By Chandrakant Lahariya
India has four decades of experience in running a national immunisation programme for children and pregnant women. It has successfully conducted large-scale mass vaccination drives for many years for polio elimination. Therefore, there was every reason to believe it could deliver Covid-19 vaccines efficiently; however, the ongoing drive in India is faltering (and even that is an understatement).
The initial challenge of vaccine hesitancy was soon replaced by that of short supply (from early April onwards); with the opening of Covid-19 vaccination for all adults in the 18-44 age group, everyone, including those above 45 years, is finding it difficult to get vaccinated. The daily vaccination rate has come down to around two million doses, nearly half the vaccination rate at its peak in April.
A successful vaccination drive is the outcome of assured supply, simplified policies and an adaptive delivery approach. All countries across the world first secured vaccine supply and then opened up the vaccination in a graded manner for various population groups. The United States, the United Kingdom and the European Union started to secure supplies by the middle of 2020.
India seems to have erred at many steps in this process. It placed the first order with vaccine manufacturers, just a few days before the launch of the vaccination drive on January 16. Nearly 940 million people are eligible for vaccination and the current total vaccine production in India is 70-80 million doses a month. A few weeks ago, the Centre placed fresh orders for a total of 160 million doses for May, June and July, which will be used for the 45-plus age group.
Can India be assured of increase in vaccine supply by July 2021? It is unlikely to be to the extent of 150 million doses a month as is being suggested. A large manufacturer in India planned to have a monthly production capacity of 100 million doses by January, a timeline which has now been shifted to July. After all, vaccine manufacturing and scaling up are complex processes and an ambitious timeline does not always work. The situation of other manufacturers is likely to be similar. The contribution of vaccine imports will be marginal to the overall supply for India.
All policy options and delivery strategies should be re-examined and simplified.
The increase in the gap between the two doses of Covishield, announced last week, and which was being suggested by many for months, is one such. There are others. Which population group can be safely asked to wait for their vaccine shots? Can vaccination for any age group (18-30 years) be put on hold till assured supply? Some of these are controversial questions – but they need to be addressed.
For six weeks now, India’s vaccination drive has been struggling. How long must one wait before acknowledging that what was planned is not working? It is often said that Indian policymakers have mastered the art of drafting policies, which, while being perfect on paper, are poorly implemented on the ground. India’s Covid-19 vaccination efforts have areas for improvement, both in policy and implementation. The government should do all that is needed to make it work, here and now.
(The opinion piece appeared in The Hindustan Times)