Covid-19 vaccine inequity: Pitfalls of quotas for private hospitals

In Mumbai, free vaccination centres got only a fraction of the doses compared to those available with private hospitals

Late one night last week, Mumbai’s municipal corporation (BMC), which controls the public vaccination programme for the city, tweeted that the next day all its vaccination centres would remain closed, as vaccines had run out.

The next day, when Mumbaikars, including those due for their second dose, could not access free vaccines anywhere, a housing society in Mumbai’s suburbs handed over Rs 3,00,000 to a private hospital as advance payment for the vaccination of 300 persons. These included its members, society employees and members’ friends.

That day, only those Mumbaikars who chose to pay sums ranging from Rs 700 to Rs 1,250 per dose got vaccinated. The rest, i.e., the majority of Mumbaikars, went without.

The story of that one day sums up the country’s vaccine policy since May 1, when the Narendra Modi government allowed the private sector free access to the two vaccines being manufactured in India, with no price cap. On June 7, perhaps thanks to the Supreme Court cracking the whip, this policy ended.

In the last five weeks, India’s vaccination programme, which had earned praise even from Modi critics for its near equitable distribution – though mostly in big cities – became yet another reflection of the unfair inequalities that have marked the Covid pandemic.

In April, Pakistani friends shocked me by revealing they had paid (Pakistani) Rs 12,200 (Rs 5,746) for two doses of the Sputnik vaccine. Indians, I told them proudly, had to pay just Rs 500 even in private hospitals. That affordable amount, however, isn’t coming back - for neither has the Centre touched the substantial 25 per cent quota set aside for private hospitals nor has it capped the price at which manufacturers can sell to them.

But while the Centre was primarily to blame for the free-market policy, as it has been for all that’s gone wrong during this pandemic, can the states be absolved? Was the Punjab government the only one to make a killing by selling its quota of vaccines to private hospitals at over 100 per cent profit?

In Mumbai, vaccination drives by corporates and housing societies tying up with private hospitals has become the norm. These drives are done with the BMC’s permission under certain conditions. MLAs, especially from the Shiv Sena and the BJP, are openly facilitating such drives.

One could argue that since private hospitals anyway are allowed to charge whatever they want for vaccines, and people are willing to pay, the BMC has simply fulfilled its role as a watchdog by stipulating minimum safety requirements for such drives.

It can also be said that these MLAs and corporators are only helping to bring sellers and buyers of a vital product together, and since this also benefits those unable to move out due to old age or sickness, as well as those unable to register on the Co-WIN website, they are actually performing a service.

Indeed, many of these elected representatives have performed a great service by getting the BMC to open multiple free vaccination centres in each ward. But the doses available at these centres are a fraction of those available with private hospitals. It’s normal to see many of these centres being allotted barely 100 doses per day, while private hospitals have enough to schedule vaccination up to 500 doses for select groups.

With the Centre as the sole distributor once more, will such unfair distribution continue? This inequality was and still is, easily preventable. The BMC could have bought and can still buy from private hospitals, the bulk of the 25 per cent vaccines allotted to them by the Centre. For a corporation with an annual budget of Rs 39,000 crore, this isn’t impossible. Failing this, elected representatives could have done the same.

After all, every MLA in Maharashtra got Rs three crore to spend on his/her constituents in 2020-21, raised to Rs four crore for 2021-22. Every corporator got Rs 60 lakh this year. Mumbai has 36 MLAs and 227 corporators; its population is two crore. The math is simple.

These funds are normally meant for 'development works', but at this juncture, what is more crucial for development than a free vaccine, with the possibilities it throws up for resuming economic and educational activities? It makes political sense too – the BMC elections are due next year.

For this to happen, authorities and elected representatives need to have a particular mindset: One which sees working for the people as their main function. The BMC, alas, is known to work for contractors. As for elected representatives, when did you last hear one promise to actually serve those on whose labour is built this glittering metropolis?

(Jyoti Punwani is a Mumbai-based senior journalist)

Disclaimer: The views expressed above are the author’s own. They do not necessarily reflect the views of DH.