No country for vaccines: How Modi govt’s missteps led to a crisis even as third COVID wave looms on horizon

After trying a couple of times every day, for almost a week, I finally managed to get vaccination slots for my family, while most people I know are still struggling.

India’s vaccination drive began on January 16, 2021. As per data released by the Ministry of Health and Family Welfare on May 16, exactly 4 months into the drive, about 18 crore doses had been administered, and 4.1 crore people or 3% of the population were fully vaccinated.

As of June 10, only 4.53 crore people or 3.3% of the population were fully vaccinated. At this rate, we will need another 132 months or 11 years to vaccinate the entire population!

How and why did we get where we are, despite India being the largest producer of vaccinations in the world?

Centre’s overconfidence

The PM announced victory over Coronavirus in Davos in front of the whole world in January 2021. In February 2021, at the inauguration of a private medical college, Union Home Minister Amit Shah said, “India is set to fulfil 70% of the world’s coronavirus vaccine needs. The world’s largest vaccination program was launched in India. Two vaccines are ready, four more vaccinations are in the pipeline.”

Little did we know then that we would not even be able to fulfil our own needs, leave alone that of the world.

Lack of planning

While almost every country in the world planned the development, production and distribution of vaccines many months back, our government did not focus on it until very late.

We placed our first order for a mere 11 million Covishield and 5.5 million Covaxin doses as late as January, 2021. For the vaccination drive for 18 plus people which was to begin on the May 1, the government placed an order for 110 million doses of SII’s Covishield and 50 million doses of Covaxin, India’s home-grown Covid-19 vaccine, only on April 28.

It was the EU that invested $210 million with AstraZeneca and Oxford to develop the vaccine known as Covishield, and it was our luck that AZ chose Serum Institute of India (SII) to manufacture it.

The Government of India did not give any support to either of the manufacturers to develop the vaccines or to help scale up manufacturing operations.

On May 11, the Union Government submitted an affidavit in the SC stating clearly, “No governmental aid, assistance or grant is made either for research or development of either Covaxin or Covishield. However, they were given some financial assistance for conducting clinical trials.” It clarified that the Indian Council of Medical Research (ICMR) spent only Rs 46 crore on clinical trials of the two vaccines.

‘Vaccine diplomacy’

India exported 66 million doses under ‘Vaccine Maitri’, of which 10.7 million doses were sent as grant.

To address vaccine inequity, the WHO and two non-profits supported by Bill Gates launched an effort to secure a billion doses for 92 poor countries. The effort, known as COVAX, backed the development and manufacturing of vaccine candidates, including those of AstraZeneca and Novavax. In return, those two companies promised COVAX hundreds of millions of doses.

SII, as a private company, exported 34 million doses to the EU and 20 million doses to WHO under COVAX. This could have been avoided had the Indian Government invested in SII.

Denying shortage

The Modi government kept saying that there was no shortage of vaccines while states and hospitals told a completely different story. Maharashtra, Punjab and Andhra Pradesh had formally informed the Centre about their fast depleting stock of COVID vaccines, while Chhattisgarh and Odisha said they too were facing a similar shortage in the first week of April.

The government officially claimed that there was no shortage of COVID-19 vaccines and that states will be provided with adequate stock as per their need. Union Health Minister Harsh Vardhan slammed the states, calling their claims “utterly baseless” and asked them to first "put their house in order".

"The information on vaccine shortage is not right. All states are being provided with an adequate number of vaccine doses," Amit Shah claimed while speaking to reporters while campaigning for elections in West Bengal.

Not opening vaccination to all adults until too late

Opposition leaders including CMs of non BJP-ruled states requested PM Modi to allow vaccination for all adults in the country. This included Maharashtra CM Uddhav Thackeray who wrote to the Prime Minister requesting him to allow the COVID-19 vaccination of all people above the age of 25 years in the state. He said this would protect young people from the rapid spread of COVID-19 at a time when they are stepping outside their homes to earn a livelihood.

But only on the 19th of April did the government announce vaccination of all persons above the age of 18 from May 1.

Center vs. states

COVID-19 vaccination in India was a Centre-driven exercise unlike the US, where the states have their own criteria for immunising their population. In some states in the US, all persons above 16 can get the COVID-19 vaccine.

India’s vaccination drive was partially federalised on April 19, and when this decision was taken, only 8% had got one dose and 1% were fully inoculated in the country. The states could buy directly from vaccine manufacturers who could sell 50% of their vaccines to state governments and the open market. The rest was to continue to be sold to the Centre mandatorily. States were also given the authority to take a call to open vaccination to any category of people above the age of 18 — a shift from the earlier policy in which the Central government decided on age-specific priority groups for vaccination.

The Center continued to provide some vaccination doses for the frontline workers and 45 plus population. While 24 states announced that they would vaccinate all in their states free of cost, not many states were actually able to start vaccination for 18-44 on May 1.

For example, UP was only able to begin the vaccination drive for its NCR districts on 10th of May, 10 days after the launch. After this mismanagement and the many flags raised by the states at being unable to access the vaccines and the manufacturers’ refusal to sell to them directly, the Supreme Court finally took cognisance of the issue and asked the Centre to straighten up its vaccination policy which the apex court called ‘arbitrary and irrational’.

Following thhis, the Centre took a U-turn and announced centralized vaccination and free vaccinations to all. The registration process has always been controlled by the Centre.

More demand, less supply

Anyone with knowledge of elementary arithmetic could have calculated the equation of supply and demand. To achieve herd immunity in a year, considering a 5% wastage margin, India needs about 200 million doses per month, as per experts. Facilities making other vaccines cannot suddenly start making COVID vaccines. That takes investment and planning, things that Modi govt doesn’t seem to believe in, other than in the case of elections.

SII was supposed to have supplied 100 million doses of Covishield every month from May, but has said it would not be able to do so before July.

Bharat Biotech, manufacturer of Covaxin, whose current capacity is around 20 crore doses annually, is supplying around 1 crore vaccines a month. It has said it will take around two to three months to start production at its Bengaluru facility, which will take its overall manufacturing capacity to 70 crore doses annually, or around 6 crore doses per month.

It is clear that India did not have the capacity to produce enough doses for our entire population. Then why did we not expand in time, or look at imports? And why did we export such a large number of vaccinations?

The government’s PR machinery put up nationwide billboards thanking PM Modi for free vaccines, which is ironical since this is the least the Centre could do after a series of mismanagement. The PR machinery also went on an overdrive to create big headlines about the record 80 lakhs jabs in one day on the first day of the centralized vaccine policy. But the numbers on CoWIN dashboard shows that the figures before and after the given day were drastically and mysteriously low. Was a gap deliberately created just to bloat up the numbers on June 21?

We would soon have the answers depending upon how steady and sustainable the vaccination drive is in the coming days.

(The author is an activist and entrepreneur. Views are personal)