Everyone aged 18 or above in India may receive Covid-19 vaccines from May 1, the Narendra Modi government said on Monday evening in a somersault that drew on some of the easier tips offered by Manmohan Singh who was treated to uncommon churlishness and ingratitude earlier in the day.
The Centre’s policy shift, which appears to have been aimed at calming a Twitter backlash against the Prime Minister in the middle of a brutal second wave of Covid-19, will also make available up to 50 per cent of vaccine stocks in the private open market.
Not that all recommendations made by Manmohan have been accepted. Neither did Manmohan suggest all the steps the government announced.
For instance, those aged below 45 will have to pay for the vaccine at a market-determined rate that will have to be announced earlier. Right now, vaccination is available for those aged 45 and above for free at government hospitals or for Rs 250 per dose at private facilities.
What stood out on Monday was the extraordinary length the Modi government went to put down Singh, the former Prime Minister who had 24 hours ago shared with his successor through a letter suggestions on addressing the pandemic crisis.
During the day, Manmohan tested positive for Covid-19 and was admitted to AIIMS with fever.
Prime Minister Modi did not extend the courtesy of replying to his predecessor. Instead, Union health minister Harsh Vardhan on Monday in an aggressively worded letter to Manmohan blamed the Congress for the slow pace of vaccination coverage and, dripping sarcasm, said: “… As a senior leader, we expect that you shall offer the same advice and wisdom to your own party leaders as well.”
In a tweet accompanying the letter, complete with a thumbs-up emoji that suggested he was pleased with his retort to Singh, the minister wrote: “History shall be kinder to you Dr Manmohan Singh ji if your offer of ‘constructive cooperation’ and valuable advice was followed by your @INCIndia leaders as well in such extraordinary times.”
A few hours later, Vardhan’s ministry announced the policy change.
What Manmohan said: States should be given some flexibility to define categories of frontline workers who can be vaccinated even if they are below 45.
What the Centre did: All stakeholders given flexibility to customise to local needs.
States empowered to procure additional vaccine doses directly from the manufacturers, as well as open up vaccination to all people above the age of 18.
Vaccine manufacturers empowered to release up to 50 per cent of their supply to state governments and in the open market at a pre-declared price.
The catch: Experts cautioned that limited domestic production capacities and high global demand for vaccines are likely to pose challenges to any rapid expansion.
“India doesn’t have nearly enough supply to vaccinate everyone over 18 starting 5/1, especially since those approved are double dose. GoI knows this. So it buckpasses to states, rich ones will hoard, poor ones will die. And Modi will wash his hands of a colossal federal failure,” MIT associate professor Vipin Narang tweeted.
What Manmohan said: The government must proactively support vaccine producers to expand their manufacturing facilities quickly by providing funds and other concessions.
What the Centre did: Vaccine manufacturers incentivised to further scale up their production, as well as attract new national and international players. The Prime Minister is also meeting vaccine makers on Tuesday.
What Manmohan said but the Centre has yet to do: The government should publicise the firm orders for doses placed with different vaccine producers and accepted for delivery over the next six months. “If we want to vaccinate a target number in this period, we should place enough orders in advance so that producers can adhere to an agreed schedule of supply,” Manmohan had written.
This information, which would have helped understand whether the Centre had acted with foresight, is not yet in the public domain.
What Manmohan said but the Centre has yet to do: The government should indicate how this expected supply will be distributed across states based on a transparent formula, which would allow the states to plan the rollout.
This is the most important component that will help states prepare for a spike in the demand for vaccines. The information is still awaited.
All-adult U-turn: Congress MP Rahul Gandhi had said on April 7: “It’s ridiculous to debate needs and wants. Every Indian deserves the chance to a safe life.”
Virtually ruling out an all-adult rollout, Prime Minister Modi had said the next day: “Developed countries of the world, who have all the resources, even they have fixed criteria for vaccination. India isn’t different from them. You know how much vaccine is manufactured. It’s not that big factories can be set up overnight. Whatever is available, we have to prioritise.”
Vardhan had said: “States asking to open up #COVID19vaccine supplies to everyone over 18 haven’t even achieved desirable coverage of healthcare workers, frontline workers & senior citizens. This shifting of goal posts is an attempt to deflect scrutiny from their poor vaccination efforts.”
Under the policy announced on Monday, the Centre would procure 50 per cent of stocks and the balance could go to states or the open market.
Imported ready to use vaccines may be entirely used in the private market.
Vaccine makers would need to make declarations before May 1 of the prices at which they would sell their vaccines in the open market.
The campaign currently open to adults 45 years or older uses Covishield from the Serum Institute of India and Covaxin from Bharat Biotech. But the government has approved Russia’s Sputnik V and invited companies such as Pfizer and Moderna to bring their vaccines into India.
Johnson & Johnson has applied to India’s drug regulator seeking permission to conduct phase-3 clinical trial of its single-dose vaccine in India as well as import licence, PTI quoted sources as saying.
Santanu Tripathi, former professor of pharmacology at the Calcutta School of Tropical Medicine, said: “There is a sizeable population in India that would pay for the vaccines. This would also reduce the financial burden on governments, allowing them to focus on providing vaccines to those unable to afford them.”