India has surpassed the US to become the country with the fastest vaccination rate globally, with the number of people vaccinated on a single day, 5 April, 2021, exceeding 4.3 million people, vindicating Prime Minister Narendra Modi’s measured and calibrated approach on this front.
Overall, till date, since the vaccination program started in India on 16 January 2021, over 91 million or 9.1 crore people have got the jab, 2.4 crore vaccine dosages are in stock and we have another 1.9 crore in the pipeline. India has vaccinated the third highest number of people globally. Humanitarianism has been amplified by the generous outreach of the Modi government, which has exported well over 60 million or over 6 crore Covid vaccines to over 76 nations under the WHO-monitored vaccine sharing initiative, COVAX. Naysayers who allege that India should not have sent vaccines to other countries conveniently forget that exporting vaccines is not merely about “vaccine maitri” or vaccine diplomacy. Coronavirus is the worst global pandemic to hit mankind in 102 years. International diplomacy apart, even from a humanitarian standpoint, India, given its status as a rising economic superpower, is obligated to assist and support those who are less fortunate. Don’t countries help each other when there are earthquakes, cyclones or catastrophic floods? So why should helping other nations during a debilitating pandemic be viewed any differently? Clearly, Prime Minister Modi’s war against the Wuhan virus has been guided by the abiding principles of “India First” and “Neighbourhood First”.
Experts opine that India should scale up the vaccination drive to stem the recent spike in cases by ramping up the inoculation drive in areas of high transmission to prevent the virus from spreading. What experts need to also understand is that it would be chaotic to simply make the jab a “free for all” kind of an exercise where anyone who wants the jab gets it. The issue at this stage is not a supply-side one to start with. Eight out of the ten high-risk zones reporting the highest number of daily cases are from the state of Maharashtra alone, which has the unique distinction of wasting 5 lakh vaccine dosages. Effectively, what this means is that states like Maharashtra need to reduce vaccine wastage and inoculate on a war footing. Despite availability, Maharashtra has had an average weekly positivity rate of 23.2%. To conveniently blame the Central Government for inadequate supplies, when the problem is actually that of inadequate and incompetent management by the utterly apathetic Shiv Sena-led MVA alliance, reeks of a poor attitude. Another example of gross mismanagement is Congress-ruled Punjab. On February 3, 2021, Punjab had only 2,122 active cases. Two months later, the number became 24,458, with cases rising exponentially in places like SAS Nagar, Amritsar, Jalandhar, Ludhiana and Patiala.
Union Health Minister Dr Harsh Vardhan summed up Maharashtra’s criminal lethargy succinctly when he said, “When states ask to open up vaccine supplies to everyone over 18, we must presume that they have done saturation coverage of healthcare workers, frontline workers and senior citizens. But the facts are altogether different. Maharashtra has vaccinated just 41% of healthcare workers with the second dose. Equivalent numbers for Delhi and Punjab are 41% and 27%. There are 12 Indian states/UTs that have done more than 60%. When it comes to senior citizens, Maharashtra has vaccinated just 25%, Delhi has vaccinated 30% and Punjab has vaccinated only 13%. There are four States/UTs that have already vaccinated more than 50%.” Maharashtra, Delhi or Punjab, all three are non-BJP ruled. In fact, with a weekly positivity rate of 13.8%, Chandigarh, like Maharashtra, is a textbook case of how shoddy governance can cause irreparable damage. Captain Amarinder Singh, Chief Minister of Punjab, is clearly overrated, given his absolutely dismal track record, be it in tackling farm issues or Covid, with Punjab reporting a high active caseload.
Dr Harsh Vardhan, elaborating on Maharashtra and Punjab further, said, “Doesn’t it seem evident that these states are trying to divert attention from their poor vaccination efforts by just continuously shifting the goalposts? Politicising such a public health issue is a damning indictment of certain political leaders who should know better. I have seen statements made by public representatives in Maharashtra about a shortage of vaccines. This is nothing but an attempt to divert attention from the Maharashtra government’s repeated failures to control the spread of the pandemic. The inability of the Maharashtra government to act responsibly is beyond comprehension. To spread panic among the people is to compound the folly further. Vaccine supplies are being monitored on a real-time basis and state governments are being apprised regularly about it. Allegations of vaccine shortage are utterly baseless. It is shocking to see how the state government is putting Maharashtrians in danger by letting people escape the institutional quarantine mandate for the sake of their personal vasooli. Overall, as the state has lurched from one crisis to another, it seems as if the state leadership is happily sleeping at the wheel.”
