When is it coming?
There are 26 vaccine candidates around the world in their clinical trial phase. The leading candidate is the Oxford University-AstraZeneca’s ‘Covishield’ whose third stage clinical trials have started at the Serum Institute in Pune (India).
If all goes well, we will have the first-ever Covid-19 vaccine- ‘Covishield’ ready to be sold commercially in just 66 days from today.
How will Indians get it?
The government has already indicated its plans to procure 680 Mn doses for 1300 Mn Indians by June 2021.
There are reports that they will directly procure vaccines from the Serum Institute and are planning to immunize all Indians for free.
But the question here is, should it be free for everyone?
Pharmaceuticals, especially vaccines, is a high-risk, high-reward business with investors who stand to lose large investments if the vaccine fails to be effective.
But since it’s a life-threatening global pandemic, there are ethics involved and it is up to the developer to decide if they want to put people first and sell the vaccine at cost or make a profit out of it.
AstraZeneca has declared that it will sell the vaccine at cost, striking deals with many countries around the globe.
So should the Indian government really provide it for free?
If we think of this vaccine as a ‘Public-good’ and argue that the Government should bear the cost of paying the vaccine manufacturers and provide it to every citizen for free, we forget the unique problems of our country.
There are two major problems with making it free for all.
- It is unlikely that we will get all 1.3 Bn doses for each citizen at a time. In the best case, we will get half of it by June 2021.
- So who gets it first?
- Given the vaccines are scarce, the effects of inequality will kick in and this might eventually pave the way for a black market and corruption involving bribing public officials for access.
- Just because it’s free, people who are not technically ‘at-risk’ will want the vaccine just out of a simple bandwagon effect.
- And the thing to keep in mind is that we still don’t know the long-term effects of this vaccine on humans due to the expedited rate of the clinical trials.
So what’s the solution?
Instead of making it free, the government should think of playing the role of a subsidizer.
They should subsidize it for low-income citizens who cannot afford the vaccine.
The vaccine should simply not be free for people who can afford it.
Also, distribution should be done in phases on a need-basis, focusing first on (not in any order as the order would vary from state to state):
- Healthcare professionals and front-line workers engaged in treating Covid-19 patients
- Other healthcare professionals
- A ‘ring-vaccination strategy’ covering major covid clusters to avoid the spread of the virus
- ‘At-risk’ people with comorbidities under the age of 65
- Pregnant women, infants and toddlers
This is one of the most complex policy issues in recent times and it will be interesting to watch how different governments around the world balance Economics and Medicine.
It all comes down to the age-old policy question- is healthcare a right or a privilege?