A prohibitively expensive vaccine, besides being unacceptable, will do little good
With over 6 million cases and the death toll from COVID-19 approaching 100,000, India is entering the first winter of the pandemic. Viral infections, particularly of the influenza variety, are also common at this time of the year and there may be new unknowns in the risks that lie ahead. However, another potential milestone approaches: the probable availability of a vaccine. Union Health Minister Harsh Vardhan, on multiple occasions has said that an India-made vaccine was likely to be available in “early 2021”. The government already has an expert committee on vaccine distribution. Their job is to decide who gets the vaccine first, how many will be eligible for the early doses, what the costs would be, and whether there should be a cost at all for the majority of Indians, who anyway were the hardest hit by the pandemic in the summer. Storage and supply of vaccines are also problems as daunting as making one and pose complex challenges in India. The government is yet to make its policy on distribution explicit but the current thinking appears to be that nobody would be denied a vaccine on the grounds of affordability. There is even discussion that a vaccine may be available via the national immunisation programme. This initiative currently offers at least nine vaccines for preventable diseases free for children and pregnant women. The pandemic’s global nature has meant that even the quest for a vaccine is international. The GAVI Covax alliance has emerged as the largest coordinator of vaccine development as well as distribution of a probable vaccine. Based on a combination of payments by 78 high-income countries and donations, the GAVI Covax aims to ensure that between 15-20% of every country’s population, or at least their most vulnerable, are able to be inoculated first.
In principle, these are laudable aims and underline principles of equity. A paucity of testing facilities and equipment in March led to stringent restrictions on who could be tested. Though the tests were ‘free’, they were first available only in government facilities and this contributed to a significant pool of untested carriers and a rapid spread of the virus that was only marginally blunted by the lockdown. Only after the number of labs expanded to both public and private labs, restrictions on who could get tested were removed and, a greater variety of tests became available that disease management improved even though testing — though not expensive — was also not free. It is to be anticipated that vaccine delivery will be a protracted process and it will be a long time before the average citizen has access to it. There are at least three Indian companies testing their own vaccines, and so a prohibitively expensive vaccine, besides being unacceptable, is also unlikely.
