India’s vaccine policy needs clarity -K Sujatha Rao
In seeking to pursue conflicting objectives, the policy architecture is complex and difficult to implement
Contrary to popular perception, public policies are made without full knowledge or facts. More often than not, they embody assumptions arising from experience, an understanding of history, and present conditions. Considering the vast sea of unknowns surrounding COVID-19, it would be understandable to place a greater reliance on historical experience. Instead, India’s vaccine policy appears to be one of experimentation. Despite several modifications, the final policy as articulated by the Prime Minister on June 7 continues to lack clarity in its intent, design, funding and outcomes. In seeking to pursue conflicting objectives, the policy architecture is complex, difficult to implement, and could be a nightmare for accountants.
The vaccine policy
After much loss of time, the final policy has the following elements: the stated objective is universal access to free vaccinations in all government and accredited facilities; the design for achieving the objective is creating a dual market under which the Central government will procure 75% of the total quantity manufactured, leaving the residue for commercial sale. The funding will be a mix of public finance and out-of-pocket expenditure. The outcome is to ensure that all 95 crore adults are fully vaccinated by the end of this year.
The policy has two caveats related to pricing and volume of sales. While Covishield and Covaxin are supplied to the Central government at 150 per dose, the price for a consumer in the private market is capped at 780 for Covishield, 1,145 for Sputnik V and 1,410 for Covaxin. To avoid cornering of vaccines by corporates and enable medium and small hospitals to participate in vaccination, the Central government will specify hospital-wise and State-wise quotas for private sales. Based on the quota allocated, the said hospitals will procure the vaccine directly from the manufacturer or use the option of the National Health Authority portal, if accredited.
Compare this maze with the policy followed under the Universal Immunisation Programme – the Central government indicates the quantity required, the delivery schedules and the rates as per global tender, and supplies quality, ready-to-use vaccines to the States to be provided free. The manufacturer is left to dispose of excess quantity, if any, in accordance with market forces and without interference from the government. Under this system, the government has negotiated incredibly low prices due to the volume of its orders. In view of its wide reach, the private sector’s participation, catering to the better-off sections which have the ability to pay, has averaged 5%-15% depending on the vaccine.
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The Hindu, 22 June, 2021, https://www.thehindu.com/opinion/op-ed/indias-vaccine-policy-needs-clarity/article34894911.ece?homepage=true