India needs a COVID-19 vaccine policy that ensures total coverage in logical phases
The race to a vaccine is a relay — at every stage, there are people passing on the baton, and it’s the government’s responsibility to grasp it at the last mile. Whether or not a vaccine for COVID-19 is around the corner, it is imperative that a vaccine policy is formulated for India, ensuring parity of access for all. As several vaccine efforts are progressing at varying paces, globally, concerns about access to a vaccine in the future have crept into the narrative. WHO Director General Tedros Adhanom Ghebreyesus recently spoke of the need to use a vaccine, when it becomes available, effectively. He also indicated the need to prioritise vaccination for some in the initial stages, while in time, as production increases, people everywhere should get it. In the initial stages, global health leaders have been advancing the vaccine for essential workers and those at risk including senior citizens and those with co-morbidities. As Dr. Tedros said, “some people in all countries, rather than all people in some countries”, should have access to the vaccine in the early phase. Even in this initial stage, the government should make the vaccine available free of cost to those who cannot pay, or at affordable rates. As production kicks off, initial production costs are likely to be high, even astronomical, and it is the duty of governments to cushion the cost. Once the economies of scale begin to kick in, it is likely that the prices are driven down and become more affordable. Besides being a moral and ethical imperative, it will also make economic sense to make sure the vaccine is eventually available to all. Leaving gaps in the delivery of the vaccine will only serve to allow the virus to survive, and continue to wreak further damage.
India has a fairly reliable vaccine delivery system for children, as part of the universal immunisation programme. It may be assumed that the knowledge and wherewithal to run a full-scale vaccination programme rests with the health administration — both at the central and the State level. However, in terms of scope, this is far wider; in fact, a mammoth task. All people in the country must have access to the vaccine, and, if necessary, periodic doses of it. Indeed, the mobilisation for this task in India should be nothing short of heroic, as and when the vaccine is available here. Meanwhile, the government must get its act together on developing a policy specific to the COVID-19 vaccine; from preparing resources — both material and human — for the manufacture, storage, distribution and delivery. This includes taking sensitive, but firm, decisions guided by evidence, on who will receive the vaccine, how, when and where. Putting down a standard operating protocol for every stage of the vaccine will serve the government well when the baton is finally passed on to it.