Divided we stand on vax policy

The shortage of COVID-19 vaccines in India has prompted states to take matters into their own hands and embark upon the process of floating global tenders to procure doses. Even though the Centre has said that it has provided more than 18 crore doses to states and union territories, the quantum falls short of the actual requirement, owing to which states like Delhi have suspended vaccinations for those in the 18-44 segment. A dozen states, including Tamil Nadu, Delhi, Telangana, Andhra Pradesh, and Karnataka will now invite global tenders to mitigate their vaccination needs, considering that the two local manufacturers here, Serum Institute of India and Bharat Biotech are stretched thin, and are not in a position to immediately fulfil the domestic demand. Last week, the TN government opted to take this route, as the state has been allocated 13 lakh vaccines, which is insufficient to inoculate people in the age group of 18-44. Chief Minister MK Stalin has directed officials to import vaccines from global pharma majors following the approval of the Centre. A silver lining is a relaxation offered by the Health Ministry guidelines, which says there is no requirement for local trials to be conducted for the vaccines, to be procured and administered to Indian citizens. This exemption sought by vaccine makers such as Johnson & Johnson, Moderna, and Pfizer, clears the deck for these companies to launch their vaccines here, sans local trials. Currently, states can only procure vaccines approved by the Drugs Controller General of India (DCGI). These include Covishield, Covaxin and Sputnik-V. It might be wishful thinking to believe that floating global tenders was the answer to the shortage of lifesaving COVID-19 drugs. But the reality is far from that. States floating tenders during a national health crisis is a measure opted out of desperation to appease public anxiety in the absence of Central intervention. These states are to compete with international governments who have already placed orders for vaccines worth billions, and that too in advance, before India woke up to the need for universal vaccination. Floating such tenders might be a sure shot recipe for creating unhealthy competition among states. Both Mumbai and Delhi are vying for 1 crore doses while Uttar Pradesh is seeking 4 crore doses. Several companies globally are now falling terribly short of meeting the demand placed by various nations. Just recently, the European Union had taken legal action against AstraZeneca for its failure to honour its vaccine supply contract with the bloc. A ray of hope has emerged in the arrival of the Russian Sputnik-V vaccine in India, through Dr Reddy’s Laboratories. The Russian Direct Investment Federation has earmarked 250 mn doses for India while tying up with many Indian firms to manufacture as many as 850 mn doses annually locally. Chinese makers like Sinovac and Sinopharm are also attempting to make headway into India. But a few states have included clauses in their tenders that prohibits procuring vaccines from neighbouring nations. The Health Ministry anticipates that India would administer about 51.6 crore vaccine doses by the end of July. The availability of vaccines might hit 216 crore between Aug-Dec, as a result of approvals granted to Zydus Cadila’s vaccine, SII’s Novavax vaccine, Bharat Biotech’s nasal vaccine and the Genova mRNA vaccine. National reputation aside, what the state-wide process of global tendering ignores is the bargaining power wielded by India as a whole when it opts for centralised procuring. As a nation, India can leverage more influence when negotiating with vaccine makers, and possibly offer doses affordable to all. But in this case, states are on their own and compelled to dip into their coffers to pay for the vaccines, a task made doubly hard due to the deficits faced by many states. In a crisis of this magnitude, if there’s anyone who needs to float a global tender, it’s India by itself.