Of Vaccine Crisis & India’s messed up policy

A botched up vaccine policy is something every Indian is affected by in the current testing times of the pandemic. From not getting slots on the COWIN app to technical issues with registration along with the confusion that the Government of India is creating with new rules every week, it seems like the Centre has a lot of explanation to do other than PM’s monologue or Mann Ki Baat.
Here’s a bit of context before we get into the details — The National Expert Group on Vaccine Administration for COVID-19 in 2020 announced that the Centre was taking full control and advised states “not to chart separate pathways of procurement”. 
Then, in April 2021, faced with a huge spike in cases, vaccine shortages was reported from around the country along with mismanagement of the pandemic. During the mess of April & May, the Centre introduced a confusing new strategy that no other major nation is following: it put the onus of vaccinating the 600 million Indians in the 18-44 age group, entirely on the states and private hospitals.
The results of this so-called “liberalised and accelerated” vaccine strategy, which came into effect on May 1, 2021, has not been encouraging. Vaccination rate, ever since, has fallen steadily nearly every week since early April. 
Worse, the Government of India also brought out a press release clearly giving out lies to people — Claiming that “no country in the world is giving vaccines to children, and some questionable arguments. The most stark claim of the Centre was to state that the Central Government is doing all the heavy-lifting, from funding vaccine manufacturers to giving them quick approvals to ramping up production to bringing foreign vaccines to India.
But, what really happened was the Centre merely enabled states to try procuring vaccines on their own, on their explicit requests. The states very well knew the production capacity in the country and what the difficulties are in procuring vaccines directly from abroad. 
But states, by then, did not even achieve good coverage of healthcare workers and frontline workers in 3 months but wanted to open up the process of vaccination. Moreover, they demanded more decentralisation. 
Despite Health being a state subject, the Centre made it look like the liberalised vaccine policy was a result of the constant requests being made by the states to give states more power. Additionally, how it made the vaccine policy appear is by showing Indians that the Centre is doing Indians a favour by carrying out the “heavy lifting” on vaccines and providing them for free. 
In fact, around the most, countries have chosen to vaccinate their population for free, unlike in India. But, if you go back to the 2020 elections in Bihar and other states, the Centre had itself promised free vaccines. But, it went back on its promise once it came out with its Vaccine Policy. 
Interestingly, in the most recent appearance on TV, PM again clarified the changes in the vaccine policy. Earlier, the centre’s policy on vaccines for those between 18 to 44 years were supposed to be paid for. This angered the Supreme Court which criticised the Modi Government for being irrational and asked why the Centre couldn’t use its Rs. 35,000 crore budget for vaccine to inoculate this group. Additionally, after making the states fight for vaccine procurement, the PM announced that the Centre will now procure vaccines and supply them to states for free. 
What should have been done at the beginning of the year as a vaccine policy is still being modified based on the whims and fancies of the government, based on its convenience and politics with states rather than a well thought-out people-friendly policy. While we have the Supreme Court and state High Courts to thank for at least putting some sense into the government in this health crisis we are in, it also shows Indians why planning and effective response is required in such dire circumstances. 
What we need now is: 
1) Strategic monthly planning — Both Centre and states must initiate specific monthly schedules for vaccination. This will help in monitoring the progress of vaccination across geographies and evaluating bottlenecks in the vaccine delivery process in a timely manner. Such a system will also make governments responsible for the proper and timely resolution of issues. Complete transparency must be introduced in the allocation to states to ensure greater trust and coordination. 
2) Targeted vaccination campaigns and Risk communication — Given the vaccine shortages that have been reported across the country, the high-risk populations as well as potential super-spreader groups among the active and mobile populations need to be actively identified and inoculated in an intensified campaign mode. India has a history of having a substantial proportion of the population remaining unaware of even the flagship schemes of the government. 
3) Countering the gender and income divide —  There is a national gender gap of four percent, in favour of males, in India’s COVID-19 vaccination programme. Current data shows that only four states have a higher female-to-male vaccine dose ratio, while states such as Delhi and Uttar Pradesh have a male-female gap of more than 10 percent. 
Furthermore, anecdotal evidence suggests that many smaller towns and villages are seeing a shortage of vaccine doses for their domestic population, as people from urban areas have been getting inoculated there, taking advantage of the first-come-first-served principle of COWIN portal’s online registration.
4) Proactive procurement and expanding manufacturing capacity — Government agencies must start engaging constructively with vaccine developers and producers to anticipate raw material requirements and ensure maintenance of necessary supply lines. 
5) Focus on rural regions and planning for new variants: The country indeed must try to pre-empt new variants through quick and comprehensive vaccination rollout, but given the vastness of the geography and the numbers that need to be covered, the system must be ready for pools of infection spawning new variants. 
While that remains the government’s responsibility, let us not forget that we, the people, also have a role to play in taking care of ourselves and our own cities, towns and the country. 
From wearing masks to following social distancing protocols, to not being negligent about our movement in public or trying to avoid gatherings, we also need to ensure that our behaviour, attitudes and actions ensure civic responsibility. From maintaining a hygienic and healthy lifestyle to avoiding littering, spitting and other such problematic public behaviour, we, the people of this country also, have a lot to learn. And, the pandemic is our time to change! 

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