Lancet panel pitches for centralise vaccine procurement, distribution amid jab shortage

NEW DELHI: A Lancet panel of experts on India on Wednesday proposed central systems for the procurement and distribution of free Covid vaccines, part of an eight-point charter of recommendations to “curtail the loss of life and suffering” caused by the coronavirus resurgence in the country.

The Lancet Citizens’ Commission on Reimagining India’s Health System, which comprises 21 experts including virologist Gagandeep Kang and Narayana Hrudalaya chairperson Devi Shetty, was launched in December last year.

In an article published in the British medical journal, the commission put forward eight urgent recommendations for the Centre and state governments.

These include a transparent pricing policy and cash transfers by the state to workers in the informal sector.

Among the key points is the establishment of central systems to procure and distribute COVID-19 vaccines free of cost, a departure from the current policy of decentralised procurement through state governments.

“Such an approach would optimise prices and minimise cross-state inequities that may result from differential fiscal and capacity contexts,” the 21 authors wrote in the article.

“These recommendations are focused on the immediate steps central and state governments must take to help curtail the loss of life and suffering caused by Covid-19 amid the recent surge in cases,” the Commission said.

The Commission also recommended that district-level working groups should have the autonomy to respond to rapidly changing local situations and must be empowered to receive funds and resources to coordinate efforts across all sectors of the health system, from front-line workers to tertiary care.

Other recommendations include a transparent national pricing policy and caps on the prices of all essential health services, wide dissemination of evidence-based information on the management of COVID-19, and marshalling all available human resources across sectors of the health system, including the private sector, for effective response to the disease.

Besides, the panel proposed active collaboration between government and civil society organisations to create and disseminate accurate information, enabling home-based care, emphasising prevention, helping navigate access to life-saving treatment, and promoting vaccination.

Another recommendation is transparency in government data collection and modelling to enable districts to proactively prepare for likely caseloads in the coming weeks.

Finally, the commission recommended minimising the “profound suffering and risk to health caused by loss of livelihoods by making provisions for cash transfers by the state to workers in India’s vast informal economy who have lost their jobs”.

“There is still time to stem the haemorrhage of life and the suffering caused by COVID-19 in India,” the authors wrote.

“We call on the central and state governments to act with urgency and in solidarity with each other and across sectors to address one of the greatest humanitarian crises facing the country since its independence,” they added.

The commission was launched to map the pathway to achieving universal health coverage (UHC) in India in the coming decade through a participatory, solutions-driven approach.

Besides Kang, who is professor at the Christian Medical College (CMC) in Vellore, and Shetty, the panel also includes Vikram Patel, professor, Harvard T.H. Chan School of Public Health, Kiran Mazumdar-Shaw, executive chairperson and founder of Biocon Limited and Yamini Aiyar, chief executive of the Centre for Policy Research in New Delhi.

Meanwhile, India has become the second country after the US to have crossed 20 crore cumulative COVID-19 vaccination coverage, the Union health ministry said on Wednesday.

India achieved this coverage in 130 days as against the USA’s feat in 124 days, the ministry said.

According to data available on Our World In Data and multiple sources, other leading countries in COVID-19 vaccination drive include the UK which has reached 5.1 crore mark in 168 days, Brazil that reached 5.9 crore mark in 128 days, and Germany which reached 4.5 crore mark in 149 days.

On the 130th day of the drive, the cumulative COVID vaccination coverage crossed the 20 crore mark (with 20,06,62,456 doses including 15,71,49,593 first dose and 4,35,12,863 second dose of COVID-19 vaccines), according to data available at 7 AM,” the ministry said.

Over 34 per cent of the population above 45 years has received at least the first dose of COVID-19 vaccine in India till date.

Similarly, over 42 per cent of 60+ years of population in India has received at least first dose of COVID-19 vaccine, the ministry said.

India’s COVID-19 vaccination drive was launched by Prime Minister Narendra Modi on January 16.

As on date, India is using three vaccines against COVID-19 in its immunisation drive, these include the made-in-India vaccines Serum Institute of India’s Covishield and Bharat Biotech’s Covaxin.

Russian Sputnik V is the third vaccine to get approval from the Drug Controller General of India (DCGI) for Emergency Use Authorisation and is being used in a few private hospitals which are expected to be increased over the coming days, the ministry said.

In Phase I of the vaccination drive, started 130 days ago on January 16, the National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) prioritised healthcare workers, and frontline workers (both government and private sector).

Phase II of the vaccination drive started from March 1, focused on protecting the most vulnerable age groups.

These prioritised age-groups included people above 60 years of age and those above 45 years with associated specified co-morbidities.

This was further relaxed to all people above 45 years of age on April 1.

In the third phase, ‘Liberalised Pricing and Accelerated National COVID-19 Vaccination Strategy’ was adopted on 1st May 2021.

Under this strategy, everyone above 18 years of age are eligible for COVID-19 vaccination.