Political
Diary
New Delhi, 25 May
2021
Policy in a mess
WHERE IS THE VACCINE?
By Poonam I Kaushish
The
proof of the pudding is in eating. In medical analogy proof of India’s vaccine
failure is in its falling rates of vaccination. Till dte only 2% of the
population has been inoculated thanks to poor planning, politics, too much
bravado, excessive control and vaccine nationalism which has led us to a scarce
situation with all asking one question: Where is the vaccine?
Shockingly, the
number of doses delivered had fallen from 51.82 million in April beginning to
29.46 million last week with about half as many people being inoculated per day
from a month back. At the peak of the second wave if 43 lakhs were getting the
jab, this month it is less than 20 lakhs with various States Delhi,
Maharashtra, Karnataka etc chorusing they had supply for just two-three days. Yet,
when the Supreme Court pulled up the Central Government asking it to revisit
its vaccine policy, the Center averred it had enough.
Compounding this, it opened up
vaccination for its 594.6 million 18-44 population when it had placed
a total order of 280 million doses from the country’s two suppliers
Serum International and Bharat Biotech, barely enough
to cover 140 million people. Totalling, just over 2% of the population with
merely 11% having received one dose.
Now
add to this mix, the Centre’s dual pricing and procurement policy from the two
suppliers whereby the Center will procure 50% of vaccines at Rs 150 and the rest
divided between States at Rs 300-400 and private hospitals and corporate at Rs
800-1200 has resulted in chaos. Alongside the
Government has ended up creating supply bottlenecks and leaving the
prioritising of doses to the manufacturers.
Further
it grandiosely announced States were free to buy and negotiate pricing from
international manufacturers as well. Only to fall flat on its face as both
Pfizer and Moderna have snubbed Punjab and Delhi by stating it would sell only
to the Indian Government. “Allocation of doses and implementation plan within a
country is a decision for local Governments based on relevant health authority
guidance,” they added.
Alas, instead of relying on its talent pool of public health
experts and scientists to guide its response and vaccine policy the Government put
over-zealous bureaucrats in charge of coordinating the vaccine drive via a
website and app. In a country where majority of the poor do not have not access
to mobile phones and internet they would need to find someone who would be
willing to register them using their phone which has aggravated the uncertainty
resulting in a wrong-headed policy.
Besides, it conveniently turned the other cheek to the National
Vaccine Policy adopted in 2011 which underscored the need and mechanism for
creating a stockpile of vaccines in case of emergencies. Even after Serum and Bharat Biotech announced their vaccine
in June last, policymakers showed no alacrity to order and did so only in
January by which time both had made commercial commitments to other countries.
Moreover, the Modi Sarkar
could have easily borne the cost of vaccinating the entire country above 18
years given that it had earmarked Rs 35,000 crores in the Budget, a little over
0.34 % of our GDP to vaccinate nearly 100 crores Indians. Instead, of giving vaccine makers realistic orders with advance payments
it chose drip-drip placement of doses.
This despite knowing the size of the
target population and production capacities of the two domestic vaccine
manufacturers, the first responders to the crisis in advance. Consequently, this resulted in a lack of liquidity and
incentives, if not disincentives, for manufacturers to rapidly scale up.
Indeed, India has
come a long way from being Atmanirbhar to
Vishvanirbhar thanks to the Government’s premature declaration of victory over
Covid 19 in January without checking if we had enough vaccines, oxygen, Remdesivir
whereby we are pleading with Western countries for vaccine and health
paraphernalia as the country stares at a full-blown crisis. It has backtracked
on its policy and fast-tracked vaccines approved by international regulators.
In January when
Western countries had booked vaccines 2-3 times their populations, we placed an
order for just 15 million, for a population of 1.4 billion. The Government’s
explanation for vaccine, oxygen and ventilators shortage? Nobody could have anticipated this. Really?
Yet the rest of the world did.
Currently, we are facing three major challenges. One,
ensuring adequate supplies in a short time. Two, sorting out our pricing policy
for the vaccine and three, the administration of the vaccine. The Government
needs to realize its current policy cannot be fixed in bits and pieces. It
needs to start from scratch.
The Centre needs to fund a part of the vaccine capacity
expansion to ramp up production and delivery, procure 70% of the vaccine output
directly at speed to vaccinate people before the virus or its mutation gets to
them and allocate it among States based on their share of the vulnerable population. It needs to lay out the hierarchy, make it
public and leave it to States to administer the jab as it our main tool to
fight this pandemic.
If
this is bad we now have to grapple with an epidemic in the ongoing pandemic a
fungal ailment mucormycosis or black fungus which if not caught early can lead
to death with the average fatality
rate being 54%. Already, it has infected over 7500 people across 18
States. Mostly those who suffer from diabetes and have been given strong doses
of steroids or immuno-suppressants to calm the immune system kicked into
overdrive by Covid 19.
Sadly,
instead of taking cognizance of this when the first case was detected the
Government sat on the data hoping the fungus would disappear. Compounded by
doctors disregarding experts advice urging them not to prescribe steroids too
early and many people self-medicating steroids s they are cheap and seen as
life savers. Two other fungus, white and
yellow fungus have also been detected.
Predictably,
like Covid 19 the Government has repeated the same mistake: there is a severe
shortage of the main anti-fungal drug to treat the infection leaving patients begging
for life-saving medicines at the mercy of the Centre which has centralized
quota allocation in its hands. Take Delhi. It needs 2000 injections daily for
500 patients but is provided only 400.
Worse,
even as it grapples with the virus our healthcare sector continues to get no
attention. Picturise a Primary Health Centre in Bihar. It only exists on paper
and doctors, nurses & sanitation workers are appointed but they come only once
a month specially on 26 January and 15 August for flag-hoisting resulting in
pigs having a field day scavenging in garbage on its premises. Multiply this pan India. Any wonder why we are
in mess.
Sadly, we not only have missed the boat
but what is worrisome is policy paralysis continues to this day. Time for the
Government to get its head of the sand and read the writing on the wall before
it is too late.
If
we fail to do so, not only will we face a third and more virulent wave, but the
mad rush for vaccines will become super-spreader events on par with election
rallies and religious congregations. We
need to maximise vaccination fast and safely. This is our only hope to try and
beat the virus. ------ INFA
(Copyright, India News & Feature Alliance)
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