By: Ashok B Sharma
The second wave of Coronavirus has brought in a tsunami-like disaster in India with mounting deaths, phenomenal rise in Covid positive cases coupled with acute shortages of vaccines, hospital beds, oxygen, oxygen transport facility and essential drugs needed for treatment like Remdesivir. Black marketing and hoarding of oxygen, Remdesivir and the like have become rampant. The wave came just after the country was steadily recovering from the shock of the first wave that began from March last year. Absolute lockdown was imposed last year to contain the situation that brought almost all activities to a standstill and the economy suffered badly. With the gradual phasing out of the lockdown, life began to return to normal.
In the period of relaxation in many cases Covid appropriate behaviour like wearing of masks, social distancing and hand hygiene was given a goodbye. Huge crowds, rallies and roadshows in poll campaign for elections to state assemblies in Bihar, Assam, West Bengal, Puducherry, Tamil Nadu and Kerala were contributory factor. Recent Shahi Snaan at Kumbh Mela at Haridwar where thousands of pilgrims and saint en-mass took a dip in the holy river Ganga was a total violation of Covid appropriate behaviour. Sane wisdom should have been to defer the elections to state assemblies in four states and Puducherry and prohibit any mass gathering at Kumbh Mela.
But Election Commission went ahead with the election. The Modi government, which has a majority at the Centre, should have discussed with the political parties to defer the polls. The government had the warning signal of the approach of the second wave as early as in February this year. But unfortunately, Prime Minister Modi did not act. He was more aggressive in winning elections in Assam, West Bengal, Puducherry and leaving footprints of BJP in Tamil Nadu and Kerala. The government machinery, therefore, had no time to plan and work out strategies for the upcoming second wave of Covid.
The Prime Minister’s dream of Atmanirbhar Bharat (Self-reliant India) that he boasted about Make-in-India vaccines, PPE kit, masks, sanitizers and others after successfully dealing with the first wave was shattered, India’s healthcare system still need a long haul. The government has claimed that its vaccination drive is one of the largest in the world. According to figures of Our World in Data, a total number of Covid vaccine doses administered in the world till April 20, this year was 928.68 million. India administered only 127.13 million doses, while the US administered 213.39 million doses and China 195.02 million doses. This shows India vaccinated only 8 per cent of its population while the US vaccinated about 40 per cent of its population.
India has contributed 21 per cent of Covid-19 vaccines to the world and not 60 per cent. This 60 per cent of vaccines were supplied to UNICEF for child vaccination like DTP, MMR, polio and the like in developing and least developed world as per International Market Analysis Research and Consulting group report 2019. However, this is a good gesture by India’s Vasudhaiva Kutumbakam (World is a family) initiative. According to the data posted by the Ministry of External Affairs by April 28, India exported 66.3698 million doses of Covid vaccines to 95 countries, out of which 10.715 million doses were granted to the neighbouring countries and poor countries, 35.792 million doses were sold as a commercial venture. In addition, India exported 19.8628 million doses to COVAX programme co-led by CEPI, Gavi and WHO. India’s Covid vaccine commercial exports include Serum Institute of India (SII) commitment to AstraZeneca. India formally banned exports in last week of March after a shortage was felt in the country.
Kudos to Indian vaccine manufacturers for participating in the Vasudhaiva Kutumbakam initiative. But they need to enhance their capacity in Covid pandemic vaccines so that there is no shortage in domestic market and the government should facilitate this. The government woke up late on April 19 and gave Rs 15,000 million to Bharat Biotech and Rs 30,000 million to SII. As per new pricing policy, in a relief to vaccine producers they are allowed to negotiate prices with state governments and private hospitals. SII has announced its revised price for Covishield – Rs 400 per dose to state governments, Rs 600 per dose for private hospitals and Rs 150 per dose for the Centre for the current order. SII needs to pay 50 per cent royalty to Astra Zeneca. Bharat Biotech is yet to follow suit. As per new policy, the vaccine producers should give 50 per cent of their production to the central pool.
The government has failed to ensure affordable price of vaccines in the new policy. It has left to the state governments to subsidise it. In central government hospitals, it is the onus of the Centre to ensure free vaccination. With the entry of foreign vaccine, it may not be possible to ensure affordable prices. India and South Africa have appealed to WTO TRIPS Council to wave IPRs on Covid vaccine temporarily. The council’s decision is awaited.
Earlier the government was boasting about Bharat Biotech vaccine Covaxin indigenously produced and SII vaccine Covishield produced in the country under Make-in-India programme with Oxford-Astra Zeneca technology. It was in no mood to allow any foreign vaccine. Now as shortage is felt, the government has allowed Russia’s Sputnik V without waiting for the results of abridging trial that Reddy’s Lab had started three months ago. It has decided to allow foreign vaccines that have been given emergency approvals by US, UK and Japanese regulators, including those listed by WHO. This is an admission that Atmanirbhar Bharat initiative has failed as far as Covid vaccines are concerned and the domestic companies are not in a position to cater to the needs of the huge population as the government has allowed all above 18 years to be vaccinated.
There is an acute shortage of raw materials needed for the manufacture of Covid vaccines, Remdesivir, medical oxygen and oxygen tankers in the country. India produces 7,510 tonnes of oxygen per day, which has been increased to 9103 tonnes. The government has restricted the industrial use of oxygen so that it can be used in hospitals. It has decided to import 50,000 tonnes of oxygen for the time being and set up oxygen plants. The issue is to make it available to hospitals by improving the transportation facility. There is a shortage of oxygen tankers which are being imported and the government has ordered the conversion of nitrogen tankers into oxygen tankers.
Countries like US, UK, France, Germany, Australia have come India’s help in supply of raw material needed for the manufacture of vaccines, ventilators, Remdesiver, oxygen and oxygen tankers. US has already accepted India’s help in supply of essential medicines during the first wave of COVID-19.
On the whole, the second wave of Covid-19 has exposed the claims of Atmanirbhar Bharat as per as country’s healthcare system is concerned. The healthcare system needs an overhaul. It also shows lack of government’s preparedness to meet the challenge. (IPA Service)