India's vaccination agenda status: No homework done

Udayan Hazarika

(The writer can be reached at udayanhazarika@hotmail.com)

Mismanagement appears to be another name of India's Covid-19 vaccination agenda. Inefficiency, ignorance and mismanagement have generated distrust among the people towards this agenda.

The government's failure to put in place a strong organisational framework and a well laid down policy is responsible for this complete failure of the agenda. First, the process started with vaccinating the healthcare workers and frontline staff in January (Phase-I) and thereafter for the aged ones in March last as usual with much publicity and campaign. At that time, the government without knowing the ground reality declared that 30 crore persons will be vaccinated by March 2021. However, that did not materialize. Even today total vaccination comes to only 18.44 crore constituting merely sixty per cent of the target of phase-I. This proves how casual the attitude of the Government on such serious matters. Thereafter, the Government came up with a completely new policy of 50:50 i.e 50 per cent vaccines will be distributed by the Centre free of cost while the State has to arrange the remaining 50 per cent. The States remained silent. This time again this 50:50 policy was laid down without examining the ground realities of procuring the vaccines through tenders. The vaccine producers kept their conditions of selling out vaccines to the States. Two vaccine prices come to rule the scenario and the States remained silent. The third phase i.e. the vaccines to 18+ was launched without having adequate numbers of vaccines in-store in almost all the States. Some major States have not yet started Phase-III. In the meantime, as per the media report, the major vaccine producer has left the country with family under the pretext of setting up manufacturing units abroad and there is nobody to comment on what is going to happen now?

The States are told to procure their necessary vaccines from the two vaccine giants and if necessary from the global markets. The Government has put a limit to the availability of vaccines to the States laying down the condition that only 50 per cent of the vaccines produced by the SII and Bharat Biotech shall be made available to the States. That quantity could not cover the requirements of the States. As a result, the States have to go for bidding in the global market. This is the most impractical part of the policy. First, the States have no expertise to participate in the global tender process for vaccines, second, it will lead to unnecessary competitions between the States if at all heir tenders come to the level of consideration. Unable to find an alternative way out some states have already participated (Mumbai Civic body and UP Government) in the global tender. Very soon Delhi, Haryana, Andhra Pradesh, Karnataka, Rajasthan and Tamil Nadu have also announced their plans to float global tenders. The question is will they be able to compete with the global buyers? Delhi Deputy CM Manish Sisodiya has rightly said, "A state-wise global tender is the worst thing to do at a time like this but since the Government of India is not doing it, states can't sit idle. This is why we are also preparing a tender and knocking on doors." Delhi wants 1 crore vaccine doses under the global tender but is also open. UP has held talks with Pfizer, Dr Reddy's Laboratories, Serum, Bharat Biotech and Zydus Cadila to procure 4 crore doses. Another important point that needs to be noted there is apart from the rich States other poor States will not be able to participate in the global tender process. What will happen to them?

As per an estimate, a total of 150 crores to 200 crore doses of vaccines are required to cover the population of India exposed to Covid-19. The total estimated population of India is 138 crore as of 2020 (RGI estimate) of which roughly 35 per cent are urban and the remaining are rural. Assuming that all urban areas have been affected by Covid-19 and 50 per cent of the rural areas have been affected, then the total affected population comes to about 93 crores or say 100 crores. So in a single dose, India needs more or less 100 crore vaccines or for double doses, it will come to 200 crore doses of vaccines. While So far, only 18.45 crore population have been vaccinated, which comprise only about 9 per cent of the total population to be vaccinated.

Now let us have a look at the position of vaccines at present. The global short supply of vaccines has now been a fact. Many countries which have already placed advance demands before the global producers are yet to receive their full quota.

The Centre has for a long time kept silent about the vaccine supply position and did not disclose anything about the shortage in supply. When the situation became grave, they started talking to various global producers such as Russia, Pfizer, Moderna, and Johnson & Johnson- to supply vaccines to India. But it was too late already. Many producers have refused to make any commitment and only gave assurances that they will be available for talks on a supply only after coming September. Thus, as of now at least till October 2021 government will have to depend fully on the SII, Bharat, and Dr Reddy's Sputnik-V and as per the assurances received, Covishield will provide 75 crore doses, Covaxin will supply 56 crore doses and Sputnik-V will make available 15 crore dozes; thus in all 146 crore doses will be available by December 2021 as per Government of India's observation. The Government also expressed with satisfaction that along with the above three vaccines, between May and December 2021 an estimated two billion vaccines will be available in India with the support of Novavax (20 crore doses), Zydus Cadila is at their phase III trial, BB Nasal in Phase I Trial etc. Although the government is sticking to this calculation, yet a close look at the situation will show that this is not a realistic calculation. It is now almost uncertain if SII will be interested in producing so much of doses Covishield mainly because of the shafting of their interest to Novavax – a new vaccine of Covid-19 and also setting up of their new manufacturing units in London. Moreover, research findings suggest that Covishileld is not equally effective in the case of various variants other than the Covid-19. SII's new interest is in Novavex for which raw materials are not various countries agree to provide the raw materials provided the vaccines are produced in that country itself. If we examine the production capability of the above three vaccines as per the affidavit filed by the Government of India SII is capable of producing 65 million doses per month, while Bharat Biotech could produce 20 million doses and

Sputnik V at 12 million doses. At this rate of 97 million doses/month, the production of the required 2 billion will take at least 20 and a half month. So in reality, neither the SII nor the Bharat Biotech can supply the 75 crore doses and 55 crore doses respectively as promised by December unless they already have a huge stock of such vaccines at their disposal.

It is time that the Central government should learn to work in collaboration with the States rising above party status. Already the government is exposed at various levels including before the Apex court about the discrimination mated out to the non-BJP States in respect of oxygen distribution and allocation of vaccines. This appears to be sufficient to learn a lesson.