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Greater private participation in vaccination demands forbearance for decentralised decision making

India’s vaccination strategy is making a welcome shift with greater choice and more private sector participation. Senior citizens and those with comorbidities getting shots from March 1 at 20,000 private vaccination centres with a reported price cap of Rs 400, is a huge leap for the vaccination campaign. After 40 days, against a target of 3 crore healthcare and frontline workers, only 1.23 crore vaccine doses could be dispensed to this target group. The challenge now is to ensure that the addition of new beneficiary categories and vaccination sites will boost capacity utilisation.

Some of the strategy shifts can certainly contribute towards this end. More people frequent private healthcare facilities. So having their choice of private service provider will provide a fillip to vaccination. Facilitating walk-ins without prior registration could be the other gamechanger. Co-Win app’s patchy performance, including pre-registration requirement, misfiring alerts, missing names, and over-centralisation by deciding for beneficiaries when and where to turn up for jabs was unhelpful. Bangladesh has a hybrid system of one-time online enrolment and in situ completion of all other formalities. Nepal is following an offline, decentralised model.

Now comes a less tech-friendly age group and a diffused population over whom authorities have even less clout than the predominantly government workforce in the first two phases. Numbers to vaccinate are also far greater. Any worsening of Co-Win glitches will dampen turnout and capacity utilisation. Experts have suggested decentralised Aadhaar-based offline data keeping to simplify and speed up vaccination. If capacity still goes unutilised – theoretically 30,000 sites should deliver 30 lakh vaccine doses daily – the vaccination strategy must be flexible enough to allow other adult age groups to take the shot.

With J&J’s one-shot vaccine mustering US expert approval and at least one Indian pharma company pitching for a tie-up, the bouquet of vaccines is growing bigger. Government must ensure that price caps don’t drag down capacity expansion, innovation and local manufacturing. Instead it must allow competition, economies of scale and technology maturation to organically discover prices, which could end up lower than present caps. With government facilities offering vaccines for free, it mustn’t obsess over private sector strategies. For instance, if a private facility can vaccinate beyond 100 beneficiaries a session – even 24,000 daily as health expert Devi Shetty suggested – free them to do so.

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This piece appeared as an editorial opinion in the print edition of The Times of India.



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