Vaccination: Charity or Right?

Consistent critique of the profit-philanthropy nexus is a must to build consensus around the demand for free and universal mass vaccination

A private hospital in Pune run by a charitable trust has announced that it will be administering a limited number of Covid vaccines every day to ‘’underprivileged’’ individuals free of charge. The information issued by the hospital regarding the procedure to avail this facility explicitly mentions this as a ‘’charity vaccine’’, and intended beneficiaries are asked to specify it as such.

Taking an instrumental view, one may not find fault with such an initiative as it would mean a few individuals getting vaccinated in time, who otherwise would not have been able to get inoculated due to the interlinked factors of availability, accessibility and affordability of vaccines.

If one accepts the differentiated (and hence discriminatory) vaccination policy of the Union government as either a desirable one or a fait accompli, then such instrumental reason would seem almost impeccable. Almost, because, even instrumentally speaking, such scattered and piecemeal vaccination in the time of pandemic could prove to be ineffective in controlling the pandemic.

However, proceeding from the normative commitment to the universal and fundamental right to life, reducing an essential life-saving service such as vaccination to an act of charity is deeply problematic at many levels.

Furthermore, it also helps us to understand the compatibility/complementarity of such charitable initiatives with a ‘liberalized free-market oriented’ vaccination policy (or public policy in general) as both are antithetical to the ideal of universal rights.

Charity and profit go hand in hand

The act of ‘donating’ for vaccines as a charity to ‘underprivileged’ individuals entails that the intended beneficiaries are implicitly not considered equal right-bearing citizens. Under such a scheme of things if one is unable to be the consumer who can purchase the commercial product, i.e. vaccine at its market price, then they will have to become the client of the charitable patron and depend on their dole or donation. On the one hand, the said hospital will sell the vaccine at the so-called market rate to earn profits and on the other hand, indulge in a piecemeal act of charity.

More often than not it would be a charity of convenience where such profit-earning entities would appeal to the public to donate and support. If indeed such an initiative is driven by the public-spirited urge to vaccinate, then why not the entire stock of available vaccines with the hospital is being brought under the purview of the ‘charity vaccine scheme’? In other words, why not universalize charity? It would be a fallacy. Such universalisation would undermine the primacy of profit, whereas, charity or philanthropy not only coexist but rather complement the profit motive or commercial interest. Hence, universalization is conceivable only if the vaccine is considered as a public good – neither a commercial product nor a charitable dole – to be availed as a right by every citizen.

Right to life

And indeed, it has to be considered as a fundamental right as the right to life cannot be devoid of the right to health and anything that protects human life and health has to be made available universally to every human being. While agreeing in principle with this reasoning, one can still argue pragmatically that what is the harm if those who can afford are asked to pay for the vaccine. It should be borne in mind that a differentiated policy of vaccination would, by design, force a section of the society to depend on charity as such policy would thwart the goal of universalization. Forcing individuals from a section of society to rely on charity is tantamount to relegating them to sub-citizens, if not subhuman level, devoid of dignity. Substantive reading of the right to life suggests that it is not about mere survival, but a life of dignity and hence it demands the universalization of vaccination is treated as a fundamental right.

What about dignity?

That the logic or language of rights and dignity doesn’t become a part of common sense in general and in the policy debates around vaccination, in particular, is partly due to the privileging of the virtue of ‘Daan’ in our society, which comes with its religious underpinnings. It is also partly due to the hegemony of the ideas of the sacrosanctity of profit, private entrepreneurship and the associated paraphernalia of the ideas of desert and luck.

However, these ideas not only sit well with the virtue of daan but in fact, feed off each other. The act of daan from which one accrues Punya, sacred merit, is so ingrained in our society that the immediate tendency is to uncritically celebrate charitable philanthropic initiatives and worse still to consider them as a substitute or an alternative to the state-led public action.

Reinforcement of the hierarchical patron-client relationships with feudal overtones is thus underplayed and one is so absorbed with the sense of satisfaction and self-importance derived through the act of giving, that its demeaning impact on the other person is overlooked.

It should be noted here that the land struggle of the landless agricultural labourers, launched under the leadership of Ambedkarite leader Dadasaheb Gaikwad and with significant participation of the communists, in the early 1960s, was consciously framed as a ‘Bhoo-Maang’ satyagraha, as against the ‘Bhoo-Daan’ launched by Vinoba Bhave. A maang, or a demand/claim, is made to the state against a corresponding right and hence the act of making a claim is consistent with the democratic ideal of citizenship.

Whereas, privileging daan is antithetical to such an ideal. However, this notion of claim-making citizens and institutionalized rights sits uncomfortably with the ideal of profit as any public action corresponding to the realization of a social-economic right would invariably encroach upon the private commercial domain in some way or the other, either through progressive taxation, or introducing price curbs or even take over through nationalisation.

Therefore, it is favourable to the upholders of the private commercial interests that daan, charity and philanthropic initiatives are encouraged so as to secure and legitimize the persistence of profit-making and stave off any real or perceived threat to it. Promoters of such a view would have private vaccine producers and private hospitals keep making a profit and at the same time also keep a façade of charity and philanthropy. They would have the abdication of responsibility by the state go unquestioned while celebrating acts of voluntarism and individual efforts.

Can this profit-philanthropy nexus be allowed to continue, potentially at the cost of human lives, in the face of the pandemic is a fundamental question that needs to be posed before all sensitive individuals. Consistent critique of this nexus is a must to build the widest possible consensus around the demand for free and universal mass vaccination.

(Vidula Sonagra is a freelance writer researcher based in Pune. Nachiket Kulkarni is Assistant Editor, Economic and Political Weekly.)

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