In anticipation of India’s vaccination drive against Covid-19 after regulatory approval of vaccines by Serum Institute of India and Bharat Biotech, questions are being raised about how states would contribute to the inoculations and manage the massive logistics challenge that India faces.
It is not yet clear what the inoculation drive, deemed to be one of the biggest in the world, would cost the Centre or the states which would soon become hubs of the vaccine rollout.
An analysis by Business Standard shows that states like Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand and West Bengal will see the most pressure on their health expenditure. On the other hand, smaller states and those in the North East spend more per capita on health, which means inoculation will cost them less than 15 per cent of their health expenditure. Kerala is also an exception, as it is a large state but its spending is such that an inoculation drive would only cost 20 per cent of its health budget.
The AstraZeneca-Oxford vaccine, called the Covishield and being developed by Serum Institute of India, will be available to private individuals for about Rs 1,000 ($14) and less than half of it, at Rs 444 ($6), to governments. To compare, the Pfizer-BioNTech will cost $37 per course.
Taking into account figures from 2018-19 state budgets, the analysis suggests that many states will have to spend their entire budgets for obtaining and administering these vaccinations alone. If the Centre chips in for this cost, the states may get some relief.
The World Health Organisation (WHO) has suggested that at least 70 per cent be inoculated in each state to attain herd immunity. For India to meet this standard, the report suggests that only obtaining the vaccine would cost about 33 per cent of the health expenditure of all the states taken together, adding that the cost of the vaccine will be a tenth of the fiscal deficit of all states together.
One way for the states to lessen the burden of vaccination on their finances is to spread the vaccination program over two financial years.
Union Health Minister Harsh Vardhan had announced that vaccines would be free for the priority groups that get inoculated in the first phase.