Stock-outs & silver linings

It’s feels like being trapped in the theatre of the absurd to see the country slide from having Covid-19 vaccines and not enough people to vaccinate — to not having enough vaccines, in just days.

And the finger-pointing has begun between government talking heads and industry; Centre and States, on taking responsibility for a situation that should never have been.

India is recognised as a pharmacy to the world. And with Covid-19, the country could have more than owned this space by playing its critical part as a vaccine-hub, as well.

Worrying signs

Instead, there are reports of failed contracts and legal notices, closed vaccine centres and, worryingly, the familiar anxiety among patient families to get medicines like Remdesivir. Stock-outs at State or hospital-levels is unacceptable, especially when a handful of local companies make this drug.

A different scenario unravels globally, where governments are realising the folly in letting their manufacturing bases go to seed. A costly decision when it comes to health. A country’s health security lies in its ability to whip-up vaccines and medicines and not be left to the vagaries of market forces, contracts and intellectual property.

India had this advantage by holding onto its manufacturing expertise. In 2010, concerns had been flagged on health security when six drugmakers (in a span of five years) sold their domestic businesses, entirely or in part, to foreign companies. The government then introduced a sluice gate to prevent the free flow of domestic manufacturing entirely into foreign hands.

Some saw this as protectionist, and some local entrepreneurs too said, it was their business decision to make on selling their operations or bring in fresh funds.

But that aside, India retained some of its manufacturing abilities, a feature getting recognised and utilised by others for their Covid-19 vaccines. Russia’s sovereign wealth fund RDIF has production tie-ups in India with six companies involving its vaccine Sputnik V, for local trials and production, as the case may be. More are in the pipeline.

Johnson and Johnson has a tie-up with Biological E, and Serum Institute has alliances with AstraZeneca-Oxford University, Novavax and Codagenix. And the UK government has a “fill finish” line at Wockhardt’s Wrexham facility, dedicated to supply them up to August 2022.

All this is excellent for Indian companies in a globalised world. The curious question is, why similar investment and procurement commitments were not made and announced in India as well, way back in mid-2020?

The government has at its disposal think-tanks, forecasters, market and scientific intelligence, public health workers, advocacy groups and data. There should have been a network in place to comfortably source medical products for India and others, and at the best prices.

Similar situations were seen in the case of personal protective kits and ventilators, where local players upped their game when it was required. But it was not till well into the pandemic, that their benefits were realised.

PSUs’ role

And that brings us to the core of health security — the critical role that public sector units (PSUs) could have played in making much of this available, at nominal prices. Instead, many health-related PSUs face uncertainties, and the country now relies almost entirely on the business acumen of the private sector, blaming them for falling short.

This pandemic is taking its toll on people and the health infrastructure. But it’s not the last one. In time for the next, the country needs to grab a silver lining from the dark cloud and build a network of independent, public, research and manufacturing capacities to anchor and secure the country’s health, along with the private sector.

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