Pavan K Varma | If only BJP were as good at vaccination as it's at election

The writing is writ large on the wall: vaccinate, vaccinate, vaccinate. We know now that the Covid virus is likely to attack in several waves. This has been seen in many countries, and is in evidence in ours too. To contain successive surges, we should, of course, retain our vigil on all health and social distancing protocols, but the real solution is to universalise vaccination and ensure its delivery in the shortest possible time.  

The government I am sure is doing its best, but its best falls short, I am sorry to say, of the optimum. The first in the line to get the shot were health workers, and rightly so. However, a great number of these still remain vulnerable. There are around three crore healthcare and frontline workers.

Of these, less than one-third have as yet received both the shots; and a little more than half have got the first shot. This is woefully short of target.  Senior citizens and those with co-morbidities were next in line. Here too performance is far below targets. It is estimated that there are 27 crore senior citizens and those with co-morbidities. But only three crore of these have been vaccinated, including some 78 lakh with co-morbidities. This is really slow going.  

It is true that there could have been some vaccine hesitancy in the initial phase. Yet, this is hardly likely to have been that high in vulnerable senior citizens eager to get some protection, and in health workers who know that it is essential in their own self-interest to get the jab. One can understand greater reticence in rural areas, but a great many have still not been covered even in urban centres.  

We need to know the reasons for this tardy pace. India, we are continuously told is not short of vaccines. Government spokespersons loudly proclaim with justifiable pride that we are the vaccine capital, producing 60 per cent of vaccines in the world. Nor do we lack experience in public health campaigns for mass vaccination. Our Universal Immunisation Program, which began in 1985, is today one of the largest and most successful programs in the world.

We have the systems in place for such a campaign — Electronic Vaccine Intelligence Network (eVIN), National Cold Chain Management Inventory System (NCCMIC), and the National Cold Chain Training Centre (NCCTS). Thousands have by now been trained in managing stocks of vaccines at the right temperatures and monitoring their safe delivery across the country.

Why then are we lagging behind in this highly critical vaccination drive, on which not only the health but the economy of our country is dependent?   In the absence of a ramped-up vaccine campaign, several of the worst effected state governments are threatening lockdowns. As many doctors and health specialists have emphasised, lockdowns are hardly a solution, quite apart from being impractical.

We have seen the disastrous consequences of the first nationwide lockdown announced at a notice of four hours, which left millions of migrant workers on the streets walking hundreds and thousands of miles to their villages and hometowns without food, water, transport, money or health support. That lockdown, and the manner in which it was implemented, far from containing the spread of the disease, ensured that it spread with impunity.  

Today, when the economy is just showing signs of a revival, a lockdown would be a fatal dampener to these green shoots of resurgence. It would also further aggravate the huge unemployment problem, the highest in years. As one worker said on national television, I would rather die of the virus than out of hunger for lack of a job. Undoubtedly, containment zones cannot be ruled out as a temporary measure, but generically spread out lockdowns, misinterpreted as a decisive response by panicky state governments, is hardly a solution. Even if lockdowns are announced, their efficacious implementation in a country like ours where people live cheek by jowl and in porous habitations, is virtually impossible. All lockdowns do is to give disproportionate powers to state agencies like the police.  

The answer, therefore, is to put an expedited and effective vaccination campaign in mission mode. For this, the government must get over its own vaccine hesitancy. The imperative is to universalise and go beyond this reticent step by step approach.

Secondly, distribution problems must be urgently sorted out, since some states have complained that they are not getting an adequate supply of vaccines, while six per cent of vaccines are being wasted for lack of use. Thirdly, we need to approve more vaccines at the speed of light. Those global vaccines that have Indian collaborations need to be given the licence without the mandatory bridging trials.

Regulatory hurdles need to be removed from vaccines such as Johnson & Johnson, Sputnik and Novavax. Fourthly, our vast previous experience of mass immunisation programmes should be aggressively harnessed to increase the pace and footprint of vaccination. There is a widespread network of anganwadi workers and health and education officials who should be roped in for this purpose. Fifthly, the private sector and civil society should be made partners in the ramped-up vaccination drive. Sixthly, state governments, under close central supervision, should gird up for the task ahead, since much of the ground implementation is in their hands. And, lastly, Covid appropriate behaviour should be consistently advertised, and containment zones carefully identified and their isolation strictly monitored.

 If the BJP, now in power at the Centre, could run the vaccination programme as efficiently as it seeks to run elections, we could perhaps see light at the end of this dark tunnel.