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Times Face-off: Was it the government’s decision to split the purchase of vaccines between the public and private sectors? | India News

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India is fighting a vaccine crisis as the country reels under the second wave of the pandemic. Was governmentWhat is the decision to divide the purchase of vaccines between the public and private sectors?
By: Shobana Kamineni
The focus should be on fixing the vaccine supply rather than creating a divide between the public and private sectors.
‘No one is safe until everyone is safe’ has been a key lesson from this pandemic, and as we fight this deadly second wave of Covid-19 in India, it is vital for us to vaccinate as many of our adult population as possible. , and do it quickly and safely.
Now is not the time to create a division or division between the private and the public, when, in fact, an inclusive method that involves as many healthcare providers as possible would help us make the most ambitious vaccination campaign in the world. have success. Although it started as a narrowly centralized affair, the government recently opened its inoculation campaign for the 18-45 age group in private facilities with the aim of accelerating the vaccination rate, allowing a possible plateau of the spread of infection whenever it is possible to flatten the curve. . This is a welcome move, as India’s infection rates have exceeded 400,000. The healthcare industry has stood by the government and continues to offer its unwavering support in these difficult times. I would like to highlight some strategic ways in which the industry seeks to support the government to help with vaccines, as well as to supply various essential intensive care drugs and devices.
Allowing the industry to source vaccines domestically and abroad helps create an enabling environment as the number of vaccines in circulation will increase. However, no foreign vaccine manufacturer will start selling here unless the government takes up the issue of compensation that protects them from potential lawsuits related to adverse events. This is currently only resolved for Indian vaccine companies. So, in theory, we can access vaccines, but the reality is more difficult. Under the Open General License (OGL), hospitals can now import, but it’s definitely a tall order for an industry overwhelmed by fighting the pandemic.
Some of the challenges on the ground that we experience include, for example, the supply of vaccines, while openly permitted, is still under the control of the Ministry of Health and the DGAC. This is counterproductive. The 20,000 private hospitals that were administering vaccines are totally out of supply today. This strict control must be streamlined, especially since there are more than 10 million Indians who need a second dose. Currently, the few private doses given to them are being prioritized, leaving those in the 18-45 age group with little opportunity to get vaccinated.
The healthcare industry has taken several steps to improve vaccination coverage across the country. Since the government has allowed companies to carry out vaccination in their facilities as long as there are more than 100 beneficiaries and has also placed spending on this for non-employed beneficiaries under CSR rules, many companies have already obtained the necessary permits to open vaccination centers in partnership with surrounding providers. Additionally, the healthcare industry is continually encouraged to expand its vaccination campaign to a greater number of members of the surrounding community.
Industry can also expand government efforts toward this vaccination campaign by providing mobile vans in rural settings for vaccination and testing. Mobile centers allow us to serve a larger population that is widely dispersed. With the provision of mobile centers, you will push communities to get vaccinated by limiting your travel distance and alleviating any mobility problems that may arise, while also relieving established medical providers in rural communities.
To further increase our outreach and efforts, the healthcare industry recommends allowing walk-in vaccinations even among the youngest eligible cohort, as CoWIN may not be available to those living in low-network areas.
The industry has complemented and complemented the government’s efforts by providing various recommendations since the formation of the National Group of Experts on Vaccine Administration (NEGVAC) and in a timely manner to ensure that the lives and livelihoods of the population are protected.
Mass communication campaigns in various media have been spread as widely as possible with the message that everyone should get vaccinated when they can, as well as continue to strictly adhere to appropriate Covid-19 behavior and also encouraged to adhere to very strict safety protocols in the store floor.
It is time to stop examining whether vaccination is a private sector or a public responsibility; It is time to stop arguing about prices and pressuring manufacturers to deliver vaccines to both governments and the private sector. There is also no need to worry about the private sector killing off all vaccines because even with the best efforts, the private sector will vaccinate no more than 20%, which is a whopping 150 million people, but only 20% of those. who are eligible. If the world can come together and relax patents for Covid vaccines so quickly, we should be able to break down all barriers and make sure we get a billion more vaccines and jab Indians quickly and safely. This is our only hope.
