How does a country vaccinate 1.3 billion people? By roping in the private sector, Indian corporate leaders think.
While the government currently controls all the supply and distribution of vaccines, Indian business leaders like Kiran Mazumdar-Shaw, Azim Premji, and Anand Mahindra want private companies to be allowed to participate in the world’s largest Covid-19 immunisation drive.
Mahindra, chairman of the Mahindra Group, had argued for private sector participation to ramp up distribution.
Similarly, Premji, former chairman of Wipro, said that 500 million people could be inoculated in two months if the private sector was roped in. “Deploying and administering the vaccine in large proportion is the key requirement today. The government is doing its best. But I would strongly suggest they should supplement the effort by involving private parties,” he said in February during an event organised by the Bangalore Chamber of Industry and Commerce.
This sentiment has also emerged from healthcare entrepreneurs, who feel if the government were to be less rigid, India’s private healthcare infrastructure could be effectively mobilised. “When the private sector gets extensively involved, we can ramp up the vaccination effort five to 10 times,” Shobana Kamineni, vice-chairperson of Apollo Hospitals Enterprise, told Mint newspaper. “We can do 50 million vaccinations in the next 45 days if the sites are ramped up and more people are encouraged to get vaccinated,” she said.
Apollo has said that it can provide 2,000 vaccine sites and over 6,000 trained staff for Covid-19 vaccinations, but only if the restrictions are removed. “Many countries are vaccinating in car parks. If you have the guidelines, I don’t see why you can’t open up the drive-in safe sites, not necessarily hospitals,” Kamineni told Mint newspaper.
As of now, the Indian government directly buys the supply of vaccines from either Serum Institute of India (for Covishield, the Oxford-AstraZeneca vaccine) or Bharat Biotech (for Covaxin, India’s homegrown vaccine). These vaccines have been sold at a special price of roughly Rs200 per dose to the Indian government, which then distributes these shots to government and private hospitals.
Despite what business leaders say, at the moment, the government is holding all the cards, even as it offers a paid version of the Covid-19 vaccine.
The paid Covid-19 vaccine
In most countries, the vaccines are free for whichever population group—healthcare and frontline workers, the elderly, or those with co-morbidities—that is being inoculated. In India, the vaccination was entirely free during the first phase, which included only healthcare and frontline workers.
Now, as India began vaccinating people above the age of 60 and those aged 45-59 with co-morbidities, it made vaccine jabs taken at private hospitals paid for. Those registering to receive Covid-19 vaccines at government hospitals and vaccine centres would still get it for free, but people who register at private hospitals would need to pay Rs250 ($3.4) per shot.
This is far below what was expected. Adar Poonawalla, CEO of vaccine maker Serum Institute of India, had said the vaccine would cost approximately Rs1,000 per dose in the private market.
Biocon’s Mazumdar-Shaw has said that this pricing is unsustainable for private healthcare operators, who get Rs100 (out of the Rs250) to administer the shot.
But this is a welcome respite to Indians, severely hit by the economic losses of the pandemic, which only made India’s inequality worse. Healthcare observers have applauded the government for this low price cap, which is a stark departure from the price cap of Rs4,500 on Covid-19 tests that were announced during the early phases of the pandemic.
Nearly 1 million people, who are eligible in the second phase, have received the first dose of the two-shot vaccine so far. India has identified a population of 270 million to inoculate in this second phase. After these two phases, nearly 1 billion people would still remain, and private sector employers could play a key role in speeding up the process.
Leading tech companies have also expressed their interest in buying the vaccines and immunising their staff at their own cost. Infosys and Accenture have already announced that they would vaccinate their employees at the companies’ cost. But even as the government has given citizens the option to pay for the vaccine, it has not yet allowed private buyers to source directly from either the government or vaccine makers.
All vaccines are currently being disbursed through the Co-WIN platform, and strictly under the government’s supervision. This, according to India’s health minister Harsh Vardhan, is essential because both Covishield and Covaxin are to be used only as an emergency measure. “One must appreciate that the vaccines are approved under Emergency Use Authorisations (EUA). During the course of EUA, it is the responsibility of the government to keep things totally under control. This is the reason vaccines are still not available in the open market,” he said during a press briefing on Feb. 15.
This is a worry even as more private healthcare centres are onboarded to administer the vaccine. “The experience so far of vaccination indicates the need for further strengthening of protocols and systems for monitoring and reporting of adverse events following immunisation,” Malini Aisola, public health expert, and Siddhartha Das, theoretical physicist, wrote in The Indian Express newspaper.