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Vaccine Inequity - Implications

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April 27, 2021

What is the issue?

  • The Government of India unveiled a completely revamped vaccine strategy.
  • The resultant vaccine inequity could make containment measures more difficult.

What is the recent decision?

  • Two key elements are the hallmark of this new strategy, which will be implemented from May 1, 2021.
  • 1) The phased roll-out of the vaccination drive (initiated on January 16, 2021), under which the vaccine-eligible sections of the population were gradually increased, has now been extended to the entire adult population.
  • All above 18 years will now get vaccinated.
  • 2) A significant deregulation of the vaccine market has been effected.
  • Vaccine manufacturers now have the freedom to sell 50% of their vaccine production to State governments and private hospitals.
  • This can be sold at prices that can be substantially higher than that hitherto fixed by the government.
  • A third element of the vaccine strategy, which was not announced formally, is a grant of ₹45 billion to the two vaccine manufacturers to boost their capacities.
    • Serum Institute of India (SII) and Bharat Biotech.

What are the concerns?

  • In the midst of the second wave of the pandemic, the Central government has abdicated its responsibility to ensure vaccine equity through free vaccination for the poor across all age groups.
  • State governments were never consulted or given prior notice about the change in vaccination policy.
  • And the two vaccine manufacturers are given a free hand to decide the price at which vaccines will be sold to State governments.
  • This has made universal COVID-19 vaccination a difficult task to achieve.
  • A large percentage of those aged 18-44 years does not have the resources to pay for vaccines.
  • Most of them will hence go without being vaccinated.
  • So, the States will have to take a leading role in the free immunisation programme.
  • Nearly two dozen States have already committed to vaccinate for free the target population.
  • It remains to be seen if they use any criteria to identify the beneficiaries.

What are the implications?

  • The Union government restricts itself to vaccinating for free just 300 million.
  • Never before has universal immunisation of nearly 600 million people been left to State governments and the private sector.
  • With this precedent, States will probably be required to vaccinate children too, when vaccines become available.
  • This will burden them even further and thereby actively promote vaccine inequity.
  • Making States pay for vaccines is an ill-conceived idea.
  • And forcing them to shell out more than what the Union government pays for the same vaccines will for sure exacerbate vaccine inequity.
  • Notably, vaccination is now the only safe way to end the pandemic.
  • So, undertaking any exercise that leaves a large population unprotected will cost the country enormously in terms of lives and livelihoods.

Is financial resource a constraint?

  • The Union government has already allocated ₹35,000 crore for COVID-19 vaccination in the current Budget.
  • It has also committed to provide further funds if required.
  • With this, it will have to spend less than ₹10,000 crore to vaccinate for free all above 45 years.
  • The sudden change in policy is therefore not due to lack of financial resources.
  • But, the State governments, which have not factored in funds for vaccination, will now be required to garner funds for the same.
  • There is hence a great compulsion to make pricing more transparent and allow States to collectively bargain for a lower price and assured timelines to receive supplies.

How does the future look?

  • The new policy takes the States and the companies to a completely uncharted territory leading to competition among States, and between State governments and private hospitals.
  • Vaccine shortage from both manufacturers is likely to last a few months.
  • There is less likely to be a smooth roll-out of vaccines for the target group given the combination of -
    • policy pandemonium
    • profiteering by vaccine manufacturers in the thick of the pandemic
    • vaccine shortage
  • This could lead to a dangerous situation where containment and mitigation measures become even more difficult.
  • In all, the new vaccine strategy could undermine “vaccination for all” (in a country that has long championed the cause of access to affordable medicines in international forums.)

 

Source: The Hindu

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