TOPIC – Jab and push

“Centre’s new vaccine roadmap will help in the much-needed ramp-up; it also raises some critical questions”

With the relentless surge in Covid-19 infections showing no signs of abating, the Union government, on Monday, announced a significant change in its vaccination strategy. The Centre has opted for a more liberalised approach in terms of both eligibility and pricing of vaccines — a welcome departure from its previous approach that drew a specious distinction between those who “want” and those who “require” the vaccine and trashed all suggestions of opening up supplies as being at the behest of “foreign pharma lobbies”. All above the age of 18 are eligible, states can prioritise them, vaccine manufacturers have also been liberated, though partially, from the tyranny of price controls, and have now the option to supply part of their production to state governments and in the open market. The balance 50 per cent will continue to be directed to the Centre, which shall provide free-of-cost vaccines to all healthcare and frontline workers and all those above 45 years of age. This change in approach, which allows for a greater role of the private sector, and gives pricing freedom to incentivise vaccine manufacturers is a step in the right direction. But this raises several issues that need to be addressed for the benefits to be harnessed. For one, by all accounts, there continues to be a supply crunch. While the government has taken steps, although belatedly, to scale up the availability/production of vaccines in the country, ramping up supplies specially post May 1, will be a challenge. There is no clear indication of the stockpiles available. Nor any clarity over how many doses of Russian Sputnik V can be imported immediately. Second, as demand outstrips supply, especially as the virus spreads, the vaccine basket will need to be dramatically expanded. Regulatory approvals will need to be expedited, financial constraints for manufacturing will need to be eased. It’s not clear how the Centre will allocate stocks under the revised norms. Which states will be at the front of the queue? Will states bearing the brunt of the virus be prioritised over others? Will it be linked to wastage? There are also questions over who should do what. Should the Centre be coordinating procurement and distribution across buyers, between states, and between the states and vaccine manufacturers? Or will individual states be left to negotiate with vaccine manufacturers, both domestic and foreign? There is also a regulatory challenge. Vaccines have been approved under emergency use authorisation which implies that these drugs cannot be sold directly in the market, only under regulatory supervision. While there is surely a greater role for the market, vaccine is a public good. The CoWin architecture will anyway register each vaccination. So the private sector needs to be welcomed under vigil by a robust and transparent regulatory mechanism managed by the Centre in constant consultation with states.