Open Forum
New Delhi, 16 June
2021
Free Vaccination
EASIER
SAID THAN DONE
By
Dhurjati Mukherjee
The Centre will start
rolling out free vaccines to all States for those above 18 years from next
Monday. However, the big question is whether this time round it would have done
its homework thoroughly. More so, as to achieve its target of fully vaccinating
its adult population of around 94 crores,by year end, it will have to step up
the average daily vaccination levels close to five times from what has been
achieved from January 16 to June 7. This possibly appears an impossible task
and experts are unanimous on this point.
States such as Uttar
Pradesh may need a nine-fold jump in daily vaccinations, Bihar over eight-fold
and Tamil Nadu, Jharkhand and Assam over seven-fold. Five of the country’s most
populous States in terms of 18 plus population face the task of raising the
daily vaccination levels five-fold or more.
According to census
projections, it would need to administer further 170 crore doses in the
remaining 231 doses of the year. That would require an average of around 75-80
lakh doses a day (weekends included), a nearly five-fold increase over the
average so far. Vaccinating such huge population is not merely a challenge of
supplies. It would mean adding many more vaccination centres than have been
used at any point in the vaccination drive and finding the extra personnel
needed to man them and to administer the doses.
Therefore, it’s
necessary that there is close coordination between Centre and the States and
that there is a task force set-up or the existing Raisina Hill-centric one
revamped, which enables proper monitoring of the vaccines’ supply and
distribution. It needs to be noted that Prime Minister Modi made the
announcement of Centre’s decision to buy 75% of jabs from vaccine makers,
including 25 per cent of the State quota, and give it for free, following strictures
of Supreme Court on the differential pricing in purchase of domestically
manufactured vaccines.
The apex court had raised
serious doubts about the Modi government’s liberalised vaccine policy of
“fixing higher prices as a competitive measure” and stated that it’s the
responsibility of the Centre and not the States to provide free vaccination.
The bench headed by Justice Chandrachud said the Centre’s policy of allowing
vaccine manufacturers to charge the States’ higher rates violated the
fundamental right to equality, as did its policy of providing free vaccination
only to those aged 45 and above. The court underlined that this year’s annual
budget had set aside Rs 35,000 crore exclusively for vaccine procurement and
wanted to know how it has been spent.
The present cost of
free vaccination would come to around Rs 45,500 crore and to make a modest
recovery of expenses, only those who can afford to pay can get the jab from
private nursing homes. Unfortunately, though the Centre chose to ignore
experts’ advise on pandemic control and vaccination of maximum population
through development of health infrastructure. Diverting maximum resources
towards this end, specially by shelving the Central Vista project by at least a
year or two, would have been the right decision.
This was a demand
among others raised in a joint letter by 12 Opposition leaders to Modi as also
a group of 187 eminent persons, who pointed out that “it is shocking that the
GoI has neither welcomed the suggestions (of Opposition leaders) nor created a
truly national task force comprising all parties, State governments, experts
and civil society to tackle the unprecedented situation India is facing”. It too
had regretted the Government outsourced procurement of vaccines to States,
resulting in “differential and exorbitant rates”.
While the sticky issue
of free vaccines for all stands resolved and the Centre giving in, it would
also need to consider seriously the large number of children in the country who
could be affected by the pandemic. Our current vaccination policy extends to
cover all those above 18 years. There is need for herd immunity level of 80% to
contain the epidemic. It is impossible to achieve this level by vaccinating
only those above age 18. Thus, India must urgently draw up plans to vaccinate
children under 18. The question that arises is how long will fear of Covid keep
children away from schools, given that parents, children, teachers,
educationists, nutritionists and paediatricians are all alarmed by the adverse
effects on children’s well-being.
With vaccinations
still moving in a rather slow pace in the past two months and unlikely to pick
up steam from July, there are fears that the incidence of the pandemic may not
be curbed in rural and semi-urban areas. However, even here an internal
government projection for August and September shared by a source put the
monthly number of Covishield doses at 100 million out of 200 million for all
the three approved shots combined, as claimed by the government.
The official figure
of those who contracted the disease had reached 30 million (widely believed by
experts to be a gross under estimate) and deaths exceeding 300,000. Meanwhile
the The New York Times had suggested last month that actual Covid
infections in India could be 20 to 26 times the government figure and the death
count could be 5 to 13 times the official toll.
A section of experts
are talking of a third wave as official warnings have surfaced of this
possibility. Though the magnitude of its impact is yet to be ascertained, its
incidence is likely to impact children. The fear is perpetuated by the shocking
slippage in vaccination coverage and the shortages of vaccines for adequate and
fast protection of the virus. Moreover, the fear factor may restrict mobility
and social and economic engagement and sentiments of consumers may not be back
to normal in the coming months.
The problem in the
country is that the Modi administration being seen as heavily centralised,
there is little scope for professionals to air their independent views, even in
internal meetings. It is said Modi does not entertain other’s views and
professionals and experts have just to carry out orders. In such a situation,
what is needed is a decentralised system where views of experts are given due
cognisance and there is no diktat from the top.Note that in the United States,
it is a renowned expert Dr Anthonu Fauci, who is taking decisions relating to
the pandemic and related issues.
Advice of experts needs
to be given topmost priority and a communication drive launched that could
clear misconceptions and effectively tackle such pandemics or other types of
disasters. While vaccination has to be enhanced with not even 15% of the
population vaccinated as on date, it is also necessary to ascertain whether a
booster dose would be necessary within 12 months of full vaccination, as
predicted by Pfizer CEO.In all, pragmatism is the need of the hour, which sadly
has been lacking in governance so far. There is need to go beyond ad-hoc
decisions and take a holistic view of building the country’s health
infrastructure. The government would do well to remember, a stitch in time
saves nine.---INFA
(Copyright, India
News & Feature Alliance)
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