Unanswered questions

Govt should remove uncertainty about next phase of vaccination

On Wednesday, the national vaccination database, Co-Win, was opened to registration for those aged between 18 and 45, and got an enthusiastic response. Appointments slots, however, will be allocated later, prolonging the uncertainty about how the third phase of the vaccination programme will be conducted. Questions abound regarding the next steps, for state governments, hospitals, and citizens alike. The Union government may have again claimed that there is no scarcity or shortage of vaccines, but it is increasingly hard to take this pronouncement at face value. In only a few days, those between 18 and 45 will officially become eligible to receive the shots, and so it is past time for the government to clarify its plans regarding the supply side.

The first question, surely, is what the supply pipeline will be. Several state governments have already said they are in no position to start vaccinating the 18-plus population in May due to vaccine shortage as the manufacturers have not yet signed purchase contracts despite firm orders. The government also needs to publish a transparent list of what it has ordered from the two existing vaccine manufacturers, and what their promises are regarding the remainder which is to be sold through the non-government route. It must also make public its discussions with other vaccine manufacturers who have been granted permission to enter the Indian market through emergency use authorisation. Recently, Pfizer India claimed it was in discussion with the government, for example. What is the status of this and other negotiations? Even if the government intends to let all of these additional manufacturers sell on the open market, it still has a responsibility to make public the assistance it is providing them to enter and what their own likely supply schedules are. Other governments have supervised and enabled deals between corporations with spare manufacturing capacity in the sector and vaccine licence holders. Indians should know whether the government is working on similar plans, and if not, why not.

The division of the vaccines being sold on the non-government route is also a matter of great uncertainty. How much of it will be given to state governments, and how much on the open market to hospitals and hospital chains? How will the non-government supplies to states be divided? Surely this decision is not being left up to the marketing managers of the two manufacturers. That is an invitation to lobbying and to outright intimidation of the companies, especially given that the prices to state governments have after all been set lower than to the open market by both of them. The government has also reportedly pressured the companies to lower the prices themselves. This defeats the purpose of a non-government route in the first place, which was to provide sufficient funds to the manufacturers to allow them to scale up.

While the government’s decision to broaden availability requirements and expand the supply chain is the right one, it must not imagine that its responsibility ends there. It needs to recognise that the overall vaccination programme will suffer if there is continued uncertainty. Given the need to accelerate the roll-out due to the rampaging second wave of the pandemic, the government must also clearly outline what it is doing to support other manufacturers and ensure licencing or production of foreign vaccines in India. It has responded well to suggestions and to the emerging situation through its liberalisation of distribution, but it now also needs to be proactive about fixing supply constraints and on making sure that information is freely and widely available.