Political economy of India’s COVID-19 vaccine shortage

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Analyze data on COVID-19 prevalence rates, relative population size and vaccine coverage in Indian states, RAVI DUGGAL explains why India needs a better and more scientific vaccine disbursement policy, and how to rampantly increase our vaccine production capacity through compulsory licensing.

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AS India enters the third phase of its ambitious COVID-19 vaccination campaign, many state governments report vaccine shortages and have to close some of their immunization centers, with supplies available for only 2-3 days. Most of these states are not ruled by the Bharatiya Janta Party (BJP), but some BJP ruled states like Uttar Pradesh are also report impending shortages.

What is causing these shortages? One of the factors is that of our total vaccine production up to March, we had exported twice the number of vaccine doses we had used in the country, according to The data furnished in the Rajya Sabha.

the other is the very low level of production contrary to the immense population of the country and its demand.

Read also: India faces multiple challenges to refine the Covid vaccination program

Some state governments are affirming that the Union government is biased in favor of BJP-led states, with those states receiving vaccines in turn with their proportion of the population or their COVID prevalence rate.

Data shows a mismatch between the prevalence of COVID-19 and vaccine supply in most states.

To verify these claims, let’s take a look at the relevant data. The graph below maps the COVID prevalence rate for all states along with their respective immunization coverage rates (states are organized in descending order of their immunization coverage).

We find that the gap between vaccine coverage and prevalence rate varies greatly from state to state rather than being flat or proportionate. This indicates that vaccine supplies are not based on population size or the prevalence of COVID cases in states.

The greater the difference between the two indicators in the graph, the greater the supply of vaccines for that state. As a result, states like Maharashtra and Delhi, with some of the highest COVID prevalence rates, have some of the lowest deviations, indicating a low level of vaccine supply.

Scientific formula for vaccine disbursement required

The Union government must develop a scientific formula for distributing vaccines since it has a monopoly of control over the purchase and supply of vaccines. Such a formula could use the population size and case prevalence weighted equally to determine the volume of vaccine a state should receive; that would reflect reasonable fairness.

As the dynamics of vaccination accelerate and demand increases, especially since we find ourselves in the throes of a second nationwide COVID wave, with new cases in a single day across the country crossing peaking at over 1.4 lakh as well as over 700 new deaths per day, the vaccine supply chain has been hit. This is both because stocks are depleted and our vaccine production capacity is struggling to keep up with the daily delivery of the required vaccine doses.

Since India started its vaccination campaign about three months ago, more than 70 million of our population has has received the first dose of the vaccine. Of these, only 10 million received the second dose. Almost 9.5 crore doses were used in the country, and around 6.5 crore doses were exported to other countries, including as donations, according to the Union Minister of Health.

Read also: Are the criticisms India faces for its restrictions on COVID-19 vaccine exports justified?

During all this time, why hasn’t India increased its production capacity by at least 8-10 times, given its status as a ‘the world’s pharmacy’? Why do we continue to rely on only two producers: Serum Institute and Bharat Biotech, and wait for them to make investments to increase their respective capacities?

India to start compulsory licensing of COVID-19 vaccines

The Union government could easily have invoked compulsory licensing to allow other pharmaceutical companies with vaccine production capacity to produce these vaccines alongside others as they were used. in the country.

The use of compulsory licenses would radically change the political economy of the COVID vaccine. With a substantial increase in volumes, the price would also be reduced and India could then supply the vaccine in greater numbers to other countries.

Read also: Lack of Political Will and DPI Rules Obstruct Mass Vaccination Against COVID-19

With further peaks in this second wave, allowing compulsory licensing and expanding the production base is something the government needs to prioritize. Once production ramps up, purchasing and distribution can be decentralized so that states can control their supplies and can also commit state budgetary resources to finance immunizations. This is the only possible way to make rapid progress towards eliminating shortages and moving closer to universal access to vaccines.

(Ravi Duggal is a sociologist, health researcher and activist associated with the People’s Health Movement. The opinions expressed are personal.)


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