Vaccination policy: Modi’s One Earth One Health only for international consumption?

By Bobby Ramakant, Sandeep Pandey* 
When India was reeling under the severest impact of the Covid pandemic, and the peak of around 450,000 new cases was reported in 24 hours around mid April 2021, then an interesting chronology of events were taking place regarding the Covid vaccination programme (along with Kumbh in Uttarakhand and elections in West Bengal and Uttar Pradesh).
The government of India had observed ‘teekautsav’ from 11-14 April 2021, then soon after had taken kudos by announcing vaccination for everyone above 18 years nationwide, and on April 23, 2021, the Ministry of Health and Family Welfare, Government of India, declared its ‘Liberalised Pricing and Accelerated National Covid-19 Vaccination Strategy’ as part of which it abdicated its responsibility of vaccinating the citizens in age group 18-44 years.
The ‘liberalised’ in the phrase did not pertain to people, it was intended for private corporations and no wonder the government was working in tandem with them. Two private vaccine manufacturers were allowed to declare their exorbitant costs for state governments and private hospitals. Nobody would believe that the companies acted at their own behest.
After protestation from various state governments, civil society, lagging behind in vaccination drive and pressure from the Supreme Court, which described its liberalized vaccination policy as arbitrary and irrational, the government has come up with Revised Guidelines for implementation of National Covid Vaccination Programme on June 8 under which it has now taken responsibility of procuring the 75% vaccines by the union government, including on behalf of the state governments.
However, the Prime Minister has still allowed 25% vaccines to be procured by private corporations. A ceiling of Rs. 150 has been put on the vaccination charges for private hospitals which will procure Covishield, Covaxin and Sputnik vaccines, respectively at Rs 600, Rs 1,200 and Rs 948. With GST, the final cost would be Rs 780, Rs 1,410 and Rs 1,145, respectively.
It is important to note that the cap of Rs 150 was announced on vaccination charges for private hospitals, but vaccine manufacturers were given a free hand to announce their prices. We should remember that government had procured Covishield and Covaxin at Rs 150 per dose earlier. Then why has the government agreed for such inflated prices announced by the manufacturers?
The office memorandum says that if Covid Vaccination Centres over-charge then strict action will be taken against them but vaccine prices can be suitably modified if the manufacturer declares changed prices. Why is the government while being strict against the private hospitals being lenient towards the private companies?
Why is the Prime Minister, whose priority should have been to vaccinate country’s population to an extent so that herd immunity would have kicked in, still allowing private companies to mint profit? Narendra Modi makes an appeal for ‘One Earth, One Health’ at the G7 outreach summit seeking support for Covid vaccine patent waiver but is reluctant to implement ‘One Nation, One Vaccine’ policy in his own country.
It turns out the private hospitals’ reach is very limited. Out of 7.4 crore vaccines made available in the month of May, 1.85 crores were allocated to private hospitals. While we witnessed government vaccination centres closed due to shortage of vaccines, the private hospitals were sitting over vaccines being able to administer only 22 lakh of the doses. Out of 1.2 crores vaccines actually procured by private hospitals, half of them were cornered by nine big hospitals in metropolitan centres.
The glaring criminal complicity of the government in helping private players make profit at the cost of people’s lives stands exposed. It also apparent that people with money will have excess supply and poor will suffer the shortage. It goes against Modi’s call of One Earth One Health, which was probably meant only for international public consumption. In Amit Shah’s words this is merely a ‘jumla.’
In a vulgar display of favouritism now the government is preparing to give indemnity to foreign vaccine manufacturer Pfizer, an advantage which is not extended to any vaccine manufacturer so far. If the indemnity is offered to all manufacturers it’ll also cover Bharat Biotech, whose vaccine is being administered under Emergency Use Authorisation as the phase III trials have not been completed.

Haunting question should be why are basic services failing to reach the most in need? Why has routine immunization not reached every child?

The clumsy handling of vaccination policy by the government gets more confounded with every decision. On one hand Indian government is joining other nations worldwide in negotiating a global treaty on human rights and businesses, so that multinational corporations can be held legally liable for human rights abuse if any, but on other hand, it is to be seen will it walk the talk on corporate accountability? People have not forgotten several instances of corporate abuse in our nation including the heart wrenching Bhopal Gas Tragedy of 1984.
Government has to move beyond market based so-called ‘solutions’ (as often they add to the problem) if it is to impact positive change for the most in need. Initiatives like using drones to deliver vaccines need to be very carefully reviewed because of the past history where profits for corporations have taken primacy over people’s interests.
Also, the haunting question should be why are basic services failing to reach the most in need populations? Why has routine immunization not reached every child? Why do most deaths happen due to diseases that were primarily preventable? Why corporations whose products make us sick and ill continue to mint profits while our populations suffer several pandemics of avoidable diseases? Why profiteering from illness is a norm and not a crime against humanity?
In a mock drill on April 26, 2021 morning at Paras Hospital at Agra, the owner Dr Arinjay Jain facing acute shortage of oxygen shut off its supply for 5 minutes to 96 patients to check which patients were critical. 22 patients were identified who started turning blue. Rest 74 were told to arrange for their own oxygen.
The hospital claimed only seven patients died over the next two days, however an enquiry reveals that 16 died. Paradoxically, the hospital has been given a clean chit. While Jain has been naïve enough to admit his dilemma and so-called biggest experiment, who should be held responsible for deaths of patients due to negligence inside government hospitals and while waiting for beds in hospitals in ambulances outside?
We have to remember that in 2017 when oxygen shortage was not yet a ubiquitous phenomenon, Dr Kafeel Khan lost his job merely because oxygen supply to the BRD Medical College in Gorakhpur, where he was nodal officer of encephalitis ward, was cut off due to non-payment of dues, something for which he was not responsible as was proved in a departmental enquiry. 

Seventy children had then died. If punitive action is the answer, then scale of deaths this time require some more heads to roll and some more institutions and establishments or even the entire governments should be sealed for abdication of its responsibility! But probably by giving a clean chit to Paras hospital, the government doesn’t want to open a Pandora’s box.
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*With Socialist Party (India)