India’s vaccine strategy is based on science
India has been undertaking the world’s largest vaccination drive. In less than three months, we have managed to provide more than 100 million doses across the country, which is more than the population of Germany. The country has already achieved one of the highest daily vaccinations per day across the globe with 4.3 million vaccinations, which is close to the population of New Zealand. India has also achieved the fastest rate of reaching the 100 million vaccination milestone, ahead of the United States (US) and China. Our daily vaccination rates are also among the highest in the world. This doesn’t mean that there is no scope for improvement. Of course, we need to expand capacity and continue innovating, which has been our approach throughout the pandemic.
When I saw an editorial with five questions on India’s vaccination strategy in this newspaper on Thursday, I was surprised. It seems that the recent bug of fact-free opinion has transcended Twitter and entered the editorials of a venerable newspaper such as HT.
In the beginning, there are two insinuations — first, that there is a vaccine crunch, and, second, that everyone immediately needs a vaccine. We must understand that vaccines are a scarce commodity in the world. They are not like candies which can be manufactured, supplied, and consumed any time and anywhere. That is why India, as well as other countries, decided to prioritise groups which are vulnerable. The primary purpose of vaccination is mortality reduction and decreasing the burden on the health care system. This was laid down by the government in 2020 itself.
The first phase of the vaccination drive prioritises vulnerable groups such as older citizens, health care workers, and front-line workers. For instance, older citizens face an acute threat as those aged 45 and above have accounted for almost nine out of 10 Covid-19 deaths across the country.
Across the globe, countries have prioritised vulnerable groups in their vaccination programmes as the supply and delivery capacity remained limited initially. Similar to India, the first phase of the vaccination drive in many countries had age and occupation-based eligibility criteria. For instance, in the US, the Centre for Diseases Control and Prevention had recommended that vaccines should initially be given to health care workers, front-line essential workers and those aged 75 years and above. Gradually, coverage was expected to include younger age cohorts and other essential workers.
India has set a target of vaccinating around 300 million vulnerable citizens by August, and we are very much on course to achieve that. There is no supply crunch when it comes to achieving this target.
Here, it is also important to understand that vaccines are a preventive tool which works after a lag period of six to 10 weeks. It is not a treatment to be administered to reduce the case-load in the middle of a wave. To focus only on vaccines and not pay attention to ramping up testing, tracing and proper treatment will be counterproductive.
It is amusing that the newspaper argued against India’s vaccine maitri programme, and advocates an inward-looking approach for the sake of a populist argument. Is it not a good thing that India has set an example for the world to follow, earned strategic advantage on various dimensions, and is being appreciated globally for its assistance? If the government had refused to supply vaccines to other countries, the same newspaper would have criticised Prime Minister Narendra Modi for being a “vaccine nationalist”.
However, this advocacy of a protectionist and “closed” India is again bereft of the facts. A large proportion of the 60 million-plus vaccines sent abroad were either commercially exported or supplied through the COVAX programme. A substantial share was part of contractual obligations that the manufacturer had to fulfil. We must remember that manufacturing rights are accompanied with contractual obligations.
The next question constructs and demolishes a straw man to make a point. It says that the government-approved Covaxin based on faith. This sentence does not do as much disservice to the regulator and Bharat Biotech as it does to the credibility of the newspaper. Data on the safety and immunogenicity of Covaxin, based on trials held in India, were available when it was approved; only the efficacy figures were pending.
The government is as eager, if not more than the newspaper, to ensure that other vaccines also get approved. It is surprising that some of those who opposed the “clinical trial use” approval for Covaxin are now arguing in favour of completely bypassing bridging trials. Imagine what would happen to the confidence of people if a hastily-approved vaccine which works well elsewhere causes some issues in the Indian population.
While I have already elaborated on why age-based criteria was adopted, I would like to engage with this argument of more vaccination in urban areas. At this rate, shall we make the vaccination programme more targeted and focus on high-rises and slums within cities? Shall we focus more on malls and markets given the high density of people found here? Is there a successful display of this strategy anywhere in the world? However provocative the argument is, when a government decides on a strategy, it needs to be both equitable and feasible. Adding additional layers of complexity is neither feasible nor desirable.
Unlike commentators, governments need to overcome real trade-offs and constraints.
Vijay Chauthaiwale is in-charge, foreign affairs department, BJP, and a senior scientist
The views expressed are personal