R. Ramakumar

R. Ramakumar



1/ <Thread> on the Niti Ayog's press release "Myths & Facts on India’s Vaccination Process". It is a pity that the Niti Ayog, unlike its venerable predecessor Planning Commission, is being turned into a joke in the public eye by its present incumbents.

2/ Myth 1: The criticism against GoI is that it delayed placing advance purchase orders for vaccines till January 2021. Other nations had placed orders by June 2020 itself. Bangladesh placed its first order with SII in November 2020. Why couldn't the GoI place orders earlier?

3/ Orders were not placed with foreign or domestic producers till 2021. On the foreign front, none of the discussions from "mid-2020" resulted in any order placed till April 2021. Further, no foreign vaccine had emergency use approval in India to facilitate placement of orders.

4/ On the domestic front, the assumptions were: (a) India's production capacity is sufficient to meet India's demand; (b) "Made in India" vaccines would be sufficient for India; and (c) all of production within India is for India's use. All the three assumptions were misplaced.

5/ On (a) and (b), even the most liberal projections never placed India's production capacity above 28 lakh doses/day, when it needed 54 lakh doses/day to vaccinate 100% of its 18+ population in 12 months. It was clear to all that we needed foreign vaccines. Except the GoI!

6/ On (c), on what basis did the GoI assume that all of India's domestic production capacity can be for India's use? GoI knew that firms like SII had export commitments? Adar Poonawalla had publicly stated in October 2020 that half his production was earmarked for other countries

7/ Myth 2: All this was after 13 April 2021. In February 2021, GoI denied EUA for Sputnik V citing absence of immunogenecity data. But it gave EUA for Covishield in Janaury 2021 without immunogenecity data. Why were different criteria applied to Covishield and Sputnik V?

8/ GoI also returned Pfizer's application for EUA citing absence of local bridging trials. But it gave Covaxin EUA in January 2021 without any Phase 3 data. In May 2021, we still do not have Phase 3 results of Covaxin! Why were different criteria applied to Covaxin and Pfizer?

9/ The reality: the 13 April decision to give EUA for more foreign vaccines was after the GoI realised (a) that its projections were all wrong; (b) its folly of betting on politics (a la atmanirbhar policy) rather than reason; (c) vaccine shortage grew dangerously after 7 April.

10/ This course correction of 13 April is now being publicised as a proactive policy initiative! The reality is that it was public pressure and ridicule that forced GoI to change track.

11/ Myth 3: The simple question is this: how much did the GoI "invest" in expanding the production capacity of vaccine companies in India in 2020 or 2021? The answer is zero.

12/ World over, governments invested in private companies to share risks with them, and later bought back vaccines from them at cheap prices. Examples are USA with Moderna; Germany with BioNTech; and UK with Oxford-AstraZeneca. Not in India, though.

13/ In India, the GoI provided money to SII and BB only after January 2021, that too in the form of advance payments on vaccine purchases. There was no support or investment. The only at-risk investment in SII of $150 million was from GAVI and Gates Foundation, not GoI.

14/ Contrary to what the release says, IPR of Covaxin is shared by GoI and BB. This is where the question arises: what did the GoI do with this IPR given that it had moved the WTO to globally waive vaccine IPRs? Why was one company given exclusive license till April 2021?

15/ Is it not true that the decision to give Covaxin licenses to three PSUs was arrived at only when the Supreme Court of India threatened to intervene? Having been forced by the court to decide so, the GoI is now showcasing it as another proactive policy initiative!

16/ On the other claims. By when will SII's capacity rise to 11 crore doses/month? On what basis is GoI saying that BB's capacity would rise 10-fold to 10 crore doses/month by October? And why is the GoI claiming higher supply of those vaccines in very early stages of testing?

17/ Myth 4: if compulsory licensing was not attractive, why is the GoI in the WTO asking for IPR waivers? The question of CL was raised in India with regard to Covaxin on which the GoI had a shared IPR. Why was a public IPR allowed to be used for private profiteering?

18/ Why was there an inordinate delay in providing more licenses to other producers in Covaxin? Even now, why is it that only three producers have been given licenses? Why not more?

19/ Myth 5: The shift of blame on to States was precisely the objective of the 19th April policy. The spirit of the State's demand was the demand for decentralisation of vaccine distribution, not procurement. It things were "well-administered" till May, why not continue it?

20/ This explanation makes the centre look silly. Was the 19 April policy introduced just to prove a point to the States? If GoI knew there were no vaccines to buy, why did it push the States into that quagmire? Is it some ego battle that is on, or serious public policy making?

21/ The GoI cannot hide the fact that it bungled on the vaccine policy. It has to accept its error and move ahead without blaming States, who are just in charge of distribution. Of course, some States may be poor in vaccination, but its GoI's job to get vaccines. Own it.

22/ Myth 6: Look at this sentence: "the hiccups and issues faced by the people in the administration of these 25% doses by the states leave a lot to be desired". You have a production capacity of less than 28 lakh doses/day. Out of that, GoI has booked 22 lakh doses/day.

23/ Of the remaining 6 lakh doses/day, private hospitals take 3 lakh doses/day. For all the States, what is remaining is 3 lakh doses/day. And after creating this sham, you turn around and blame the States?

24/ Its high time that the Niti Ayog stops being a tail of the BJP. You are a policy-making body. You have to provide reasoned policy advises to the GoI. It is not your job to enter into political fist fights with opposition parties. Seriously guys, have some sense! Do your work.

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