaccination programme till date has been a microcosm of how we as a nation have mismanaged the pandemic. Back in November 2020, the US and EU had pre-ordered hundreds of millions of vaccine doses while they were just in the later stages of their clinical trials. The Indian government announced orders of 15 million doses in mid-January, hardly five days before our immunisation drive kickstarted. Even now, our purchases are placed in small batches.
Despite regular announcements of noteworthy vaccination milestones by our Central government, we have partially vaccinated just 10 per cent of our population. We have fully vaccinated less than 3 per cent. Immunising a country that is home to almost one-fifth of the world’s population is certainly no easy task. However, we clearly did not anticipate a second wave, or had misplaced priorities. Otherwise it would have been incomprehensible to export 6.6 crore immunisation doses through “Vaccine Maitri”.
With a lot of fanfare, the Centre had announced the inclusion of anyone over 18 in an expanded vaccination policy. However, then onwards, state governments and various private organisations are competing with each other for the limited doses produced by our two manufacturers. Concerns were raised then that these renewed guidelines would encourage manufacturers to give priority to clients with higher purchasing power, and that processing numerous orders would make our vaccination drive more inefficient. These fears have now become realities.
The pace of vaccination has dropped significantly since May 1. Eighty-five per cent of people vaccinated in the 18-44 age group are from seven states. Across India, only a few private hospitals have the requisite inventory to vaccinate this age group. Because of scarcity of vaccines, many states have already rolled back their inoculation programs for the newly added segment.
CoWin and Arogya Setu Apps have furthered our vaccine inequity. It is difficult for anyone without a certain degree of technical know-how to navigate them. The slots that open up for the 18-44 age group are booked within minutes. Meanwhile, because of shortages, millions above 45, including the elderly whose second doses are nearly due, are struggling to get the jab.
The National Technical Advisory Group on Immunisation’s recommendations at this stage to increase the gap between Covishield vaccination to 12-16 weeks, and to defer vaccination of those testing positive till six months after recovery raise more eyebrows.
India will have to urgently accelerate vaccine production to get over these shortcomings. The Serum Institute of India currently produces 2.4 million doses a day, and Bharat Biotech will produce around two million shortly. We would need a lot more. Universal vaccination would require well over 2 billion doses. Nonetheless, India has the potential to deliver them.
The government could invoke compulsory licensing to transfer technology from our existing manufacturers to other organisations with capacity. Makers of Sputnik, Janssen and Novavax vaccines have already tied up with Indian partners for indigenous manufacturing. Providing our domestic manufacturers funds and freeing them from regulatory red tape would enable them to quickly ramp up production.
Options to import should also be aggressively explored. However, renowned foreign manufacturers are all tied-up in long-term contracts. These vaccines also have high price points. Hence, their short-to-medium term availability would be limited, and they would only cater to a premium market that constitutes a small segment of our population.
The Biden administration’s support of the India-South Africa led proposal to temporarily waive the patent rights for COVID-19 vaccines could lead to long-term results after several rounds of deliberations, arrival of a consensus at the WTO, and further steps including technology transfer to prospective manufacturers.
There are a few organisations within and outside India working on intranasal and oral drop COVID-19 vaccines. These projects, if successful, would be game-changers, as these highly scalable solutions are ideal for Indian conditions.
New viral strains are proving to be dangerous to even the younger population, including children. With more mutations and future waves looming over us, recovering and rebuilding from the devastating social and economic ill effects of the virus would not be possible without universal vaccination covering our entire population. This exercise would have to be India’s mission project till completion.
This would cost India around 1.1 lakh crore, or 0.6 per cent of our GDP. The financial losses we have incurred during the pandemic days would already be much higher. The expenses also pale in comparison to the hundreds of thousands of lives lost, and are still at risk, to the virus. The success of this task, arguably the most critical in our modern history, would require our Centre, states and private sector to equitably collaborate, with far better cohesiveness and planning than what we have seen since the onset of the pandemic.
Anil K. Antony is the Cofounder of PIIndia.org, a national Covid-19 action group, a graduate of Stanford University, and a National Co-coordinator, AICC Social Media and Digital Communications Department
