In numerous interviews, Medical Advisor to the POTUS, Dr Anthony Fauci, has reiterated that despite the divisiveness, our common enemy is the virus and not each other. The message is to fight this pandemic unitedly. Sadly, that spirit is missing among Indian politicians who are so paranoid about Narendra Modi that even a pandemic has failed to drive some sense into them.
I would not need to quote Dr Fauci for a society that has always banded together in times of crisis. But for some, political survival has become more important than the lives of people. In their enthusiasm to score political points, they are ignoring the negative impact their murky tricks may have on people. Yes, I am talking of the vaccine politics being played out in full public view. While PM Modi and his team have been trying their best to empower the country and vaccinate people as quickly as possible, the Opposition parties are trying their best to undermine the efforts by spreading rumours and raising demands that may make the society more divisive and confused.
The Prime Minister, who worked overtime to ensure that scientists come out with vaccines earlier than expected, is being accused of not making enough efforts to meet the vaccine demand. Facts, however, would reveal that Modi has been way ahead of the Opposition’s thought process. The Opposition did try to derail the process but has failed desperately.
First, the timeline. The rotavirus vaccine that prevents diarrhoea in young children first came to the US in 1998. It was withdrawn and then reintroduced in 2006. India included this vaccine in the Universal Immunisation Programme in March 2016. The Hepatitis B vaccine was available in the world commercially in 1982. India launched this in 2002. The polio vaccine was approved by the WHO in 1955. The oral version of the same came to be commercially marketed in 1961. India launched the vaccine in 1978.
Compare this to the vaccine for Covid-19. The WHO gave the first emergency use authorization for the vaccine against Covid-19 on 31 December 2020. India got its first vaccine in January 2021 and it had already launched its vaccination programme on 16 January 2021. Also, India achieved the rare feat of having an indigenous vaccine and joined the elite club of about a dozen countries that can say so too.
While scientists must be complimented, one cannot take credit away from the leadership. PM Modi set up a task force of experts in April 2020 and personally monitored vaccine development and ensured that the country was not lagging behind. Covishield and the indigenously produced Covaxin became the first two vaccines which were given clearance for emergency use.
When talks were going on that the vaccine being developed by Bharat Biotech and Indian Council of Medical Research (ICMR) would be India’s weapon against Covid-19, very few believed it. But the Prime Minister was sure about it. When the ICMR was trying to fast-track trials, everyone raised eyebrows and charged the PM with putting pressure on the process. But the PM was only encouraging and asking them not to compromise on parameters.
Everybody in the country heaved a sigh of relief and pride when the PM announced on 15 August 2020 that the vaccines were at various stages of trial and a fully ‘Made in India’ vaccine would be ready soon. While promising that the vaccines would reach every Indian, he said that the distribution roadmap was ready. And both the vaccines, Covishield and Covaxin, after satisfactory trials, were given emergency use authorisation on 3 January 2021.
While India was celebrating and the world looked towards India with hope, the Opposition reacted with bitterness. Some called it haste and dubbed it as vaccine nationalism. Senior Congress leader Shashi Tharoor called the approval “unseemly haste”. He said, “Chest-thumping ‘vaccine nationalism’ – combined with the PM’s ‘self-reliant India’ campaigning – trumped common sense and a generation of established scientific protocols”. “Jingoism is no substitute for common sense,” he added. While demanding full disclosure about the trials, CPM leader Sitaram Yechury said that “any attempt to short-circuit the regulatory process for political gains will damage the good reputation built by Indian pharma over the years”. A Samajwadi Party leader called it the “BJP vaccine”. One cannot say whether these leaders were acting at the behest of pharma lobbies that were keen to sell their vaccines to India, but it was certain that they saw the vaccine as the most powerful weapon to solidify Modi’s image as India’s most beloved leader.
Ever since, their single-point agenda has been to damage this image and they have tried their best to argue that the vaccine was going to undermine the health of the people. Thousands of articles and media reports came, opposing vaccine use. No one asked the simple question: can any PM do that? Congress-ruled Chhattisgarh raised objections to the use of Covaxin in immunization even when the programme rolled out on 16 January. Punjab, Chhattisgarh and Kerala opposed Covaxin even when its efficacy was proved after the third phase of trials. The TMC in West Bengal joined the chorus and the Jharkhand government termed people on whom the vaccine would be used as “guinea pigs’’.
