Vaccine Discrimination Strategy

Every Govt./ Every Kingdom is procuring vaccines for its citizens/population on its own to be administered at the Govt.’s cost as it is pandemic. Like our PM says, once in a century pandemic. Why is it that Govt. of India is dragging its feet on vaccination? Our Govt. always plays hockey with data is known to everybody. But this time, they are playing ping pong with States as if the citizens represented by Centre and State are two different set of individuals. Especially when India is amongst the top 5 worst handlers of the virus in the world. May be it is about Modiji being loyal to his friend, Mr Doland Trump (Not Donald, as that is how our PM likes to call him).

 

On April 18, 2021, when Corona cases had jumped 2.75 Lakh for the day with 1600+ deaths and our PM was lauding the efforts of the public to attend his rally in West Bengal and expressing his pleasure to see the huge turnout of crowds. The States were making clamour for more vaccines as they had to reach out to its respective citizens with answers to problems and not an explanation for failure to deal with the problem. Perhaps some CMs were just posturing to care which the case may not be.

Barely 50 days with the modified rules of the new Vaccination Program, the policy stands scrapped and new policy has replaced with the old one. Will we witness further changes into the Vaccination Policy, especially because Centre plays dumb down with MoHFW focused on Congress rather than vaccines or perhaps that’s the case with the every Minister of Govt.

 

The arbitrary and irrational vaccination guidelines were framed after receiving the letter from former PM, Dr. Mute Singh. Apparently he is not mute in Opposition and while as PM, his work did the talk rather than tongue. Lets look at what Dr. Singh said and what our Govt. did in response.

First, the government should publicize what are the firm orders for doses placed on different vaccine producers and accepted for delivery over the next six months. If we want to vaccinate a target number in this period, we should place enough orders in advance so that producers can adhere to an agreed schedule of supply.

 

To counter, Data is not the strong forte of our Govt. under Modi. Though their party is empowered with data at every booth level during elections. Govt. has given some numbers of orders placed and we know it will keep revising over the next few months to create total confusion to the already chaos created by our Govt. Guidelines and circulars for gag orders to States on Vaccine stocks have been issued in second week of June.

 

Second, the government should indicate how this expected supply will be distributed across states based on a transparent formula. The central government could retain 10 percent for distribution based on emergency needs, but other than that, states should have a clear signal of likely availability so that they can plan their roll out.

 

On empowerment of States for vaccination, Govt. of India has over extended itself. To bring transparency, Central Govt. developed a quota system and made an effort to wash their hands from vaccine procurement process. The Govt. said, “Manufacturers would transparently make an advance declaration of the price for 50 per cent supply that would be available to State Governments and in open market, before May 1”.

 

Dr Manmohan Singh is talking about distribution process and our Govt. understood it as procurement process. In addition, they have further allayed the process on private hospitals. The quota system of supplies between the Government of India and “other than Government of India” channels would be applicable “uniformly across for all vaccines manufactured in the country”.

 

Third, states should be given some flexibility to define categories of frontline workers who can be vaccinated even if they are below 45 years of age. For example, states may want to designate school teachers, bus, three-wheeler and taxi drivers, municipal and panchayat staff, and possibly lawyers who have to attend Courts as frontline workers. They can then be vaccinated even if they are below 45.

 

On this point, our Govt. agreed fully; so Govt. responded with the change. States have been given the authority to take a call to open vaccination to any category of people above the age of 18 — a shift from the current policy in which the central government decides on age-specific priority groups for vaccination.

 

Fourth, over the past few decades, India has emerged as the largest vaccine producer in the world, thanks to policies adopted by the government and robust intellectual property protection. The capacity is largely in the private sector. At this moment of a public health emergency, the Government of India must proactively support vaccine producers to expand their manufacturing facilities quickly by providing funds and other concessions. In addition, I believe this is the time to invoke the compulsory licensing provisions in the law, so that a number of companies are able to produce the vaccines under a licence. This, I recall, had happened earlier in the case of medicines to deal with the HIV/AIDS disease. As far as Covid-19 is concerned, I have read that Israel has already invoked the compulsory licensing provision and there is an overwhelming case for India to do so as well quickly.

 

On this point, Govt. has extended advance payments to vaccine manufacturers, which they had to pay in any case, but there is no support from Govt.’s end. On compulsory licensing issue, the Govt. does not want to wrong signal to the investing community and they would continue to put all their eggs in two baskets of two domestic manufacturers. Let’s see for how long they drag their feet. Govt. gave affidavit in SC that it is not tenable but the PM is asking for TRIPS waiver in G7 summit for all Covid related medicines/vaccines.

