Covid-19: what you need to know today
Not much information is available on India’s Covid-19 vaccine game plan. We know – HT’s Saubhadra Chatterji broke that story – that there is a vaccine committee. We also know that this committee is talking to various vaccine developers. And we know that states have been asked to prepare a list of people who should be given priority to receive a vaccine. However, there are several unanswered questions.
The chairman of Infosys and former director of the Unique Identification Authority of India (UIDAI), Nandan M Nilekani, wrote a two-part article detailing how he thinks India should do it, but again, it is not known if the government is thinking in that sense. or if those responsible have read Nilekani’s article. I’m not sure (and this is based on my own interactions) that these people are as knowledgeable about the pandemic as they should be. A long career in India’s sprawling and bureaucratic healthcare system, or a medical degree of some sort, doesn’t matter as much as an open mind, the ability to read and understand the current literature on Covid and then synthesize what that means in India. context. The United States has Dr. Anthony Fauci; we have a man who thinks flu and Covid viruses are in the same family. It is the reason I recommended, Dispatch 108, titled One Million and One Manifesto, on July 18, shortly after India crossed the million cases mark, that the country appoint a Covid Commissioner. But I digress.
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There are four aspects involved in vaccinating a population.
The first involves identifying and purchasing a vaccine. Sure, if you’re a country like the United States, you can launch a program like Warp Speed, funneling billions of dollars to companies that develop vaccines; But even otherwise, it makes sense to secure supply through agreements, private bilateral trade agreements with companies that develop the vaccines. The UK and the EU have such agreements. Like many other countries. India does not, and relies heavily on vaccines from a WHO initiative, Covax, but not all vaccine developers are part of this equitable access platform; Pfizer, for example, is not (and its vaccine will likely be the first available). India should actively pursue bilateral agreements and use as a cover, as many other countries plan, the vaccine doses for which it will be eligible under Covax. The next few years will be about vaccine stocks; most initial vaccines can be two shots; people may need an annual vaccination, and India should be serious about building its own.
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The second involves financing. India needs to find out who is eligible for a free vaccine and who pays. The easiest but most expensive option is to cover the costs of vaccination for the entire population, something that could cost tens of billions of dollars. And at least for the first few years (I’m not sure anyone has thought of this), until a lifetime protection vaccine is developed, this staggering amount of money may have to be spent annually. The government could also consider providing the vaccine for free only to people who need it (for example, those covered by the Public Distribution System) and having others pay for it.
The third has to do with distribution. Here, the government should do the smart thing and draw on the experience of those who do it best: companies in the consumer products business such as ITC, Hindustan Unilever Ltd, Parle, the Gujarat Milk Marketing Cooperative Federation and others. These companies are dedicated to ensuring that their products are available in remote corners of the country. Some are even dedicated to perishable products and others to products that require refrigeration.
The last involves management. This is perhaps the most complex part of the exercise, but also the one in which India has a very good staff: the general elections, even the voting booths in the neighborhoods. Just as government employees, usually school teachers, are recruited to fill the voting booths, health workers from government and private hospitals must be asked to man the vaccination booths. National elections, held in phases, in just a month and a half, provide the perfect model for a national vaccination campaign. People know what their positions are; go there, present some identification (even a phone number will do, or a name and fingerprint in the extreme case of someone who has no ID), get vaccinated, get a receipt to that effect, and perhaps one of those indelible-marks of ink on a finger.