Need that dose

Make vaccination more expansive as infection spikes. Those who want vs those who require it — is bad science, poor policy

The last thing India needs is the breakdown of Centre-state cooperation that has marked many of the successes against COVID so far.

On Tuesday, when India recorded the highest number of vaccinations in a day, Union Health Secretary Rajesh Bhushan said that the goal of vaccination in a pandemic was to cut down deaths in the vulnerable population and to “protect the health system”. There can be no disagreement on this. But, subsequently, he framed it as a binary: “those who want the vaccine versus those who require it the most”. The aim, he said, is to vaccinate the latter, not the former. That’s bad science and poor policy. Anti-COVID vaccines are so far available only to those above the age of 45. But the recent spike in infections has led to calls for a more expansive approach. The Indian Medical Association has lent its weight to these demands. Unfortunately, however, the Centre has refused to accede to these requests. It fired off a vitriolic note Wednesday accusing states of messing up their COVID management.

The last thing India needs is the breakdown of Centre-state cooperation that has marked many of the successes against COVID so far. Hopefully, when the prime minister meets the chief ministers today, he can strike the conciliatory note — for this isn’t about blame games, it is about saving lives. The Centre’s strategy was drawn up when the virus was on the wane. Its basic approach is still dictated by supply-side dynamics — vaccine being a scarce resource, priority has to be accorded to the “most vulnerable”. That made sense when the immediate aim was to protect those at the frontlines of the battle against the virus. But the litmus test was always going to be the pace at which a substantial section of the population was shielded against the virus, paving the way for more and more to get protection and, therefore, decreasing the severity of the disease. That about 6 per cent of the country’s population, just under 9 crore, has received one jab speaks of the challenges and incapacities that lie ahead. To its credit, the government seems aware of these problems and has rectified some of them. What it does not seem to recognise is that its incremental approach does not match up to the challenge of the sheer scale of inoculation necessary.

This reluctance to reimagine the vaccination project is more unfortunate given that India has the acumen to combine the best of market-based and directed welfare approaches. Its vaccine production capacity is globally recognised, it has substantial experience in inoculating people against deadly diseases — notably polio — and reasonable success in rolling out targeted projects such as Jan Dhan. But have policymakers reached out to manufacturers with the right incentives? Why are vaccine stocks suddenly a problem? Why is Serum Institute of India waiting for the government to respond to its financial request? Why not leverage capacities of those who can pay market rates, while those who cannot, get subsidies? These questions require urgent answers. One year on, emergency rooms know a lot more about how to fight COVID but the vaccine remains the most potent weapon in their arsenal. It needs to be used effectively — with science as the compass, not politics or PR.

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