Vaccine politics: Why the BJP’s Bihar election move comes as a surprise to states

States are trying to figure out what the implications are. Many see this as the first indication that the Centre will procure the vaccine — or vaccines — at rates it negotiates and states may then be asked to purchase their own stocks.

This is reinforced by the fact that the National Expert Group on Vaccine Administration – part of the Centre’s Covid task force — made it clear, in its very first meeting, that states should not chart their separate pathways for procurement.

Also, significantly, minutes after the statement made by Finance Minister Nirmala Sitharaman, BJP IT cell’s Amit Malviya tweeted: “Like all programs, Centre will provide vaccines to state at a nominal rate. It is for the state Govts to decide if they want to give it for free or otherwise. Health being a state subject, Bihar BJP has decided to give it free. Simple.”

It isn’t so simple. Once the BJP – ruling both in Patna and the Centre – has announced free vaccines for all in Bihar, few states will take a contrary stand. Indeed, within hours, Chief Ministers of Tamil Nadu, which has elections next year, and of BJP-ruled Madhya Pradesh announced free Covid-19 vaccination. More states are expected to make their announcements.

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For the Centre to assure free vaccine across the nation, it may have to be brought under the flagship Universal Immunization Program (UIP), under the National Health Mission, and the program will have to be extended to the entire adult population.

The UIP is a fully funded Central government scheme that, currently, provides free vaccination to all children – including 2.67 crore newborns — and 2.9 crore pregnant women annually.

At present, under the UIP, free vaccines are provided for nine diseases at the national level: Diphtheria, Pertussis (whooping cough), Tetanus, Polio, Measles, Rubella, a severe form of childhood Tuberculosis, Hepatitis B, and Meningitis & Pneumonia. Regionally, and in select endemic districts, free vaccines are provided for three more diseases: Rotavirus diarrhoea, Pneumococcal Pneumonia, and Japanese Encephalitis. Bringing Covid into this list will need work.

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The BJP has promised free vaccines for Covid-19 to “residents of Bihar” if voted to power. (ANI Photo)

Said an expert, who has worked closely with the government and has been part of the National Immunization Technical Advisory Group: “This pandemic is the first time that an entire adult population is a target. Today’s statement is political. But for it to be translated into policy and for the adult population to be included in the UIP, modalities on pricing have to be worked out with the states.”

Responding to the BJP’s announcement, Health Minister T S Singh Deo from Congress-ruled Chhattisgarh reflected the views of many states: “We have not been told anything by the Government of India about the purchase of the vaccine. It is not an issue if we (states) are asked to pay. If we have to pay, we will…but vaccines should be made available in proportion to the population. A vaccine cannot be assured for a particular state. The Election Commission should take cognizance of this announcement.”📣 Follow Express Explained on Telegram

Today’s announcement also comes when the expert vaccine group is exploring multiple mechanisms including advance market commitments as has been done by US and European countries.

The view in the government is that “realistic prices” of the vaccine will be available only when they are cleared by regulators.

“Any indicative price for a single dose or double dose vaccine becomes a plausible figure once the vaccine has been able to demonstrate its safety and efficacy. Once that is done by multiple vaccines, prices will decline and decline drastically. Therefore we cannot hazard a guess of how much the outgo will be (until, possibly) July,” Union Health Secretary Rajesh Bhushan had said.

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The Centre is actively in communication with private health care providers who have said they are ready to vaccinate at their hospitals.

Health Minister Harsh Vardhan had said the Government expects to receive and utilise 400-500 million doses and cover approximately 20-25 crore people by July 2021.

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