India changes policy but still lacks vaccines

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NEW DELHI (AP) – Starting Monday, every adult in India will be eligible for a free vaccine paid for by the federal government.

The new policy, announced by Prime Minister Narendra Modi last week, ends a complex system introduced last month of vaccine procurement and distribution that overburdened states and led to inequalities in the way vaccines were distributed.

India is a key supplier of vaccines to the world, and its missteps in her country have caused it to halt vaccine exports, leaving millions of people around the world waiting unprotected. Only about 3.5% of Indians are fully immunized and although supporters hope the policy change will make vaccine distribution more equitable, poor planning means shortages will continue.

Here’s a look at India’s vaccine policy changes and what they mean.

PREVIOUS POLICY

India has extensive experience in managing large immunization programs and distributes 300 million vaccines free of charge to infants and mothers annually. For these programs, the federal government is responsible for purchasing the vaccines and then works with the states to determine the best way to distribute them.

But the scale of the COVID-19 vaccination campaign is unprecedented. And a massive surge in March pushed India’s healthcare system to breaking point. As hundreds of thousands of people were infected every day and hospitals were teeming with breathless patients, states complained about not receiving enough vaccines from the federal government and demanded more control over vaccine distribution. .

So, starting in May, the federal government agreed to buy only half of all vaccines produced for use in India and continued to distribute them free of charge to health and frontline workers and people over the age of. 45 years old. The other half became available to states and the private sector. hospitals to buy directly. These vaccines were intended for people between 18 and 45 years old; they were free if obtained from the states, but cost money if obtained privately.

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WHY IT DIDN’T WORK

States had never bought vaccines before and a limited supply meant they were in competition with each other as well as with private hospitals. They were forced to pay higher prices than the federal government could have negotiated, said Dr Chandrakant Lahariya, a health policy expert.

“This makes it essentially ineffective,” he said.

Private hospitals passed this cost on to people, and amid shortages in government centers, people had to either pay for a vaccine or not be vaccinated.

The policy change also expanded eligibility to all adults. Broadening the criteria despite the shortages meant the shots did not always go to groups the federal government initially said it would prioritize: those in essential jobs and the elderly. Since May, more people under 45 have received their first injection than those over 60. More than 74 million people over the age of 60 remain unvaccinated.

Modi said these decisions were made to satisfy states’ demands, but the fractured response could have cost lives, said Dr Vineeta Bal, who studies immune systems at the Indian Institute of Education and Research. scientists in the city of Pune.

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WHAT HAS CHANGED NOW?

The federal government has now decided to purchase more of the vaccine, but it still does not fully revert to its original policy. He will buy 75% of all vaccines for use in India and likely renegotiate prices. These photos will be returned to States and will continue to be distributed free of charge. Private hospitals can buy the remaining 25% at capped prices and can charge for them.

States will receive vaccines based on their population, disease burden and number of people vaccinated. They will be penalized for wasting doses.

But procurement remains a challenge. Delhi Chief Minister Arvind Kejriwal said: “Where the vaccines will come from is a big question.”

India has placed orders for vaccines that are still in development, but for now will continue to rely on existing and overwhelmed suppliers like the Serum Institute of India.

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The Associated Press’s Department of Health and Science receives support from the Department of Science Education at Howard Hughes Medical Institute. The AP is solely responsible for all content.


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