A retired JNU professor who could not get a hospital bed or an oxygen concentrator in Delhi died of Covid-19 at home. Many such heart rending cases in different parts of the country have been reported in the media. The Judiciary had to pull up the Executive to gear up the machinery to procure and distribute Covid related material and medicines.

With the government floundering, many NGOs, civil society groups and people stepped in to give succour to the hapless victims.

After the first wave peaked in September 2020, coronavirus cases started increasing again from the first week of March, 2021. Health experts had predicted the possibility of the second wave. In fact, the Institute for Health Metrics and Evaluation at the University of Washington has been continuously estimating and updating the impact of Covid-19 since March 2020 and projected the total number of fatalities in India at one million by July 1, 2021.

The first wave had exposed the utter inadequacy of health infrastructure and health services in the country. Instead of preparing for such an eventuality Prime Minister Narendra Modi boasted: “We not only solved our problem but also helped the world to fight the pandemic”.

A general sense of complacency as well as the recent Assembly elections led to the catastrophic handling of the second wave of the pandemic. The government had six months, from the September 2020 peak to the start of the second wave in early April, to strengthen the healthcare system and push the vaccination drive.

Health experts stressed that the only way to win the fight against Covid is by rapidly vaccinating at least 80 per cent of the country’s population to create herd immunity. Its importance cannot be overemphasised especially in the context of the virus’ spread in rural India which is beset with rickety healthcare infrastructure. This is already borne out in some of the rural areas of UP and Bihar.

Fortunately scientists succeeded in developing several vaccines in a record time. Pune-based Serum Institute of India partnered with the University of Oxford and AstraZeneca and expanded its manufacturing capacity even before drug regulator’s approval of Covishield vaccine.

Bharat Biotech in collaboration with the Indian Council of Medical Research-National Institute of Virology indigenously developed Covaxin. In addition, Hyderabad -based Dr Reddy’s Laboratories will begin production of Russia’s Sputnik V by August 2021 and till then it would market the vaccine, of which two batches have already arrived. There are also Pfizer and Moderna vaccines which could be imported.

Shambolic policy

The government’s vaccine policy is in shambles. The vaccination drive started on January 16, 2021 and till May 21, 2021 only 19.23 crore doses had been administered, which is around 16 lakh doses per day. It is not that the country lacked the capacity to administer vaccines. On April 2, India administered 42.65 lakh vaccines while in six consecutive days till May 21, it did less than 20 lakh on an average. It is the supply crunch which is responsible for this slump.

Chaos in the vaccination drive worsened after it was opened up for the 18-44 age group without assessing the supply situation of vaccines. There are long queues of vaccine seekers while vaccine centres do not have adequate stock of vaccines. Due to vaccine shortage, many vaccine centres had to be closed and many States delayed the jab for the 18-44 years group.

The disarray in the government’s vaccine policy can be seen in other areas as well. First, of the total supply, 50 per cent is earmarked for the Centre while the balance is to be shared equally between the States and the private sector. Again, a discriminatory price regime requiring the States to pay double the price that the Centre would pay has placed much larger burden on the already stressed finances of the States. What is more, on April 17, the Centre allowed States to procure vaccines on their own. Does this not amount to the Centre shirking its responsibility to procure vaccines despite being better placed than the States to operate effectively in the international market?

This leads to a larger question in Centre-State relations. The Covid-19 pandemic is a national crisis, where the Centre has to take primary responsibility in dealing with it. Of course, public health being a State subject, States too have an important role to play. Also the right to life is a Constitutionally guaranteed right.

According to official statistics, close to three lakh people have lost their lives to Covid between March 2020 and May 23, 2021. If some assessments, which put the actual toll to be at least four times the official figures, are to be believed, then the death toll has already crossed the million mark.

To minimise further casualties as also to avert the possible third wave, the pace of vaccination has to be increased on a war footing. With its huge positive externality, vaccination is a public good which should be provided free. With nine State taxes being merged in GST, the States are left with limited tax capacity to mobilise the revenue.

On the other hand, the Centre with access to far larger resources including unlimited borrowing power, money creation and foreign resources should easily be able to mobilise the required resources for providing free vaccination. In any case the cost of vaccinating the population above 18 years does not seem to be very high. An estimate puts the cost at ₹671 billion accounting for just 0.36 per cent of GDP.

To conclude, both the Centre and States must shake off their complacency, crank up the government machinery to administer vaccination at a rapid pace, facilitate vaccine producers to ramp up their production and procure vaccines from international market to meet the country’s requirement.

After all, creating herd immunity through rapid vaccination seems to be the only answer to this catastrophic pandemic.

Sarma is Distinguished Professor at CSD, New Delhi, and Sunder is working with a leading Indian corporate. Views expressed are personal

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