Vaccine policy must be guided by transparency

It has not been made clear how many doses were contributed to the WHO common vaccine pool and how much India drew from the pool. Did Covishield and Covaxin doses that went to the WHO come back to the country from the WHO’s common stock? Perhaps, these details will only be revealed under duress — when asked by the Supreme Court, through a parliamentary panel or an MP when Parliament meets later this year.

Loose end: There is a huge fumbling at the level of implementation. PTI

Parsa Venkateshwar Rao Jr

Senior Journalist

Governments are generally known to be economical with the truth. In the case of Prime Minister Narendra Modi’s government, it is more so. This can be seen especially in the case of its vaccine policy. Bits of facts have been tumbling out from the affidavit filed in the Supreme Court by the Central Government and from the press conferences of BJP spokespersons.

Last month, there were reports in the media that the Finance Ministry had approved the release of Rs 4,500 crore to the two vaccine manufacturers — Serum Institute of India (SII), the maker of Covishield, and Bharat Biotech, the maker of Covaxin — and that the government had to go beyond the existing rule framework because there was no way of releasing government funds without guarantees, but that the waiver had been given. Of course, there was the allocation of Rs 35,000 crore just for the vaccines which was announced by Finance Minister Nirmala Sitharaman during the presentation of the Union Budget on February 1.

It is in the Centre’s affidavit we get the nugget that the government did not spend any money on the research and manufacture of the Covid-19 vaccines, and that it has spent just Rs 46 crore to support the clinical trials at Pune-based SII and Hyderabad-based Bharat Biotech. It was also revealed in the same affidavit that the government paid an advance payment for the vaccine doses for May, June and July an amount of Rs 25,200 crore —

Rs 17,325 crore to SII for 11 crore doses and Rs 7,875 crore to Bharat Biotech for five crore doses.

So, who had paid for all those doses from January 16 to April 30 for the health workers, frontline workers, the above-60 folk and those between 45 and 60 who had comorbidities? The total vaccine doses administered till April 30 were 15.48 crore.

It is through BJP spokespersons Sambit Patra and Gopal Agarwal that we came to know that not all of the 6.5 million vaccine doses of Covishield and Covaxin were part of the government’s diplomatic gesture, and that a majority of the doses sent abroad were part of the commercial commitments made by the two vaccine manufacturers. They said that only 1.6 million doses were part of Vaccine Maitri.

Also, it has not been made clear how many of these doses were contributed to the World Health Organisation (WHO) common vaccine pool and how much India drew from the pool as it was eligible to do so. Did Covishield and Covaxin doses that went out of the country to the WHO come back to the country from the WHO’s common stock?

Perhaps, these details will only be revealed under duress — when asked by the Supreme Court or through a parliamentary panel or a question by a Lok Sabha or Rajya Sabha Member when Parliament reconvenes during the Monsoon Session.

But the issue of how the money was being allocated both for Covid management and for the vaccines was raised in the July and August 2020 issues of the Journal of Indian Medical Research (JIMR) by two public health research scholars Indrani Gupta and Rama Baru under the title ‘Critique Economics & Ethics of the Covid-19 vaccine: How prepared are we?’

They laid out the issue most clearly: “While a number of steps have been taken to tackle the pandemic in India, one area that remained unclear is that of public financing. Testing and treatment have been steadily ramped up, but it is not clear how funds have been raised and resources allocated across different needs.”

They follow this up with this observation: “This opacity in public financing and policy should be avoided at all costs in the case of vaccines.”

And they make the suggestion: “Thus, it might be useful for India to bring out a White Paper on Covid-19 vaccine and share it with citizens. All policies around the vaccine must be guided by the principles of accountability and transparency.”

The sequence of events shows that there has been a huge fumbling at the level of implementation. As early as June 30, 2020, Prime Minister Modi, at a high-level meeting, had already envisaged how the vaccination programme should be implemented across the country and had talked of identifying the priority groups to be vaccinated, starting with the health workers.

Buoyed by the PM’s involvement, the Indian Council of Medical Research (ICMR) had announced on July 3 that Covaxin would be launched on August 15, 2020. When the scientific community expressed concern about the haste, this was retracted on July 4, saying that that was meant to “cut red tape”. And, there is a strong hint of “indigenous vaccine” and the implied vaccine nationalism.

It is on August 8, 2020, that a task force was set up under Dr VK Paul of Niti Aayog and Health Secretary Rajesh Bhushan to deal with the issues of the raising of finances to procure and distribute vaccines, and ‘inventory management’. And, on August 23, 2020, Health Minister Harshvardhan announced that the vaccine would be ready by the end of the year, and there were three vaccine candidates — those of SII, Bharat Biotech and Zydus Cadila.

Then, on November 17, 2020, a member of the expert team on vaccines said that the government was looking at all vaccines, including Pfizer, Moderna and Sputnik. There is then confusion beneath the hyper-activity.

Today, five months into 2021 and the rollout of two vaccines, Covishield and Covaxin, the government is looking for adequate supplies, unable to decide about the distribution of the vaccines and about the moneys that these would entail.

The government representatives have a lot of explaining to do about India’s vaccine uncertainties and the procurement of the required doses from home and abroad.