(The author is the Executive Vice President of Apollo Hospitals)
Against: Dr. T Sundararaman
Revised policy allows vaccine manufacturers to benefit while increasing burden on states
There would have been nothing wrong with involving the private sector in vaccine delivery if achieving universal vaccination was faster, more efficient, and more affordable for the individual and the government. There is immense capacity in the private health sector, and any government that is serious about universal vaccination must take advantage of this.
The previous policy announced on February 28, 2021 seemed to understand this. Vaccination at government facilities was free for all “eligible persons”, and at private facilities it was available at Rs 250 per dose. Eligibility was healthcare workers, frontline workers, and those over 60, which later expanded to the 45-60 age group. It was expected that as the vaccine supply increased, more population groups would be eligible. The crux of this policy was that all purchases and allocations belonged to the central government. The prices set were reasonable and, according to the public admission of India’s leading vaccine manufacturer, provided a reasonable profit.
One might have asked why even this Rs 250 was necessary. But at this rate, the total cost of universal free vaccination would have been just Rs 32,500 crore, a mere 0.3% of GDP. All of this had already been budgeted for and would coincide with political promises to provide free vaccination to all. Most countries have made vaccination universal and free. Private hospitals could have been reimbursed at this rate, rather than charged to the patient. But perhaps the government hoped to make modest cost recovery from those who could afford it and create an audit trail to track the performance of the private sector.
The private sector may not have been very enthusiastic about this policy, but it was not reluctant either. And this increased the space for the public sector to focus on reaching the most vulnerable where the demand for vaccination could be low, while the private sector will take care of the beneficiary without an appointment. In this approach, the private sector is an additional technical capacity contracted for the delivery of vaccines in a universal and free publicly administered vaccination program.
But surprisingly, on April 21, when the pandemic was at its peak, the government announced a revised policy. In this, 50% of the vaccines manufactured for India will be sold to the central government. The other 50% would be sold on the open market, with state governments and private hospitals competing for it. This is not really market competition, because the two manufacturers can set their own prices.
Furthermore, they can do so without the intervention of the National Pharmaceutical Product Pricing Authority, which is mandated to set prices for essential drugs and vaccines. Private hospitals can also import vaccines at prices they negotiate and deliver them at prices they determine. Today, there is a huge black market for beds, ambulance services, drugs, and oxygen cylinders. Rather than act against this, the government appears to have gone out of its way to create the conditions for such a market to emerge in vaccines as well.
This policy change was projected as necessary to include the 18-45 age group. The requirement to include this age group is justified if it helps to prioritize many vulnerable occupational categories whose protection is required by both common sense and the imperative of equity. Examples would include sanitation workers, vegetable and fish vendors, transport workers, postal services, etc. But such prioritization is not apparent, except in Chhattisgarh. Instead, the policy restricts access to those arriving via the CoWin digital platform with vaccines for this age group available only in the private sector, unless states choose to fund it. The rates that the Serum Institute of India has announced for sales to the private sector are higher than those at which the same vaccine is sold in Western markets. Bharat Biotech’s fees are even higher. This, despite the fact that there has been liberal public funding in the innovation and expansion of the manufacture of these vaccines.
This policy, as indicated by a request for intervention in the Supreme Court, goes against the universal vaccination policy and the spirit of cooperative federalism, against the policy of drug price control. By implicitly withdrawing from the goals of universal vaccination, it denies the right to health and puts the health of the entire population at risk from future pandemics. Free vaccines would be available only in the public sector and the volume of such vaccination would be limited by central allocations – for which, as of now, there are no transparent policies – and the ability of states to shoulder the excessive financial burden. There is no reason to believe that this policy would lead to increased vaccine manufacturing.
The above policy could have been developed as a path to universal vaccination, where both the public and private sectors contribute. This policy appears to be aimed at allowing the private sector to seek higher profits in the manufacture and delivery of vaccines while restricting the obligation of universal vaccination to the poor and highly abused public sector.
(The writer is the Global Coordinator People’s Health Movement-India / Jan Swasthya Abhiyan)

Times of India

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