India's vaccination policy 'to cost' poorest 20% households 43-86% of monthly income

Counterview Desk
Insisting on a time-bound, equitable vaccine policy to ensure universal access to a free vaccine before it is too late, public health practitioners and civil society members, in a letter to Prime Minister Narendra Modi, have said that India’s current pace Covid-19 vaccination drive will take 2.4 years to complete, warning, global epidemiologists feel it could take under a year before the virus may mutate making it difficult for current vaccines to contain the spread.
Endorsed by notable civil society members such as Jayati Ghosh, Jean Dreze, Ravi Duggal and Malini Aisola, the letter, which is based on analysis of India's vaccine policy by the top international NGO Oxfam India and the Forum of Medical Ethics Society (FMES), comes amidst claims by the Government of India launching the "world's largest vaccination drive."
The letter says, the live dashboard of the vaccination drive may provide real-time updates about the vaccination amidst the second wave of Covid-19 across India, but many states and Union Territories (UTs) are facing multi-dimensional challenges in implementing vaccination. It insists on the need to accelerate the pace of vaccination in India and put India on the post-covid recovery track by providing free and accessible vaccines is crucial.

An Oxfam note:

567 prominent public health practitioners, doctors, economists, workers unions, human rights groups, student groups, civil society organisations and concerned citizens in India have appealed to Prime Minister Narendra Modi to demonstrate leadership in doing what it takes to address inequalities in supply to ensure vaccines reach the vulnerable and ramp up manufacturing to address shortages. 

The collective letter signed by organisations from 22 states and UTs across India have urged Prime Minister Narendra Modi to remove barriers to vaccine production through modes like a waiver of intellectual property rights to achieve universal coverage.
Amitabh Behar, Chief Executive Officer, Oxfam India said, “The support for India’s global ask for a patent waiver at World Trade Organisation (WTO) is growing. India’s government needs to show leadership domestically, by lifting patents to its own vaccine and follow its own National Vaccine Policy by ensuring equitable access to everyone to the vaccine but prioritizing the vulnerable and excluded.”

The extremely slow pace of vaccination in India is delaying the pandemic

Overall rates of vaccination are stalling, and shortages are expected to continue until at least July-end. The joint policy brief and analysis by Oxfam India and Forum for Medical Ethics Society (FMES) highlights the several flaws in India’s current COVID vaccination strategy, including failure to adequately explore compulsory licensing of the vaccine. The current policy of differential pricing for the Centre and states and pushing the states to the market for its vaccines, would force India’s poorer and more populous states to pay relatively more. Furthermore, vaccine allocations to states are also not in proportion of the emerging demand from those under 45 or the quantum of COVID cases.

Sunita Sheel, Secretary General, Forum for Medical Ethics Society said, “The Government of India’s approach to COVID-19 vaccine policy stands to be a mockery of Indian Federalism and will be remembered for decades to come for its lethal consequences to common people of India, particularly those at the margins. Given the current global order and deeply interconnected world, lack of access to vaccines anywhere around the world implies threat to global health security agenda. This can be averted only if government puts people first, that is, people over profit and power, NOW!”

COVID-19 Vaccine policy crippled with unfair prices and exclusion

Both Serum Institute of India and Bharat Biotech vaccine in private hospital will cost an Indian family with 3 adults Rs 3,600 for a full course of the Covishield vaccine or Rs 7,200 for Covaxin. For the poorest 20% of households, this burden will be 43% (Covishield) and 86% (Covaxin) of their monthly income, respectively. Indians are paying world’s highest vaccine prices despite providing significant funding and in-kind support for development of the vaccine and pre-clinical and clinical trials.
Successful vaccination drives are rooted in detailed district plans and social mobilization strategies to reach vulnerable communities; these are missing in this drive. The near complete reliance on on-line appointments for vaccination without providing walk-in facilities tends to exclude those who lack internet access, the elderly living alone, those with disability and populations such as homeless and pavement dwellers and those in institutions.
Only 15% rural households have access to the Internet and only 24% of India’s population has smartphones. A more targeted bottom-up approach is needed to ensure vaccination nearer to peoples’ habitations, especially in high coronavirus prevalence areas. The civil society has urged the Prime Minster to take the following actions to make vaccines accessible for all before it is too late:

1. Ensure that the vaccine is purchased at true cost prices and provided free of charge to all
2. Ensure its fair allocation which prioritizes at-risk groups, is sensitive to the existence of the digital divide and can reach the vulnerable where they are
3. Be rooted in large scale vaccine procurement by the Central Government at regulated prices which do not financially cripple the finances of India’s states or pitch them against each other in the quest of scarce lifesaving vaccines
4. Immediately enhance financial outlays to public health and do what it takes to make the above happen through all possible steps including compulsory licensing of vaccines and ramping up public sector vaccine manufacturing capacity, to strengthen the public health system to be better prepared for the potential next wave of the pandemic.

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Click here for the letter/petition to the Prime Minister, here for the policy brief . Please read complete policy brief here