On June 27, Prime Minister Narendra Modi spent almost 10 minutes of his monthly 30-minute Mann Ki Baat address to the nation on a call with representatives of Dulariya, a village in the district of Betul, Madhya Pradesh. The interaction was about Covid-19 and carried a message the Prime Minister wanted to convey to his pan-Indian audience — the importance of vaccination. Modi emphasised that mass vaccination is the only way to arrest the spread of the pandemic that is destroying lives and livelihoods.
Weeks earlier, the Modi government had set a December 31, 2021 deadline to vaccinate approximately 94-crore citizens and provide Covid cover to all of India’s adult population. With each person requiring two doses, it meant administering close to 190-crore jabs in the next five and a half months — a herculean task given that only around 40-crore doses have been given since India began vaccinations early this year. To meet the target, around 150-crore doses of Covid-19 vaccines need to be administered (90 lakh jabs daily on an average till December 31) and the government has been struggling to create an ecosystem to make that happen.
Domestic manufacturing of Covid-19 vaccines are being ramped up, a liberal approval process for foreign vaccines okayed by developed countries is in place, quality testing facilities have been added, logistics and supply chain mechanisms have been strengthened and private healthcare providers have been roped in. However, all of these are in an evolving phase and what Modi’s Mann Ki Baat touched upon was just the last critical piece — public support — that needs to be in place to make India's universal adult Covid-19 vaccination programme a success.
Things look a bit difficult, at least for now. But, thanks to a Supreme Court (SC) order, the mission mode approach of the government, including Modi’s outreach, will see India go a long way in Covid-19 vaccination, from the slow and rocky beginning since its launch.
On June 26, a day before Mann Ki Baat, Manohar Agnani, Additional Secretary, Ministry of Health and Family Welfare, filed an affidavit in the Supreme Court to clarify certain issues that were flagged by the apex court while hearing a suo motu writ petition initiated on April 22, against the perceived mishandling of the second Covid wave by the Centre. The SC had raised questions about the Centre’s vaccine policy, procurement and distribution, role of private hospitals, differential pricing, logistics, etc, indicating possible lapses. In an order on May 31, the apex court flagged three broad issues — vaccine distribution among different age groups, the procurement process, and the augmentation of vaccine availability in India. The government’s current Covid-19 vaccination plan, as spelt out in the affidavit filed by Dr Agnani, attempts to address all such concerns by introducing a revised vaccine policy to augment availability, vaccinate all adults by the year end, and to centrally procure 75 per cent of the jabs produced in the country for free distribution to states.
Lav Agarwal, Joint Secretary, Ministry of Health and Family Welfare, says India has come a long way in enhancing its production capacity of Covid-19 vaccines. “From 2.5-lakh doses of vaccines given in a day we have come to 41 lakh. Vaccine supplies have been enhanced by regular handholding with manufacturers in the last six months. The whole process of vaccine logistics management is also done almost in just-in-time approach,” he adds.
What Agarwal means is that through the Centre’s vaccination management system, one can identify how much vaccines are going to be produced, by when, and as soon as each batch is tested and cleared for use, it can be sent anywhere in advance, giving each state an idea about the number of doses expected in the next 15 days.
“We have been working with states to ensure that 75 per cent of vaccines produced in the country is available for free delivery to states. When such consistent efforts are being done to increase production, we should not be bogged down by daily targets. The target is to work with manufacturers and make sure we are able to cover the required population as early as possible,” says Agarwal.
The just-in-time approach, which means real-time shipping and near-time vaccination (of the same number) of 75 per cent of vaccines produced in India, gives us an idea of monthly production. Match that with the capacity claimed by companies and you will get an idea of how far India’s daily vaccination numbers can be pushed upwards. For instance, the Serum Institute of India says it can produce 6.5-crore doses of Covishield per month by July. Bharat Biotech International Ltd will have the capacity to produce 5.5-crore doses of Covaxin a month, also by July. Since these are the only Covid vaccines that have been administered in India till now (apart from the negligible doses of imported Russian Sputnik V), the combined production capacity of India — 12 crore a month — can only support the current level of vaccination — 40 lakh a day —and not the 90 lakh per day target to meet the December 31 deadline.
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