The Union Health Minister also exposed the Congress-ruled Chhattisgarh, and rightfully so. “Similarly, we have seen regular comments by leaders from Chhattisgarh that are intended to spread misinformation and panic on vaccination. I would like to humbly state that it would be better if the state government focusses its energies on ramping up their health infrastructure rather than on petty politicking,” said Dr Harsh Vardhan. The Chhattisgarh government, in fact, refused to use Covaxin despite it being given Emergency Use Authorization (EUA) by the Drug Controller General of India. Not only this, by its actions, Bhupesh Baghel’s government has the dubious distinction of being perhaps the only government in the world to have incited vaccine hesitancy.
Maharashtra, with only 8% of India’s population, has recorded the highest number of Covid deaths in India, accounting for 34% of the total country-wide deaths, in a classic case of embarrassing misgovernance under the MVA alliance. Again, Maharashtra, accounting for 60% of India’s active caseload, is currently a non-BJP-ruled state and led by a Congress-centric alliance. It is, in fact, one of the worst performing states, having reported almost 57,000 fatalities, with the corrupt MVA netas busy trying to ward off allegations of vasooli (extortion), rather than caring for the citizens of the state. In sharp contrast, Uttar Pradesh, a BJP-ruled state, which has a massive population of over 200 million people and is almost the same size as Brazil, has reported less than 9,000 deaths. Brazil, in the meanwhile, has reported over 3.41 lakh mortalities.
On 16 January 2021, India, the world’s largest democracy with a population of 1.38 billion people, kickstarted the world’s largest Covid vaccination drive, with 2.07 lakh people vaccinated in a single day, across 3,351 sessions, involving 16,755 vaccinators. What makes India’s vaccination drive against Covid unique is its sheer size, scale and meticulous planning, guided by the humanitarian concept of “Jan Bhagidari”, or peoples’ participation. The plan is to inoculate 300 million or 30 crore “priority population” in the first two phases by July-August 2021, including 3 crore healthcare and frontline Covid workers. From March 1, 2021, the eligibility criterion was expanded to include people over 60 years of age and those between 45 and 59 with comorbidities. The third phase of the vaccination drive aimed at everyone above the age of 45 was launched on 1 April.
The calibrated approach of the Modi government is both practical and the need of the hour. A vaccine is not some kind of a “life jacket” that can prevent a person from getting infected, but it certainly reduces the severity of the infection and helps in breaking the transmission chain. It is important to inoculate vulnerable age groups first and therefore prioritising some demographic age brackets over others, which is exactly what the Modi government is doing. Those who allege that India should start vaccinating everyone above 18 fail to realise that the vaccine has to be given at this stage to those who need it, not necessarily to all those who want it. Not everyone who wants the vaccine needs it! The Central Government is spending around $5 billion on free doses at state-run clinics, public health centres and hospitals.
Inoculating 300 million people within six to seven months is akin to vaccinating almost the whole of the US or equal to vaccinating the combined populations of Germany, the United Kingdom, Italy and France, and in record time! India has a national recovery rate of over 92.48% and the case fatality rate (CFR) of just 1.3%, the lowest globally. India’s cumulative positivity rate too is hardly 5.07%, which is commendable given that many states in the US like Florida and Connecticut, till recently, were reporting daily and weekly positivity rates in the higher double digits. It is indeed noteworthy that despite having a population density of 455 per square kilometre, amongst the highest in the world, India, which has tested over 250 million people, has done an unprecedented job of reining in the total number of cases at barely 13 million. In sharp contrast, the US with a population density of just 36 per square kilometre, has reported a staggering 31 million coronavirus cases and over 5.59 lakh deaths.
The Modi government has built a war kitty of 2,360 master trainers, 61,000 programme managers, over 2 lakh vaccinators and over 3.7 lakh vaccination team members so far. Serum Institute of India’s Covishield and Bharat Biotech’s Covaxin, which it has developed with the Indian Council of Medical Research (ICMR), are homegrown vaccines that vindicate PM Modi’s clarion call of “vocal for local” and are reflective of the country’s innovative and scientific temper. Both the vaccines have been approved by the DCGI.
In effect, India’s vaccine roll-out is not only the largest in the world, but also the most affordable, with no compromises whatsoever on any standard operating procedures (SoPs). The PM-Cares fund will bear the entire cost of the first phase, which will innoculate 30 million or 3 crore frontline Covid workers. Earlier, in June 2020, over Rs 2000 crore was allocated from the PM-Cares fund for the supply of 50,000 ‘Made-in-India’ ventilators to government-run Covid hospitals in all states and UTs. Out of the 50,000, 30,000 ventilators were manufactured by Bharat Electronics Limited, yet again showcasing India’s indigenous manufacturing prowess. While a jaded, directionless and clueless Rahul Gandhi keeps taking needless jibes at the Modi government, the fact of the matter is that for over six decades, India just had 47,000 ventilators. However, in one go in June 2020, the Modi government made available 50,000 ventilators to ensure that no life is lost for want of life-saving equipment.
