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Repeated appeals and lakhs of infections later, the government has finally decided it will allow imports from global vaccine makers such as Pfizer for emergency use without bridging trials. While that is a good concession, decisions on key elements—pricing and procurement—are yet to be taken, and till that is done, it is unlikely that there will be a sharp increase in vaccine production from either existing players or the ones whose vaccines have just been cleared for use. It not clear why the earlier round of discussions with some of these vaccine producers fell through, but it could be the need for bridging trials, the Indian price being too low for some of these producers to feel it was worth the effort; given these vaccines had already been approved by health regulators in their respective jurisdictions, India should never have insisted on local clinical trials before a launch.
Speed is of essence given the severity of the crisis, and the government needs to be far more pragmatic. It must allow these vaccine makers to charge higher prices and also allow the private sector—hospitals, dispensaries and even companies—to procure them directly. Those that can afford these expensive vaccines should be allowed to access them; depriving them of vaccines at this stage is patently unfair. In any case, given the stringent storage specifications of some of them, it would be difficult to distribute them on a large scale; they would merely be supplementing the production from Bharat Biotech, Serum Insitute and others including Russia’s Sputnik-V whose supplies are expected to be available next month via imports and via local production thereafter.
Ideally, the government needs to free up pricing for the local vaccines like those produced by Serum Institute and Bharat Biotech as well, perhaps with a certain amount purchased at a lower price by the government for administering in government hospitals and health centres at subsidised rates or even free. The decision to cap prices at a low `150 per dose has proved to be a costly one as it has delayed the rollout and, as a result, increased the pressure on the health system. In Ahmedabad, patients requiring oxygen are lying in ambulances since there are no hospital beds available while other cities seem to be running out of oxygen, hospital beds and remdesivir, leaving state governments—like the one in Maharashtra—with little choice but to enforce strict restrictions on mobility; in Delhi, the chief minister has said he will have no option but to declare a lockdown if the health services fall short. Indeed, apart from augmenting supplies of vaccines—so far, states have received 131 million doses and have used up 115 million, including wastages—the government needs to augment other health infrastructure as well with daily infections of 1.8 lakh around twice the peak in the first wave. This requires setting up of many more jumbo facilities, with the help of the armed forces and perhaps also get the Railways to start converting—as it did in the first wave—its bogies into isolation wards.
Also, it must offer financial support to millions in the informal sector who will not be able to earn until the pandemic is under control and may be forced to go back to their native places. Allocations under the MGNREGA scheme need to be increased substantially. This year (FY22) is going to be as tough as FY21, if not more, so the government will need to come up with new measures to deal with the slowing recovery; it doesn’t help that, while existing projections assume a rosier tax outlook, the loss of one or two quarters of growth can change things quite dramatically, including the country’s debt dynamics.
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