Covid-19 Vaccination: Challenges, Chinese Model & Way Forward

HEALTH/ GOVERNANCE

Topic:

• GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

Covid-19 Vaccination: Challenges, Chinese Model & Way Forward

Context: Eight months ago, India had begun a decline in daily Covid-19 infections to the extent that many experts believed that a devastating second wave was unlikely in India. However, the second wave of Covid-19 has brought health infrastructure to a near collapse

Moreover, India’s options for containing the pandemic are narrowing as it can ill-afford another lockdown now. In this context, the combination of panic, public pressure, and the magnitude of the crisis has prompted the Union Government to authorize vaccines to anyone above 18 and give states more control over procurement.

Issues with Accelerated Rollout of the Vaccine

• Vaccine Shortage: Problems in scaling up production, and in the supply and management of vaccines continue amid the surge in cases. At the optimistic rate of three million doses a day, it would take at least 260 days from April for every adult to get at least a single shot.
• Changing Vaccination Policy: The processes initiated by the government in early January 2021 to expand India’s manufacturing capacity were under the assumption that it would be at least August before vaccines could be fully opened up for all. Given the shortage of vaccines, India cannot afford to have a single or universal policy and needs to make it more targeted.
• Weak Bargaining Power of States: Leading international vaccinators such as Pfizer and Moderna have supply commitments already tied up and it is unclear if merely the policy move of liberalising vaccine supply will leave States in India with the finances and negotiating power to procure enough stocks of vaccines. 
• Unequal Access between States: Leaving states to their own means will only increase policy incoherence and unequal access between states with different fiscal capacities and healthcare infrastructure
• Shortage of Raw Material: The inability of getting the much-needed raw materials from the United States – bags, vials, cell culture media, single-use tubing, specialized chemicals, etc. that have now been banned for export has disrupted the vaccine production in India.
• Balancing Global Commitments: Another issue is concerning international obligations. Of the 38 million doses the global alliance program Covax has so far distributed to 84 countries, 28 million doses were from India. That obligation may have to be followed up perhaps as they would need for their second dose.

How China Contained COVID-19 Virus? – Stellar role by Residential Committees

• At the grassroots, the most critical role was played by the residential committees (RCs). Though officially not part of the state and defined as institutions of self-governance, these committees are the instruments of the communist party for effective governance and political control. 
• They are mandated to perform administrative tasks, implement policy, mediate local disputes, and assist government agencies with maintaining public surveillance, health and sanitation, care for the elderly, etc.
• At the outbreak of the epidemic, after the initial days of confusion and voluntary action by individuals, the RCs soon took charge.
• In Wuhan, for example, all 7,148 communities were closed off. Community workers strictly enforced rules of entry and exit.
• They also made calls to residents asking about family members’ health and status, knocked on residents’ doors to conduct regular temperature checks, gathered information about travel history, provided home delivery of daily food necessities to people in self-quarantine and elderly residents, helped in contact tracing and transferring sick persons to community health centres. etc.
• Central leadership made provisions for the benefit of the workers like subsidies, provision of health equipment, insurance, publicity, and other institutional support. Clear channels were established by Central Leadership to pass down resources and authority from central to local organisations.

Way Ahead

• Massive Multimedia Campaigns: If fresh lockdowns are to be avoided, we need to enforce masks by investing in massive multimedia campaigns for information, education, and communication, like it was done for polio and HIV.
• Strengthening VaccineSupply Chain: Enhancing Electronic Vaccine Intelligence Network (eVIN) system will enhance real-time information on vaccine stocks and storage temperatures across all country’s cold chain points.
• Boosting Domestic Production: Government should provide necessary financial packages for ramping up domestic production of vaccine manufacturers for expanding their production facilities and improving upon their supply chains.
• Learning from China’s RC Model: Many urban areas have residential associations and local governments that can undertake similar mobilisation as RCs in China. However, this cannot be done without a centralised plan of action, which is the key aspect of this model. 
• Centralised Leadership & Support to states: Given the nature of this pandemic, the need of the hour is for the central leadership to step up and coordinate policy measures across the country.