India has begun
the vaccination drive against the Chinese virus induced COVID-19 pandemic. Given
the population size of nearly 1.4 billion, it would perhaps be the largest
vaccination drive ever undertaken. The fact that it has to be undertaken in a
very short time say about less than a year, the ambitions would be sheer
audacity given the logistics involved in such a mammoth effort. It is not just
about production of vaccines, but going beyond into the quality control, the
transport from the plants to the different storage centres further to be
distributed to the states and the districts and then to the vaccination
centres. To add, the supply must be continuous with little disruption. The conditions
for transporting the vaccines would have to be adhered to. Furthermore, the
preparations at the each of the centres in terms of administering the vaccine
apart from training the vaccinators itself would be daunting. There is
furthermore need to coordinate with the people in fixing their appointments and
ensuring the people do keep their appointments with the centre. Managing and tracking
the delivery of vaccine along with it being administered is a challenge that
not many would accept it to be less difficult.
When one
observes the preliminary experiences of other countries, it is not easy to run
a programme on such a scale. Even the mighty US and UK are struggling to
maintain decent levels of vaccination on a daily basis. To add, the current
vaccines are to be administered in two doses separated by 28 days. This puts
additional pressure. In the 28 day period of second dosage, either the new
first doses have to be stopped or alternatively, a fresh vaccinator team has to
be prepared of administering first doses. The production levels of the vaccine
manufacturers must match the rate of administering the vaccine both from first
and second dosages. Apart from Israel, no country has been able to vaccinate
double digital percentage of population so far. It is a tribute to the Israeli
innovation, resilience and capabilities that they have been able to vaccinate
more than a fifth of its population. UAE has barely touched double digits in
terms of population percentage. Notwithstanding the small size of Israel, it’s performance
stands humongous relative to similarly populated countries including UAE, Bahrain,
Singapore or New Zealand.
The Indian
vaccine programme might have begun few days late. In contrast to many others
including the United States which began the drive within 48 hours of the approval
from the regulators, India have taken nearly two weeks to begin the programme. The
delay might or might not prove to be costly but in the context of the public
health, the swiftness in which the vaccine drive begins and reaches its target
is critical. Israel apparently paid a premium to Pfizer to get deliveries ahead
of schedule. India too needs to coax its vaccine makers to produce higher volumes,
ahead of the schedule. In fact, all over the world, hardly less than a handful
of vaccines exist. They further are constrained by production limits, to a
substantial extent by the reluctance of the producers to license to other
parties in different parts of the world. Pfizer for instance would produce and
export from US than sign licensing agreements with other countries to speed up
the production. The emphasis on stringent enforcement of intellectual property
rights (IPRs), refusal to grant exemptions on IPRs even in critical substances,
the emphasis on nationalism resulting in vaccines for their domestic countries
first, all could distort the vaccine allocation and delivery in the first few
months of the administration. This might prove to be critical in the societal
battle against the Chinese virus.
To achieve a
significant success, India needs to administer nearly 70% of its population by
this year end. Given this number would run close to one billion, the challenge
is not easy. In fact, calling it a difficult challenge itself is an
understatement. If the drive goes slowly, there is a possibility that virus
might develop resistance to the vaccine. While the scenario is unlikely, it
cannot be ruled out. While other countries could target even a few hundred
thousand per day and complete their drive within months, India’s initial
priority vaccine phase itself would amount to around 300 million people. In fact,
the health care workers along with armed forces and paramilitary and police
personnel combined with the essential municipal services, the number itself comes
to around 30 million. Therefore, the daily vaccine target must exceed five
million fresh doses per day notwithstanding the second doses that might have to
be administered 28 days from now. This would call for setting up nearly twenty
five thousand centres with each centre giving around four hundred to five
hundred vaccines per day including those receiving the second dose. It must be
recognized that the vaccine delivery must be 24*7 job with centres functioning
through the clock. The vaccines must become available in the market on demand. For
those willing to take a jab by paying a price, they should be allowed to do so
rather than make them wait in a government queue. There is no reason why the digital
process using Co-Win app along with Aadhar authentication rounded up by a QR
vaccine certificate cannot be linked to the private players delivering the
vaccine.
The battle
against COVID-19 has been a long drawn out one. It is just the beginning of the
end. The endgame too is likely to be long before India vaccinates a critical mass
needed to achieve herd immunity. This of course is contingent on new mutations
that virus might metamorphoses into. The task needs rapid execution at a very
high scale. Anything lacklustre would invite serious issues. The Modi
government has handled the pandemic fairly well. To the Western world, India
was expected to be a basket case of all what has gone wrong. They anticipated
that India would lose in millions especially given what happened in the Spanish
flu a hundred years ago. The current scene roughly 11 months since the
discovery of first case in India has been very optimistic. India has managed to
avoid the worse in the last year. It is expected given the current trends to
better its performance. The economy too has escaped the worst so is the
society. This despite the sheer population, the absence of social distancing,
the routine violation of mask norms, and the Indian caseload has remained
fairly low relative to the more advanced countries. India has exported lot of pharmaceutical
products as with the healthcare accessories and will soon begin exporting
vaccines too. There continue to remain sceptics but the overall performance has
something to be appreciable about. Without doubt, Modi has consolidated his
leadership. Yet there is lot of time before the beginning of the endgame and
the final victory. It is where PM Modi would face even tougher task to carve
out his legacy. All his actions might be undone, if the vaccine programme
suffers some kind of slack. PM Modi has been known for execution at scale and
this is perhaps his biggest challenge. How he emerges out of the same will
determine his place in history.
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