Freeing up vax pricing & opening it up to adults good but give more to raise supplies fast, increase gene sequencing
Having completely misread the available supply of vaccines needed to inoculate an increasingly infected population, the government is now working to speed up what has been an excruciatingly slow rollout. While it has liberalised the procurement policy—state government, hospitals and corporations can now buy vaccines directly from the producers—what is critical is that local production is ramped up and that this be supplemented with imports.
Local capacity, right now, is just around 75 million doses a month. Last week, imports of a set of foreign vaccines were authorised for emergency use with conditions like the bridging-trial requirement being waived. Hopefully, imports will soon be a reality with producers like Pfizer or Johnson & Johnson starting to to distribute vaccines in India.
This is important given how it will take a while for local producers to scale up output and the government must not put off suppliers by quibbling over the price or indemnity clauses; any delay will compound what is already excessive damage. The government must respect the prices that vaccine makers charge and subsidise them to the extent it wants to help the underprivileged sections; the rest should be allowed to access the vaccine at the market price.
In order to do this, it must offer local producers like Serum Institute of India (SII) and Bharat Biotech meaningful financial support. SII, for instance, is understood to have asked for a grant of Rs 3,000 crore to compensate it for the loss of production of non-Covid-19 vaccines in response to which the government has approved advance payments of Rs4,500 crore to both SII and Bharat Biotech. This is is not the time to be parsimonious but to ensure no one is turned away from a vaccination centre. While the Centre has denied it, several states have complained of shortages.
There should be greater transparency now since the Centre will procure only 50% of the supplies and state governments, private hospitals and corporations will be permitted to buy the remaining 50% from producers in the open market. The announcement suggests vaccine producers would be allowed to charge the price they want, as long as they declare the price beforehand and, hopefully, the rollout hereon will be a smooth one.
Despite a promising start in mid-January, just about 127 million doses have been administered so far. With 2-lakh-plus fresh infections being reported every day, allowing everyone over 18 years of age to be vaccinated is a good idea. But, the government has also failed to ensure that enough genome sequencing to detect strains in circulation is done. The Indian-origin double-mutant strain, believed by many experts to be the cause of the recent surge, was detected in early October 2020 through genome sequencing of the virus from a sample. Had the genome sequencing progressed at the requisite pace, scientists could have recognised the destructive potential of this mutant and alerted the authorities.
However, for various reasons—the lack of direction, a paucity of funds or complacency—the laboratories seem to have lost the momentum between November and January. With a third mutation having been discovered, the government now needs to provide the necessary resources so that the initiative is not lost. Despite having the wherewithal, India’s vaccination strategy has been a super flop; we owe it to the medical fraternity to get our act together.