Vaccine inequity lurks as govt pushes private sites

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Experts say the insistence to lean on private facilities, where vaccines are available against payment, is likely to be a deterrent for people from the lower-income groups and further delay the vaccination efforts at the shortest time.

Vaccine inequity lurks as govt pushes private sites
India's COVID-19 vaccination efforts continue to be lacklustre with several states reporting intermittent shortages. The signals emanating from the Center is confounding on how the lofty target of vaccinating all adult Indians can be met by the year-end. To a pointed question on the crisis and existing supplies at a recent press briefing, a top government official urged people to increasingly use private vaccination facilities.
Experts say this insistence to lean on private facilities, where vaccines are available against payment, is likely to be a deterrent for people from the lower-income groups and further delay the vaccination efforts at the shortest time. "Vaccine inequity" is seen as a major challenge by the World Health Organization (WHO) in getting a grip on the spread of the virus and ending the pandemic.
When questioned on the shortage of vaccines, particularly, Covaxin, at government centres, VK Paul, Member, Niti Aayog and at the helm of India's virus control and vaccination strategies, called for 'optimal utilisation' of vaccines available at private centres. He said, "We should look at that channel of availability also. We should encourage people and also help people to take a vaccine from the private channel as well."
COVID-19 vaccines are administered free of cost at government centres and at private sites charged Rs 780 for Covishield, Rs 1410 for Covaxin and Rs 1,145 for Sputnik V.
Paul added that overall vaccine distribution is done systematically based on availability from manufacturers. This supply 'visibility' is shared with the state governments, and they need to plan their vaccination drives accordingly and prioritise second doses.
At a time when states and municipalities are suspending vaccination drives amid shortages, the government promoting private sector risks skewing the inequity further.
On Friday, the Gujarat government suspended the vaccination drive for three days. Vaccinations were paused at government centres in Chennai and Mumbai since Friday due to a lack of doses. Last week, Rajasthan had suspended sessions for three days till stocks arrived.
India stands as the only country where 25 percent of available vaccines are open to the private sector for direct procurement from manufacturers.
Since May 1, when the vaccination was opened up for all above the age of 18 years and for private sector procurement, disruption of supplies have been reported at government centres across the country. Private centres have been operational throughout since May 1.
Two clear reasons:
First, the production of vaccines is slower than the offtake and demand. While the government has shared an increasing uptake in the vaccination program and says production increased by 'hand-holding' the manufacturers, the numbers are underwhelming. After a high of 88 lakh doses administered on a single day on June 21, India has been administering average 35 lakh doses daily.
Two, the majority of the citizens prefer getting vaccinated at government centres versus the paid ones at private sites.
Multiple reports of unused vaccine stocks at private centres highlight citizen preferences. While most states do not give a breakup of vaccination done by government and private centres, some have indicated the abysmal performance of the private ones.
Case in point Chhattisgarh. Of the 31,81,992 vaccine doses administered between May 1 and July 5, the private sector accounted for just 12,057 doses, which is 0.38% of the total.
In Tamil Nadu, the private sector totalled just about 5 percent of the total vaccination drive since May 1. Mumbai is possibly the only city where nearly 40 percent of the vaccination is done in the private sector. Hence, state governments are now suggesting reducing the private sector quotas.
Rajasthan Health Minister Raghu Sharma had last week written to the former health minister Harsh Vardhan requesting that private sector vaccine quota be diverted to the state government. Sharma told CNBC-TV18 that vaccine offtake in the private sector is negligible and the demand at government centres is quite high. "At government centres, we need 75 lakh vaccine doses just for second dose commitment in July and we have been allocated a total of 48 lakh doses (including Covishield & Covaxin). The private sector has been allocated approximately 16 lakh doses. Even combined it is just 65 lakhs. We are requesting the government if the private quota is also given to us we can provide private centres with their requirement, which is very little.”
The Indian Express earlier reported that nine private hospitals in the urban metropolis had cornered 50 percent doses meant for the private sector in May, raising questions of vaccine equity and access.
The Centre has been pulled up for its inept vaccine procurement and distribution policy by the Supreme Court and raised questions on the widening inequity in vaccine distribution.

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