There’s No Logic In Delaying Induction Of Private Parties And Making Covid Vaccines Available For A Price

“When the facts change, I change my mind – and what do you, Sir?”

The authenticity of the above quote, attributed at various times to John Maynard Keynes, Winston Churchill, Paul Samuelson and even Joan Robinson, is not material. But it contains a huge truth in a situation where facts on the ground change dramatically from month to month, if not week to week, in dealing with the Covid pandemic.

Over the last few days, at least two high-profile business leaders – one running a healthcare institution (Dr Devi Shetty) and another a software services company (Azim Premji) – have spoken out calling for an accelerated programme of vaccinations aided by the private sector.

While Shetty wrote in The Times of India last week that 500 million Indians can be vaccinated in just one month by pooling the resources of the public and private sectors, Premji put the time horizon to achieve the same numbers in two months.

The time horizon isn’t the problem; the government’s vacillation on it is. The Union Health Ministry made plans – no doubt in consultations with all stakeholders – that it will first vaccinate healthcare workers, then frontline workers and then those above the age of 50, especially those with comorbidities.

But three facts have changed in the meanwhile.

Fact one, thanks to unnecessary propaganda against the CoviShield and Covaxin vaccines, the first two stages are running far behind schedule.

Fact two, and more important, events have overtaken us. Between the time the old vaccination schedule was drafted in early January and now, Covid has made a comeback, first in Kerala and now in Maharashtra.

India’s active cases have now crossed 150,000 again, driven by Maharashtra this time.

In a couple of days, the state will have the dubious distinction of reclaiming the Covid crown after losing it to Kerala for a few weeks. Its active cases stood at 54,149 on Sunday, 21 February, versus Kerala’s (falling) count of 58,593.

India’s cumulative case load of 11 million Covid cases is now roughly equal to the amount of 10.65 million vaccine recipients. This tells us how slow the vaccination drive is proceeding under the centralised control of the Union Health Ministry.

But thanks to the rise in active cases, the first fact – of low response to vaccination calls – is reversing. On Saturday (20 February), Maharashtra fulfilled 133 per cent of its day’s vaccination target, and it is likely that more people will now shed their fear of the vaccine.

Fact three is that fact two has neutralised the propaganda against the vaccine and, from now on, there may be no general reluctance to get vaccinated.

Given facts two and three, it is common sense for the government to now quickly rework its strategy for roping in private sector institutions and also start commercial vaccinations (subject to rational price ceilings). The induction of priced vaccinations and private healthcare agencies and hospitals has to be fast-forwarded.

This is how it can be done, and also partially funded.

One, while all government institutions will offer free vaccines, private hospitals and companies should be able to buy the vaccines for a reasonable price in bulk. They only need to follow the protocols and reporting procedures to start vaccinating people. If this can be done with testing and tracing, why not vaccinations?

Two, CSR (corporate social responsibility) funds can, and should, be used to enable profitable companies to vaccinate the poor in and around their own workplaces for free, apart from contributing to state-led vaccination funds that can be created through corporate and private contributions that are tax-exempt.

Three, we also need to fast-track more vaccines now seeking emergency approvals (the Russian Sputnik, for one, and many other domestically created vaccines that will enter phase three trials) so that supplies do not fall short as we head for the 500 million target by May-June.

Additionally, other vaccine candidates, including Pfizer’s and Moderna’s, can be given approval in the same way Bharat Biotech’s Covaxin was – in clinical trial. These vaccines may not be easily available, and the logistics involved may be tougher (they need to be kept in ultra-cold storages), but why not let the rich give themselves these vaccines at high prices (say, Rs 5,000 a dose), where the excess over costs can be used to fund free vaccines for some of the rest?

Four, as an additional incentive to provide a safety net for those adversely affected by the mass vaccination programme – unexpected deaths or cases that need hospitalisation – the state can provide compensation through cash and free insurance covers.

India’s new Covid wave should be stopped in its tracks before it ruins livelihoods once more. Already, Maharashtra is imposing limited lockdowns, but if this spreads to commercial cities like Mumbai, Thane and Pune, we can kiss goodbye to the V-shaped economic recovery we are banking on.

The earlier logic of expanding the vaccination drive in a slow and steady manner was that Covid was anyway shrinking, and so not all people may need to be vaccinated at high cost to the exchequer in double-quick time. But the facts have changed, and India cannot afford another livelihood killer in the name of a strategy evolved centrally.

Last year, the migrant crisis blew up into a humanitarian crisis precisely because the plans of government babus – to keep migrants where they were to prevent them from carrying diseases to their villages – did not anticipate an exodus on foot. Babudom took more than a month to revise plans to take them home once the facts changed.

We cannot allow the best laid plans of babus, mice and men to constrain our fight to roll out the vaccine faster than we had earlier thought was needed. We have to induct the private sector, and also start pricing the vaccine for those who can afford it.

Harsh Vardhanji, please get a move on. You have all the data on efficacy and safety from the 10 million people who have already been vaccinated. Delay will cost us more than quick decisions.