The novel corona virus or Covid-19 pandemic has wreaked havoc on this whole world. The contagion has brawny ramifications in every sphere of life from health care to education to the real estate industry. With the contagion spreading, various medical researchers were all set to the task of developing an effective vaccine, in which they were at-last successful although their efficacies are debatable.
Universal vaccination programmes have eliminated innumerable afflictions ranging from small pox to measles to polio. But in a short span of time the world will witness one of the most anticipated and challenging events of the year 2020 – ‘The great COVID-19 vaccination errand’.
With a population of 1.3 billion, India is currently battling the COVID-19 pandemic and is ranked second in infections. With fresh cases reported daily, it is now developing a strategy for effective vaccination which hitherto might be a daunting task in itself.
Challenges emerging before ‘The great Co-vid vaccination errand’
With more than 9 million active cases in the country and a battered economy, India is set on a mammoth task to vaccinate 1.3 billion people in two doses (1.3 *2 = 2.6 billion doses), in the midst of the following challenges: –
- PROGRAM CHALLENGES
Though India has the world’s largest vaccination scheme – the universal immunisation programme, but it doesn’t have a program for adult vaccination except for tetanus for pregnant women. Even children’s vaccination program developed is bound to have loopholes leaving behind a majority of children, especially in rural areas. In such a situation, developing a program covering the entire population where vaccine would be given in 2 doses (at some days interval) is a onerous task.
- PHYSICAL CHALLENGES
- A) Supply Chain Challenges
There are three front runner vaccines whose Phase 3 interim results have been made public globally, two are m-RNA vaccines which have to be stored and transported at sub-zero temperatures (-70 degree) and thus unsuitable for India for vaccination drive which indeed might take place in the scorching summer heat.
The supply chain has to be kept under a hawk’s eye as the vaccines are very sensitive to temperature variations.
According to a report by the International Air Transport Association’s Centre of Excellence for Independent Validators in Pharmaceutical Logistics, ‘25 % of vaccines are degraded by the time they arrive at their destination while temperature errors cause losses around $34.1 billion annually’
Without a proper cold chain facility, vaccines face the risk of being exposed to temperatures outside the recommended range, resulting in reduction of potency and wastage. The problem is further aggravated by loss and variations in electricity supply, which in many places in India tends to get interrupted frequently.
- B) INFRASTRUCTURE CHALLENGES
Infrastructure related challenges are yet another hindrance for India which is worsened because of the oppressive summer and gigantic population. India needs to get billion vials of vaccines manufactured, filed, tracked and shipped to the needy at top speed by scaling up its cold chain and distribution infrastructure and making arrangements for cooling facilities in final delivery stages and storage facilities at clinics.
- C) REGIONAL DISPARITIES
What adds to the vaccination challenge are the regional disparities among states in the distribution of cold chain storages across the country, concentrated mainly in urban India. Jharkhand, Uttar Pradesh, and Bihar are among the least served states when it comes to cold chain infrastructure.
- ACCESS CHALLENGES
- A) AFFORDABILITY
There is a lot of uncertainty over who will bear the burden of cost since most of the rural India cannot afford to pay for the vaccine and government revenue is itself in a dire state because of disruption of operations due to pandemic. There are also issues of corruption which further intensify the problem.
- B) VACCINE’S SECURITY
Crucial choices have to be made regarding the choice of vaccine from a pool of indigenous and foreign vaccines depending upon a range of factors such as minimum cost, minimum to no side effects in the long run, efficacy, transportation related feasibilities. Decisions have to be taken regarding identifying groups of early vaccination, etc.
Another stumbling block for India would be vaccine uptake and monitoring. India has also to battle with vaccine hesitancy owing to the population’s precepts regarding resistance to change.t
- ETHICAL CHALLENGES
Many ethical issues revolve around the development and use of vaccines such as taking of vaccination by law, laws regarding developing and testing of vaccines, informed awareness about benefits and risks of vaccination and equal distribution of vaccines. Though vaccines fall within the clutches of distributive justice the health ministry has developed prioritization population groups which comprises of the following: –
- Healthcare personnel and staffs from both Government and Private Healthcare facilities
- Frontline Workers including personnel from state and central police department, armed forces, home guard, civil defence organizations, disaster management volunteers and municipal workers and
- Prioritized Age Group, which includes those aged above 50 years & those with co-morbidities.
- VACCINE NATIONALISM CHALLENGE
Vaccines Nationalism Challenge poses a threat to equitable distribution of vaccines across the globe, materialized due to pre-purchase agreements, advances where a single country or a particular group of countries is sole developer of vaccine. COVID-19 has already proved to the world that global public health is borderless and a virus can travel globally. Thus, even if vaccine nationalism were to happen, man is only at loss here.
India has little cause to worry about this threat due to its strong relations and alliances with foreign nations and the fact that various indigenous vaccines are on their way.
India has a colossal task before itself of immunisation of 1.3 billion from the virus which has taken a toll on human lives. The plan has already been set in motion to accomplish the above task procuring all indispensable tools & equipment, making all vital arrangements. There is a glimmer of hope, easing things into motion, when the ICMR’s (Indian Council of Medical research) director confirmed that “If we are able to vaccinate a critical mass of people, and break that virus transmission, then we may not have to vaccinate the entire population.” The hour is dark, the odds are not in our favour but one should not lose hope and do all that is necessary to aid the government for efficient vaccination program of India, for the contagion has already taught us ‘An outbreak anywhere is an outbreak everywhere’.
This article is written by Ankur Tulysan for The Connectere.