All this was bound to impact people negatively. There were reports that many people in Kolkata refused to take Covaxin at private hospitals, saying they would take Covishield instead. For the Opposition, their tirade seemed to work. They had undermined their own vaccine.
‘Who should be vaccinated first?’ This has also been an issue since day one of the vaccination drive. This was the first time that even people who considered themselves powerful did not try to short-circuit the system. Even the Prime Minister had to wait for his turn to take the jab. There was no rush, no scramble to be the first. Everybody knew he would get the jab when his turn came.
At a meeting of the Covid Vaccine Group on 30 June 2020, the PM had formulated four guiding principles for vaccination: “First, vulnerable groups should be identified and prioritized for early vaccination, for example, doctors, nurses, healthcare workers, non-medical frontline corona warriors, and vulnerable people among the general population. Second, vaccination of ‘anyone, anywhere’ should take place without imposition of any domicile-related restrictions for getting the vaccine. Third, vaccination must be affordable and universal – no person should be left behind. And fourth, the entire process from production to vaccination should be monitored and supported in real time with the use of technology.”
Based on international norms and discussions with experts, the Covid Vaccine Group devised the mechanism to roll-out vaccines in India. The target was to vaccinate 30 crore people by August 2021. In the first phase it was open to healthcare and frontline workers whose numbers came to 30 million. In the second phase the free vaccine was applicable to all above the age of 45 and above. The Centre was to take the tab. More than 18 crore people were already vaccinated, having taken one or two doses by Friday, 14 May.
As the PM launched “Vaccine Utsav” from 11 to 14 April to speed up the vaccination drive, the country witnessed a second Covid wave with a severity not imagined by anyone. States that had started celebrating and preparing to bid goodbye to the pandemic, despite warnings from the Centre, and people who had become complacent suddenly found caught in the vortex.
Despite the severity, the trend of the infection was the same. While it severely impacted the younger generation too, close to 70 percent of those affected were in the 70-plus category. The impact could have been mitigated by better preparation and a war-like effort, but helplessness was visible all around. Delhi, which had recorded a peak of close to 9,000 cases on 11 November 2020, crossed the 30,000 mark daily on some days in April 2021.
In this situation, opposition parties discovered that the best way to deflect attention from poor management was to shift the focus to vaccination for people in the age group of 18-44 years. The demand was first made by Maharashtra Chief Minister Uddhav Thackeray who on 5 April appealed to the PM to include people in the 25-44 age group. Delhi CM Arvind Kejriwal had already written to the PM saying all adults should be vaccinated. Chhattisgarh CM Bhupesh Baghel wanted this to be extended to 18 years and above. The Indian Medical Association also requested the PM for the same and suggested that public places be opened to those with vaccination certificates.
The Health Ministry responded by saying that the inoculation strategy was crafted to minimize deaths and protect the vulnerable. Union Health Secretary Ranjit Bhushan said, “The basic aim is to reduce death through vaccination. The other aim is to protect the healthcare system. If doctors, nurses and paramedics are infected then who would run the hospitals? These are the two objectives of vaccination in all countries.”
The vaccination objective was not based on demand but need, he stressed, while asking people not to trivialize the government’s decision. He said, “When we talk about opening vaccination to all, our focus reduces on controlling the pandemic. Did you hear about any country that vaccinates those younger than 45 years?”
Rahul Gandhi perhaps sensed an opportunity to score a political point and to create a wedge. He tweeted: “It’s ridiculous to debate needs and wants. Every Indian deserves the chance to a safe life.” Politics hijacked his sense of balance and he ignored the fact that since vaccines were in limited supply it was not possible to open it for all. Chairman of the National Expert Committee on Vaccine Administration VK Paul clarified that when the time would come, this would be open to all.
Rahul Gandhi and his supporting parties raised the issue of vaccine export. “While our nation is facing vaccine starvation, more than 6 crore (60 million) vaccines have been imported,” he said. Such intemperate criticisms can come only from a person who is completely irresponsible and does not bother about the interest of the nation. Vaccine export was a part of the commitment to the GAVI alliance that takes care of poor countries and is applicable to all vaccine manufacturers.
What Gandhi and other Opposition leaders have been saying would have made India a pariah in the international community. The SII alliance with AstraZeneca had clauses for the compulsory sale of vaccines. Considering that the SII depended on crucial raw material from the US to make this vaccine, should India have tried to default on the commitment? One just needs to recall the panic that had been caused when news about the US stopping supplies of raw material for Covishield came out. The Government of India had to intervene to smoothen the process. India’s goodwill earned through vaccine diplomacy has also compelled the world to come to India’s help when it got engulfed in a crisis. Indian vaccines helped the UN peacekeeping forces to continue their operations and also healthcare and frontline workers to work safely to save lives. No wonder world leaders expressed their debt to India for saving the lives of their citizens.