Prime Minister Narendra Modi’s food security scheme for the needy, called the Pradhan Mantri Garib Kalyan Yojana (PMGKAY), provided free ration to 81 crore or 810 million people every single month, for nine months in a row, during the pandemic. Effectively speaking, this means that a population 2.5 times the size of the US was fed, showcasing the Modi government’s generous, welfarist and people-centric approach.
Contrast this with the policy of obfuscation and apathy followed by China, with the probity and transparency shown by India, in taking Covid head-on. Be it building over 116 million toilets under the “Clean India” or “Swachh Bharat” mission, making India’s 5.5 lakh villages open defecation-free (ODF), giving free health insurance to 50 crore Indians under the “Ayushman Bharat” scheme, producing over 60 million PPE kits and 150 million N95 masks between April and October 2020, bringing home over 3.9 million stranded Indians from different parts of the globe via the “Vande Bharat Mission”, or extending medical and humanitarian assistance to over 150 countries in the fight against the pandemic, the Modi government’s fight against the Wuhan virus was made easier by the fact that a huge amount of effort went into ramping up India’s health infrastructure and making cleanliness a way of life in the last 6.5 years. What is worth mentioning here is that, during the initial days of the Covid outbreak, there was only one lab in the country that could undertake testing for the infection. But today there are over 2,000 testing laboratories.
A key concern now is vaccine wastage. What is vaccine wastage? While wastage cannot be fully eradicated, it has to be within recommended limits. In general, high vaccine wastage inflates vaccine demand and increases unnecessary vaccine procurement and supply chain costs. Vaccine wastage is directly linked to vaccine usage, which is the proportion of vaccines administered against vaccines issued to a vaccination site. What is causing the wastage? For instance, each Covishield vial has 10 doses in total, while a Covaxin vial contains 20 doses—each dose being 0.5 ml (for one person). Once opened, all doses have to be administered within four hours, otherwise it goes to waste and the remaining doses have to be destroyed. The vaccine wastage in India can be largely be attributed to low turnout of beneficiaries, which is due to inadequate planning of sessions by a few states. For instance, if a vial contains doses for ten people and only six turn up, four doses would go waste. In a few Opposition-ruled states, opening vials, despite an inability to mobilise a critical mass of people, has led to vaccine wastage. Till date, around 6.5% of Covid vaccines have gone to waste nationally, according to Central health officials. Over 23 lakh vaccine doses have been wasted, translating into a wastage rate of 6.5% nationally, with the wastage rate being as high as 18% and 12% in Telangana and Andhra Pradesh, respectively.
The second reason accounting for vaccine wastage, identified by the Centre, is inadequate training. Officials said some vaccinators are drawing only nine doses against ten doses. “We are seeing that trained vaccinators know how to draw a vaccine. These trained vaccinators will tell you that even in a vial of ten doses, you can actually take out 11. This is a crucial aspect to reduce vaccine wastage,” the official said. Also, open vial policy guidelines have to be strictly followed to minimise vaccine wastage. In the Covid-19 vaccination drive, the Health Ministry factsheet sent to the states mandates that both Covishield and Covaxin have to be discarded after four hours of opening.
The Modi government’s CoWIN (Covid Vaccine Intelligence Network) app, owned by the Ministry of Health and Family Welfare, was earlier the platform used for conducting Pulse Polio and other crucial and highly successful immunisation programmes across the country. The same platform has been expanded for doling out Covid-19 vaccines and the Ministry of Electronics and IT along with the National Informatics Centre are handling the backend and the tech infrastructure for it. CoWIN is again an example of how the Modi government has seamlessly embraced technology to ensure last-mile delivery. When it does become open to everyone, it will have four modules—user administrator, beneficiary registration, vaccination and beneficiary acknowledgement and, of course, status updation. The CoWIN app is likely to be made accessible to the general public for registration by the end of March-April 2021.
“Good governance is not firefighting or crisis management. Instead of opting for ad-hoc solutions, the need of the hour is to tackle the root cause of the problems”; this is a famous quote by PM Modi. Better words have not been said. Undoubtedly, India’s outstanding and successful war against Covid will go down in history as a textbook case of what a sensitive and nimble-footed leadership can accomplish. It would be apt to conclude with a quote by John F. Kennedy, who said, “When written in Chinese, the word ‘crisis’ is composed of two characters. One represents danger and the other represents opportunity.” Undoubtedly, while a reckless China foisted the Wuhan virus on an unsuspecting mankind, a visionary leader like Prime Minister Narendra Modi utilised this unprecedented global crisis as an opportunity to reach out to and heal millions, both in India and outside, showcasing India’s true spirit of “Vasudhaiva Kutumbakam”, which means, “the world is one family”.
The author is an economist, national spokesperson for the BJP and the bestselling author of ‘Truth & Dare: The Modi Dynamic’. The views expressed are personal.