Releasing the Bharatiya Janta Party's election manifesto for the upcoming Bihar state elections, Finance Minister Nirmala Sitharaman on October 22 promised that every citizen of Bihar would receive the COVID-19 vaccine for free once the BJP is elected in the northern state.
Bihar has the twelfth highest cases in the country. After seeing a surge in early August, the state has been reporting between 700-1700 cases daily.
At a time when India has recorded over 7.7 million cases of COVID-19 and has three vaccine candidates at different stages of clinical trials and several others awaiting approval, Sitharaman's statement came under fire from activists, opposition and social media users who accused her of politicising an essential need. Moreover, the Ministry of Health and Family Welfare has repeatedly stated that the vaccine will be distributed on the basis of priority. The Ministry is still chalking a COVID-19 vaccine prioritisation strategy.
Rahul Gandhi took to Twitter to jest about India's COVID-19 vaccine distribution strategy on the backdrop of this announcement.
Activist Saket Gokhale even filed a complaint with the Election Commission of India stating that the BJP was creating an aura of falsehood and misleading the people.
BJP IT cell chief Amit Malviya jumped to the defense of the Finance Minister by stating that the vaccination just like public health is a State subject and the prices of the vaccine would be decided by every state.
Meanwhile, Tamil Nadu Chief Minister Palaniswami stated that citizens of Tamil Nadu will receive the vaccine for free. In Madhya Pradesh, Chief Minister Shivraj Chouhan has promised free vaccines for the poor in his state.
Will Every Citizen of Bihar, Madhya Pradesh And Tamil Nadu Receive The COVID-19 Vaccine?
The vaccines are still at the preliminary stages of trials and their safety and efficacy data still needs to be study and ascertained.
Even if a vaccine is approved by the end of 2020, the central government has to first work on improving its infrastructure to adapt to the needs of the vaccine. India currently has 29,000 cold storage machines as a part of its Universal Immunisation Programme which includes 12 vaccines for children, said Rajesh Bhushan, Health Secretary at a press conference on October 20. These will be utilised for the distribution of the COVID-19 vaccine once approved while the government is also working to build its capacity.
Moreover, the vaccine will be distributed on the basis of priority. Bhushan also added that the National Expert Group on Vaccine Administration for COVID-19 headed by NITI Aayog member Dr. V.K.Paul is formulating a strategy for prioritisation as well as vaccine distribution. Responding to a question of about 30 crore priority members identified by the ministry, Bhushan said "We have come up with a draft prioritisation plan and are also matching it with the number of doses that would become available tentatively from January to July. We think that if the present trials proceed according to plan and succeed, then the number of doses that would be available in the aforementioned period would be sufficient to immunise the priority list persons that we are working on."
On October 11 in his Sunday Samvaad, Health Minister Harsh Vardhan stated that the Bharat Biotech and Serum Institute of India vaccines need to be administered in two doses while the Zydus Vaccine needs to be administered in three doses. Earlier on October 4, he also stated that the government plans to vaccinate over 20-25 crore people through 40-50 crore doses on priority by July 2021. This means that not every citizen will receive the COVID-19 vaccine at the same time.
Each state has been provided a format to create its priority list which focuses on frontline health workers. These include government and private sector doctors, nurses, paramedics, sanitary staff, ASHA workers, surveillance and field officers responsible for tracing, testing, and treating. People belonging to the old age bracket who are more vulnerable as well as people with co-morbidities will be given preference in the priority lists.
The Health Minister has time and again asserted that the vaccine distribution will occur on the basis of prioritisation and in a phased programmed manner to avoid any scope of black marketing in the process. Such a prioritisation does not define any state or region of the country.
Will The Vaccine Be Distributed For Free?
As Malviya stated, the pricing of the vaccine will be the prerogative of the respective states. However, under its Universal Immunisation Programme, India has a roster of vaccines that are administered for free to children.
BOOM spoke to Dr. Gagandeep Kang, former member of the dismantled ICMR R&D task force and virologist at Christian Medical College, CMC Vellore to understand the prioritisation mechanism and promising the vaccine for free for citizens.
"Everyone in the country should get safe and effective vaccines that are recommended by and provided by the government, for free. A prioritisation framework is essential to ensure that those most at risk of occupational exposure (such as frontline Healthcare staff) and severe disease (such as the elderly and those with co-morbidities) get the vaccine first, then immunisation of others can follow," said Dr. Kang.
India has, however, not discussed its strategy for pricing and providing immunisation for free, yet. The Health Ministry has hinted at using the UIP and Mission Indradhanush scheme as a possible route for vaccine distribution but has not shared its strategy so far.
India as a low-middle income country will reap the benefits of the ACT Accelerator and COVAX- a coalition of the World Health Organisation, Global Alliance for Vaccines and Immunisation and Coalition for Epidemic Preparedness through its equitable distributions of vaccines. Serum Institute of India which is manufacturing the Oxford, AstraZeneca vaccine has been funded by the Bill and Melinda Gates Foundation to produce 200 million doses under this scheme.
Adar Poonawala, CEO of SII, on September 26 questioned whether the Indian Government was willing to shell out around ₹80,000 crore for the COVID-19 vaccine. In response, on September 30, Rajesh Bhushan disputed the costs calculated by Poonawala. Though he did not state the exact amount calculated by the Ministry, Bhushan said that the National Committee was mulling over the costs. The Oxford vaccine is priced at $2-$3 as decided by the vaccine manufacturers along with the distributors to ensure equitable access of the vaccine at affordable prices.
On October 30, Bhushan mentioned that the Ministry is looking forward to work with the private sector for the distribution of the COVID-19 vaccine once it is deemed safe to be used and elicits an immune response. However, whether the public sector alone will purchase the vaccine and distribute it or even allow the private healthcare players to acquire the vaccine is still unclear.
According to information accessed by sources, Bloomberg reported that India has sanctioned around ₹ 51,000 crore for vaccines. This amount has been provisioned for the period ending on March 31. Sources quoted by Bloomberg also stated that India would shell out more funds if required.