The first among the 11 promises in BJP’s Bihar manifesto- a sankalp patra, technically- declares that “every Bihar resident will be given free vaccination”, wherever it is available. If you vote for BJP, of course.
Direct, likely and indirect inferences can be drawn from this. Direct inference is that the Centre does not have a nationwide vaccine allocation plan in place yet and will probably take vital public health decisions as the pandemic and election schedule progresses.
The likely inference is that the Centre will procure the vaccine — or vaccines — at rates it negotiates and states will be asked to buy from it. This was reiterated by Amit Malviya of the IT Cell who also tweeted, “Health being a state subject, Bihar BJP has decided to give it free. Simple.”
The indirect is that the promised free vaccine will come painfully late or it might be inferior to those available to be bought.
Till date, only two vaccines have received regulatory approval, both Russian and both approved without Phase-3 trials. The ICMR vaccine portal launched by the government last month shows three vaccines under trial in India. Two are under stage II trials and Serum Institute-ICMR candidate Covishield is conducting stage II & III together. There is no indication on how long these will take to get approved and distributed. The mumps vaccine— fastest ever to be approved— took 4 years to develop and get licenced. The Health Minister has meanwhile stated that a vaccine would be out by early 2021.
Tamil Nadu and Madhya Pradesh have also promised free vaccines whenever it is available, so have the governments of Japan and Norway and President hopeful Joe Biden. But only in the case of Biden, the freebie is contingent on getting elected. Even then, Biden does not have the advantage of incumbency that the BJP has in Bihar or the increased leeway to make dispassionate promises that comes with being an incumbent.
Who gets the vaccine first is a question of bioethics. Gavin Yamey of the Duke University writes that, ideally, “the initial doses should go first to health workers and to countries that have an uncontrolled epidemic, then to the elderly and medically vulnerable, and finally to the whole population.” Also, the government must have credible data on exactly who has been infected and hence, does not need a vaccine. The Electronic Vaccine Intelligence Network (eVIN), which provides real-time information on vaccine stocks and cold chain points, is already being readied for distributing COVID-19 vaccines in India.
Who gets it free shouldn’t be a question at all. Putting a price tag on any future vaccine would have dire implications, even if that price is low.
The rich— in any country— would buy or bribe their way into getting the vaccine, just as leaders of rich nations are manoeuvring at the international level. Almost half of all supply of potential vaccines has already been reserved by a small minority of nations. For India to follow the market rationale domestically would be morally hypocritical. Instead, it should push for an international coalition for fair distribution of vaccines.
Side note: In reply to a complaint by RTI activist Saket Gokhale, the Election Commission on 30th October said that no violation of any of the provisions of Model Code of Conduct had been observed. Gokhale had claimed that the promise of free vaccine to Bihar was discriminatory and a misuse of powers by the central government during elections.