 

Fifth, since domestic supplies are limited, any vaccine that has been cleared for use by credible authorities such as the European Medical Agency or the USFDA, should be allowed to be imported without insisting on domestic bridging trials. We are facing an unprecedented emergency and, I understand, experts are of the view that this relaxation is justified in an emergency. The relaxation could be for a limited period during which the bridging trials could be completed in India. All consumers of such vaccines could be duly cautioned that these vaccines are being allowed for use based on the approval granted by the relevant authority abroad.

 

In response, the Centre has allowed imported, fully ready-to-use vaccines to be entirely utilised in the other-than-Government of India channel. This means that if and when pharma giants like Pfizer bring their vaccines to India, they can directly sell their entire supply in the open market at competitive prices.

To further complicate the India’s Vaccination Policy. Central Govt. is also working on a complex formula. We have 29 States with population size of 135 Crores of people. I really don’t understand who puts such out of the world ideas in our Govt.’s head. Or perhaps they are forced by politics.

 

In the next phase, the Centre will allocate its share of 50 per cent to states based on the extent of infection (number of active Covid cases) and vaccination performance (speed of administration). States are at present receiving vaccine doses based on demand (the number of registrations and walk-in vaccinations). “Wastage of vaccine will also be considered in this criteria and will affect the criteria negatively. Based on the above criteria, State-wise quota would be decided and communicated to the States adequately in advance,” the Centre said.

 

“India has been following a dynamic mapping model based on availability of vaccines & coverage of vulnerable priority groups to take decisions of when to open up vaccinations to other age-groups. A good amount of coverage of vulnerable groups is expected by April 30,” the Centre said.

 

Nobody knows if this policy was in discussion for a day or a week or a month. May be our Govt. was also thinking clearly on the lines of Dr. Manmohan Singh. In order to take credit, they jumbled up the whole issue, wherein our PM is yet to respond to his predecessor and MoHFW headed by Mr. Matru wrote about the politics naming the political parties in response. The reason he could not become part of the discussion process, while inventing the mumbo-jumbo, they are feeding the public amidst the pandemic, when people were dying due to lack of oxygen, hospital, medicines.

 

Central Govt. was heading for a shake down from Supreme Court and hence they changed the policy. Good sense prevailed in our Govt. to scrap the policy. Is it the impending elections in 5 States scheduled for early next year? Everybody knows, our PM’s and our Govt.’s heart and mind is always stuck in elections. They make decisions and formulate policies on how it would appear in elections.

 

Truth is stranger than fiction and an enemy of reality.

CoWIN

 

India’s largest vaccination drive and World’s largest vaccination drive, to be achieved in the least amount of time or as quickly as possible has been named as CoWin by our hard working PM. The politician in our PM, Narendra Damodardas Modi is the best, much higher above the best. The man born with only the marketing (building narratives) bones in his body. Always thinking about marketing in elections, the name of his schemes are always catchy, short for people to remember with a solid punchline; to show he is working.

 

The world was gasping for breath to know when the vaccine will be launched, so that the world can heal and perhaps start getting back to normal life. India kickstarted its vaccination program on January 16, 2021. On April 18, 2021, PM was addressing the election rally with much thunder and boasting about the number of people who had come in attendance to hear their PM. On the same day, India recorded 2.75 lakh new cases with 1620 deaths. On April 19, 2021, our Govt. opened vaccine for all (eligible group), which means everybody who is eligible to vote is also eligible for vaccine and the mass vaccine drive would begin from May 1, 2021.

 

The speed for taking decisions from our Govt. is commendable. Modi is a man possessed to do so much in as little time as possible. He is always racing against time. They have not developed a think tank to make properly reformed, researched decisions but they just sense in which direction, the wind is blowing and the shoot their arrow in that direction, mostly with blind folded eyes.

On April 6, 2021, IMA (Indian Medical Association) had requested vaccine for all and as the virus spread was again going up and vaccination was the only way to save the citizens from the impending disaster, we are staring at. However, the Centre (on the same day) refused to open up coronavirus vaccinations for all age groups, saying the aim was to cover the people who are the most vulnerable at the earliest. “The approach is that those vulnerable to mortality need to be covered soonest,” Union Health Secretary Rajesh Bhushan said at a press conference. “The aim is to protect the most vulnerable. The aim is never to vaccinate whoever wants, but always on whoever needs.”

 

On April 7, 2021, Rahul Gandhi aka Pappu demanded vaccine to be opened for all age groups. “It’s ridiculous to debate needs and wants,” tweeted Gandhi. “Every Indian deserves the chance to a safe life.”

 

For the past two months, Rahul Gandhi tweets are actually dictating the decisions of the Govt. Whatever the Pappu says/tweets, the Govt. after refuting and mocking his tweets/words makes the exact decision. Decision taking is fast, but there is no planning or thinking whatsoever regarding the execution. I am totally confused, who is Pappu here, our Govt. or Rahul Gandhi or us, the citizens, who are left to die under the able guidance and leadership of Narendra Damodardas Modi. Nonetheless we have to applaud our Govt for making some efforts, even if it's too little too late. May be it is only a charade again to project, they are working and taking care the needs of the citizens for which they were elected with thumping majority.

