Vaccination drive: Liberalisation and decontrol are the need of the hour

As India battles a destructive second wave of the Covid-19, a lot of questions have been raised about the country’s vaccination programme and its limited reach so far.

Ever since it opened its vaccination drive, India has managed to vaccinate an estimated 13 per cent of its population. In contrast, several countries around the world recognised timely, the need for accelerated vaccination and went all out to inoculate their populations. Israel has vaccinated over 58 per cent of its population, UK has achieved more than 30 per cent coverage while the US has provided Covid jabs to over 45 per cent.

Economic benefits too

Not only do fast vaccination programmes reduce death and severe disease, they also save countries the economic blues of lockdowns and lost livelihoods. Not to forget the high financial costs of treating severely ill patients. Clearly, investing heavily in a fast-tracked vaccination programme has health as well as economic benefits.

As of May 15, 2021, about 3,673,802 people had been affected by the deadly virus in India. Even as the threat of an impending third wave appears possible, vaccinating a large part of the population and doing it fast is the only way out of this pandemic. India currently stands well behind the target of vaccinating 60-70 per cent of its population that could usher in herd immunity and restore normalcy.

Given India’s large population, the effort is going to be humongous and will need a multi-pronged approach of ensuring adequate vaccine supply together with harnessing of all medical infrastructure including hospitals, clinics, doctors, nurses, paramedics and its wide network of ASHA workers.

Importantly, India needs to put in place a truly liberalised and decontrolled inoculation strategy while fast-tracking approvals for other globally-approved vaccines and procuring all available supply from the global market rather than wait for the Indian manufacturers to fulfill the colossal demand.

The way forward

India needs to move quickly to leverage existing capacities and harness multiple new channels of vaccine procurement from across the world. Simultaneously, the country needs to significantly augment its capacity to dispense the vaccines and leverage its entire infrastructure of hospitals and healthcare workers. Buying must also be calibrated in tandem with capability to dispense.

The lack of urgency shown by the government in placing orders for vaccines when Covid cases reached a trough has been a glaring policy miscalculation. This must be remedied quickly.

Here is how the government can accelerate vaccine procurement and the immunization drive:

* The government must move fast to procure vaccines because time is of the essence and further delays can prove costlier.

* Time has come for the initiation of a monthly schedule of vaccination by both Centre and State governments. This will be vital to monitor the progress of vaccination across geographies. It will also help in evaluating various bottlenecks in the vaccine delivery process in a timely manner. With such system in place, the governments would become more responsible for the proper and timely resolution of the related issues.

* In addition, there is need for introduction of complete transparency in the dose allocation to States to ensure greater trust and coordination.

* Given the vaccine shortages being reported across the country, there is a need to identify high-risk populations, including potential spreader groups and mobile populations and inoculate them in an intensified campaign mode.

* It is not unknown that a large portion of the Indian population is mostly unaware about the government flagship schemes. Hence, it is required to actively engage local governments, health workers, and community, political as well as religious leaders to help in identifying and vaccinating the vulnerable segment.

* Despite multiple vaccines being approved and in use globally, India has so far been using only two domestically manufactured vaccines — Covishield and Covaxin. Only recently has the Russian jab Sputnik V been given emergency use approval. This approach of complete domestic dependence needs to be jettisoned. We need to liberalise the import of vaccines, provide expedited regulatory approvals to vaccines proven elsewhere and throw the market open for them.

* It is equally important to mobilise all available capacity domestically. This includes direct manufacture as well as in-licensing and out-licensing of domestic vaccines such as Covaxin and others in the pipeline. Contract manufacturing and buy back to high quality capable units within and outside the country, must also be considered. This may be done to units in Bangladesh, Vietnam, Thailand, Indonesia, Sri Lanka and Ireland.

* All decks should also be cleared for in-country ramp up of factories where possible. For instance, HLL Biotech’s 100-acre integrated vaccine facility at Chengalpattu that is presently lying idle, can be revamped urgently and offered to private enterprises on a PPP basis.

* Clearing the obstacles to fast-track local manufacturing by enabling fast movement of raw material, distribution and logistics is another critical policy need. This includes allowing private participation in logistics, distribution and delivery.

* Given that over control creates bottlenecks in distribution as well as affordability, it is also recommended to provide leeway and flexibility in pricing through a route of price discovery.

* Considering the reports coming in about the new variants, it is important to proactively engage in extensive research and development of new vaccines. Also we must be prepared for quick and comprehensive vaccination rollout to curb the spread at a mass level.

* Lastly, strict enforcement of appropriate social distancing behaviour, preventing large gatherings, increasing facilities for testing, and tracking the spread of the virus by targeted data sharing is extremely important to prevent future waves.

Make no mistake, if India needs to emerge from the pandemic and escape a potentially deadly third wave, it must inoculate at least 60 per cent of its population by the end of this year. This will not be possible without harnessing all possible options in upscaling local production and starting a major import initiative.

The writer is President, Council for Healthcare and Pharma; Founder- REVA Pharma

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