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Tuesday, July 27, 2021

Why India is missing its vaccine targets

R Ramakumar writes: Production capacity has not risen as claimed by Centre and its projections of vaccine availability are inflated and unrealistic

Written by R Ramakumar |
Updated: July 19, 2021 10:00:28 am
A beneficiary gets a shot of a Covid-19 vaccine in Mumbai. (Express Photo: Amit Chakravarty)

Half-way into July 2021, India’s problem of vaccine shortage shows no sign of abating. The new Union Minister for Health has upwardly revised the target for July 2021 from 12 crore doses to 13.5 crore doses. In June, India administered 11.9 crore doses at a rate of 39.6 lakh doses per day. To administer 13.5 crore doses in July, the vaccination rate should rise to 43.5 lakh doses per day. Yet, the vaccination rate between July 1 and July 15 was 39.8 lakh doses per day; for the seven days ending on July 15, it was lower at 37.7 lakh doses per day.

The fact is that the supply of vaccines remains considerably lower than the demand for vaccines. In this article, I submit two arguments. Firstly, India’s vaccine production capacity is not rising as is regularly claimed by the Government of India (GoI). Secondly, GoI’s projections for vaccine availability are consistently inflated and unrealistic.
Currently, India produces two vaccines: Covishield by the Serum Institute of India (SII) and Covaxin by Bharat Biotech (BB). In May 2021, GoI told the Supreme Court of India in its first affidavit that SII produced 6.5 crore doses per month and BB produced 2 crore doses per month. In July 2021, SII’s and BB’s capacities were to rise to, respectively, 10 crore and 5.5 crore doses a month. If these claims were true, India should have produced 8.5 crore doses per month (28.3 lakh dose per day) in May and June, and 15.5 crore doses (51.7 lakh doses per day) in July.

Yet, India administered only 27 lakh doses per day in the second, third and fourth weeks of April, and 19.3 lakh doses per day in May. While the number of doses administered rose to 39.5 lakh doses per day in June, it was due to a curious one-week blitzkrieg between June 21 and June 28. There is still no reasonable explanation for the poor vaccination rates between June 1 and June 20, and after June 28.

The situation looks bleak for July 2021. GoI originally aimed to administer 12 crore doses in July. The target was revised to 13.5 crore doses. Firstly, both these targets are less than the 15.5 crore doses projected for July in the affidavit. Secondly, if the average vaccination rate in July continues at the current rate, administering 13.5 crore doses appears difficult. In sum, GoI has regularly been overstating India’s production capacity.

In a second affidavit to the SCI in June, GoI claimed that “from January 2021 to July 31 2021, a total of 51.6 crore doses will be available”. Till June 30, only 33.1 crore doses were administered. To reach 51.6 crore doses by end-July, India must administer 18.5 crore doses in July. Yet, according to the same affidavit, only 12 crore doses were being planned to be administered in July.

GoI had ordered 34.6 crore doses from SII and BB over three orders placed between January and May. India also received 1 crore doses from the COVAX facility of the WHO. Thus, a total of 35.6 doses were to be received by GoI till July. The remaining 16 crore doses were those expected to be directly purchased by state governments and private hospitals under the earlier 50:25:25 allocation across GoI, state governments and private hospitals.

However, these 16 crore doses were never purchased, as the 50:25:25 allocation flopped. State governments and private hospitals could directly purchase only about 4.2 crore doses. Yet, the affidavit added all these 16 crore doses to the total availability till July. In sum, India simply cannot administer 51.6 crore doses by the end of July. Even if 12-13.5 crore doses are administered in July, the cumulative number of doses would reach 45-46.5 crores.

On May 13, GoI claimed that India would administer 216 crore doses between August and December. This was nothing but puffery. The production capacity in some vaccines was overstated, and several vaccine candidates in the early trial stages were included in the projection. In the second affidavit to the SC in June, GoI accepted the error. Vaccine candidates like Novovax, Gennova and BB Nasal were dropped, and the August-December projection was downscaled from 216 crores to 135 crores.

It is doubtful if even the revised projection of 135 crore doses is realistic. Only the contribution of 50 crore doses of Covishield by SII appears realistic. The biggest disappointment is in the supply of Covaxin. GoI expects 40 crore doses of Covaxin between August and December. However, BB is yet to fulfil its earlier commitments. Over three orders placed in January, March and May, GoI ordered 8 crore doses of Covaxin from BB to be supplied by July. Only 4 crore doses of Covaxin were administered till June 30.

With a self-declared monthly capacity of 2 crore doses, BB must supply about 4 crore doses in July to fulfil its earlier commitments. Between July 1 and July 15, only 80.1 lakh doses of Covaxin were administered. Only after supplying the remaining 3.2 crore doses can BB begin supplying for the fourth order placed in June, for which supply is to begin in August. Three public sector units have been allowed to manufacture Covaxin, but their supply is unlikely to begin in full speed before late-2021.

The other vaccines expected between August and December are Sputnik V (10 crore doses), Corbevax (30 crore doses) and Zydus-Cadilla (5 crore doses). Currently, these projections are pure speculation, though the supply situation may indeed ease by December. In sum, it is doubtful if 135 crore doses will become available between August and December.

This column first appeared in the print edition on July 19, 2021 under the title ‘Missing the vaccine targets’. The writer is professor at the Tata Institute of Social Sciences, Mumbai

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