And this export of vaccines did not impact India’s own vaccination programme for the 45-plus category. It was merely a matter of prioritization since vaccines were not available anywhere and it takes time to ramp up production. The Union Government always said that the entire country needs to be vaccinated. To prevent the society from getting divided on vaccines and to enable faster vaccination, the Union Government on 19 April announced vaccination for the 18-44 years category from 1 May. The expert group had been mulling over this already. But it wanted to ensure a smooth supply line and uniform policy.
The government’s new liberalised vaccine policy allowed the two vaccine manufacturers to earmark 50 percent of their production exclusively for the Central government and 50 percent for state governments and the open market. Opposition-ruled states and Congress leaders had already demanded that states be given greater leverage in the procurement of vaccines and that they should not be held hostage by the Centre. Under the new system, states could lift their quota of vaccines based on their population directly from the Centre. They were also allowed to float tenders for procuring vaccines from other manufacturers.
The states that were asking for a liberalised procurement policy suddenly realised that they could not do much since buying it from outside at competitive bidding could be costly. All those who were talking of decentralization suddenly took a U-turn and started demanding that the Centre do the purchasing and give to state governments.
Was the Centre unaware of this? It was fully aware that such a policy could lead to chaos. After its meeting on 12 August 2020, the National Expert Group on Vaccine Administration for Covid-19 (NEGVAC) had specifically advised all the states “not to chart separate pathways of procurement”.
There was bound to be a vaccine shortage because of the technical issues involved. It needs a different kind of laboratory security and the government cannot risk the lives of people. Already it is taking steps to increase production and the country would soon have sufficient vaccines to give it to other age groups too. But rather than depending on the wisdom of the government, Rahul Gandhi and others started lobbying for other vaccine manufacturers. The Modi government was clear that any vaccine manufacturer must follow the process of bridge trial to test its suitability for India that has a different climatic condition. Some vaccine manufacturers opted out. The pride of a country and lives of people are more important than the ego of these manufacturers.
When the Opposition found that none of these were sticking and that the government was on firm wickets, it raised the issue of differential pricing. How can the Union Government buy the vaccine at the rate of Rs 150 per shot and ask states to buy the same at Rs 300 or private players at Rs 600? This was a way to help vaccine manufacturers make a profit. This argument will not hold ground when seen in the proper context.
The vaccine procured by the Centre is also going to the states and that too free of cost. Differential pricing is a way to encourage private players to keep some margin so that there is an incentive for them to invest in the expansion of capacity. This would also help other global players to come to India. If the government fixes the price for all, this would drive away others and also prohibit investment in research by pharma companies. Competition may bring the prices further down.
All states have declared that they would administer vaccines to people free of cost. The people are thus not impacted by the cost of the vaccine. Why can’t states therefore take the tabs? For example, the Delhi government, which spends crores on advertisements and self-promotion, can easily afford to buy the vaccines. When a BJP-ruled state like Uttar Pradesh, the most populated in the country, can do it, why can’t Maharashtra, the richest, and other states do it too?
Allowing private players would further ease down the burden on the respective states. Those who can afford and don’t mind paying can go to private hospitals and get their jabs. There are many in the country who do not want it for free and would rather go to a private hospital and get the shot of their liking. Why are states trying to stop them from doing this? Availability, not pricing, is the issue.
Federalism is a shared concept. The Centre is under pressure due to a massive investment need for infrastructure. This year alone over Rs 3 lakh crore was spent on health. Besides the emergency need due to Covid, such as extending help to states to strengthen their response system, the government is also setting up hospitals and reinforcing the healthcare system across the country.
Sharing the burden of vaccinating everyone is not a bad proposition. Rather than playing politics and getting elated in their own echo system, which is filled with anti-Modi venom, the Opposition should know that the PM, who worked in a focused way to give India its vaccine, would also ensure that everyone is vaccinated. His timeline is better than yours because he has planned much in advance. Just listen to him and follow him and remember that the virus is the enemy.
The writer is convener of the Media Relations Department of the BJP and represents the party as a spokesperson on TV debates. He has authored the book ‘Narendra Modi: The Game Changer’. The views expressed are personal.