Updated: October 23, 2020 7:25:34 am
For the Center to guarantee a free vaccine throughout the country, it may have to join the emblematic Universal Immunization Program (UIP), the National Health Mission, and the program should be extended to the entire adult population.
BJP’s announcement promising free Covid-19 vaccination for everyone in Bihar as part of its election manifesto has taken several states by surprise.
Above all, since until now the conversation about the vaccine between the Center and the states revolved around identifying who should receive it as a priority.
Thus, the announcement of a free vaccine as an electoral promise highlighting one state adds a political twist to an issue, Covid management, which has so far been largely framed by cooperative rather than competitive federalism.
States are trying to figure out what the implications are. Many see this as the first indication that the Center will procure the vaccine, or vaccines, at negotiated rates and states may then be asked to purchase their own stock.
This is reinforced by the fact that the National Group of Experts on Vaccine Administration, which is part of the Center’s Covid working group, made it clear, at its first meeting, that states should not chart their separate routes for acquisition.
Furthermore, significantly, minutes after the statement made by Finance Minister Nirmala Sitharaman, Amit Malviya from the BJP IT cell tweeted: “Like all programs, the Center will provide vaccines to the state at a nominal rate. It is up to state governments to decide whether they want to give it free or otherwise. With health being a state issue, Bihar BJP has decided to give it away. Simple.”
It is not so simple. Once the BJP, which rules both Patna and the Center, has announced free vaccines for everyone in Bihar, few states will take a contrary position. Indeed, within hours, the top ministers of Tamil Nadu, which has elections next year, and Madhya Pradesh, ruled by the BJP, announced free vaccination against Covid-19. More states are expected to make their announcements.
For the Center to guarantee a free vaccine throughout the country, it may have to join the emblematic Universal Immunization Program (UIP), the National Health Mission, and the program should be extended to the entire adult population.
The UIP is a fully funded central government scheme that currently provides free vaccination to all children, including 2.67 crore newborns, and 2.9 crore pregnant women annually.
Currently, under the IPU, free vaccines are provided for nine diseases nationwide: diphtheria, pertussis, tetanus, polio, measles, rubella, a severe form of childhood tuberculosis, hepatitis B, and meningitis and pneumonia. Regionally, and in select endemic districts, free vaccinations are provided for three more diseases: rotavirus diarrhea, pneumococcal pneumonia, and Japanese encephalitis. Getting Covid on this list will take work.
Said an expert, who has worked closely with the government and has been part of the National Technical Advisory Group on Immunization: “This pandemic is the first time that an entire adult population has been a target. Today’s statement is political. But for it to be translated into policies and for the adult population to be included in the UIP, the pricing modalities must be established with the states. “
In response to the BJP announcement, Congress-governed Chhattisgarh Minister of Health TS Singh Deo reflected the views of many states: “The government of India has not told us anything about purchasing the vaccine. It is not a problem if we (the states) are asked to pay. If we have to pay, we will … but vaccines should be available in proportion to the population. A vaccine cannot be guaranteed for a particular state. The Electoral Commission should be aware of this announcement ”.
Today’s announcement also comes as the group of vaccine experts is exploring multiple mechanisms, including anticipated market commitments, as the United States and European countries have done.
The government’s view is that “realistic prices” for the vaccine will be available only when approved by regulators.
“Any indicative price for a single or double dose vaccine becomes a plausible figure once the vaccine has been able to demonstrate its safety and efficacy. Once multiple vaccines are done, prices will drop and drop dramatically. Therefore, we cannot risk guessing how much the spending will be (until possibly) July, ”said Union Health Secretary Rajesh Bhushan.
The Center is in active communication with private healthcare providers who have said they are ready to vaccinate at their hospitals.
Health Minister Harsh Vardhan had said that the government expects to receive and use between 400 and 500 million doses and cover approximately 20 to 25 million people by July 2021.
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