 

There is vaccine hesitancy, the reason for vaccine wastage in India, wherein States and Centre are playing hockey on data. Distribution is purely and purely States responsibility, it is State Health Department’s responsibility to ensure minimal wastage. 25.35% of 136 Crores citizens were eligible in 45+ category and the number comes out to 34.5 Crs. Total of 12.39 Crs of vaccine doses were administered till April 19, 2021.

 

India remains at number 3 in terms of total doses administered. Well in any case, India cannot go beyond the 10^th place, even if Mexico had covered their entire population. On per capita basis, India is ranked somewhere at the bottom along with some third world country of Africa.

 

When we have barely covered one third in 45+ years category, what was the urgency to open 18 – 45 year age category for vaccination. Was it compulsion for optics or Govt. of India is taking instructions from Pappu? Less than two weeks in May and almost all the States have stated vaccination shortage and closed vaccination for 18 – 45 age until further notice.

 

The decision was fast but no working/study/analysis was undertaken regarding availability of vaccine or it was ensured after checking with States if they can speed up vaccination distribution strategy or not. 45% of citizens in 18 – 45 age group constitute 60 Crs on top of existing 25.35% of population and we have no vaccine. Right now, we are only looking at crashing of CoWIN App.

 

The digital push to Govt. work is another great vision of our PM. The way the Govt. has launched Apps for citizens to avail or take updates on different schemes, programs of the Govt. CoWIN is also part of the Digital India framework. Digital India has more or less failed, except for Jio’s success and the cheaper access of data, they have made for every Indian. But yes GoI has launched hundreds of apps for assistance of citizens.

 

Zero strategy, zero planning, zero execution. When the Govt. knows, they are opening up registration for 18 – 45 age category, the category of people who are most user friendly with smartphone, the same set of people carry the maximum number of smartphones in India or for that matter anywhere in the world. The largest subset of population with 60 Crs (no other country has as much population) number and the Health Ministry didn’t even check with IT Ministry to give them 10x or may be 100x bandwidth for CoWIN App to keep working smoothly.

 

Consultation and planning amongst different departments of the Govt. is null and void, if there is any. This was one of the most brilliant aspect of Modi’s style of working (as CM of Gujarat), he made all Secretaries sit together to sort out the problem instead of files being pushed for consultation and objections from one department to another. Health Ministry cannot complain because they didn’t ask. There are citizens who had predicted the crashing of the App as soon as registration is opened for 18 – 45 age category. And our IT Ministry is busy in blocking tweets, which are critical of our Govt. IT Ministry has its hands full in censorship of information.

 

To get back to Mr Gupta’s tweet, App crashing is a good sign for vaccine hesitancy. But it also implied it was hurried decision from the Govt. without proper thought, knowledge and information or lack of all stated here.

 

The stories amongst the citizens remains the same. Majority of the population is under lockdown, not by Govt. of India; GoI is shit scared about the image of its bearded babaji. Almost all States have imposed lockdown and hence crores of citizens are spending morning to evening on App to get a slot booked.

 

Almost all 18 – 45 age category couldn’t land on the booking page. CoWIN was overwhelmed with issuing captcha(s) or sending OTP(s), which in some cases took a day or two. But as usual Govt claims victory before the race has started by throwing numbers, which possess zero significance to vaccination drive. 80 Lakh registrations in first three hours of opening the booking.

 

If the Govt. couldn’t plan, anticipate the App’s workload, I sincerely and earnestly doubt if the ground situation has any hope of improving. Citizens can look at the slot available and press their choice and App starts processing and all slots gets filled. It is the story across the India. Now Citizens are betting, 70 slots available, booked in a minute, another says 120, third 200.

 

A large subset of marginal population who cannot afford smartphone is left out by CoWIN considering only 55% of Indians possess a smartphone. Is it Govt.’s feeble attempt to generate employment that the computer centre/operators around the country, get the work for getting the poor citizens registered at nominal charge of Rs. 50 – 100.

 

It has always been the essence of Modi Govt. make decisions at lightning speed without any thought process or planning and make crores of crores of citizens of this great Nation suffer. It all started from Demonetisation. A humble reminder to citizens to not fall for fake platitudes of PM but make him accountable for his actions and his lop sided policies and not only the boldness or the intention of the scheme.

 

Right now only WIN remains secluded in the CoWIN. Citizens who have been lucky to get a slot can actually claim victory over the App if not the virus by posing for a selfie with a V sign. We shudder to think of what will happen to CoWIN, when Govt. aims to clock One Crore doses/day in July/August. Will CoWIN go the Aarogya Setu App way? Redundant when its needed the most.