Transparent distribution

Centre must have a clear formula for sharing vaccines

Speeding up the roll-out of the vaccination programme is likely the only way that the government will be able to manage mortality in the current wave of the Covid-19 pandemic and mitigate the third wave that doctors and epidemiologists have declared is now almost certain to hit India. To this end, the Union government had announced the third phase of the vaccination programme, declaring that from the beginning of this month all Indians above the age of 18 would be eligible to receive vaccines. However, although this is the right direction, problems are already beginning to crop up. For one, the rate of vaccination has slowed from its peak last month, in spite of more people now being eligible. Naturally, the government must do whatever it can to enhance supply, including investing further in capacity and granting vaccine manufacturers the appropriate waivers. But there are also questions of distribution that must be addressed.

 
The third phase of the vaccination programme said that vaccines could now be bought on the open market by private health care providers and by state governments. These would be responsible for vaccinating those in the 18-44 age group. Some questions have been asked about the prices being set for state governments and for the other purchasers by the vaccine manufacturers. However, the government must resist the temptation to meddle in price-setting, since the scale of the roll-out is the primary question at this moment. If state governments need additional financing to buy, then the Union government should stand ready to assist them. That said, the most politically fraught question is likely to be one of inter-state distribution of the vaccines, including those being distributed for the over-45s by the Union government. This is already leading to anger in many state capitals, and the head of the Serum Institute of India, Adar Poonawalla, said in an interview that he was receiving “aggressive” demands from politicians and others. The Union government needs to ensure that states are on board with the distribution mechanism used for vaccines, and it is seen as being fair and transparent.

 
The transparency of inter-state distribution leaves a lot to be desired as it currently stands. The State Bank of India (SBI), in a recent disaggregated analysis that included factors such as the relative share of each state’s adult population, the number of Covid-positive cases, and so on, has noted that several states can justly complain that they are receiving a smaller than expected share of the vaccine. The report noted that, according to its calculations, Maharashtra should receive almost 18 per cent of the vaccines being distributed, but it is currently receiving only about 10 per cent. Some states, including Rajasthan and Gujarat, have received more than their share. Many could disagree with SBI’s formula. But what is clear is that some such generally agreed formula is at the least necessary in order to ensure the political sustainability of the current roll-out. The ball is now in the Union government’s court. It must make its formula for distribution public, and invite comments from experts and from state governments. That is the only way in which to nip this growing firestorm over vaccine distribution in the bud.