Few Indians got vaccine, need right policy design: Read Manmohan Singh’s full letter to PM Modi

There are many things we must do to fight the epidemic but a big part of this effort must be ramping up the vaccination programme, former PM Manmohan Singh wrote.

Indian PM Manmohan Singh | Photo: Sondeep Shankar | Bloomberg

Dear Prime Minister

It is now over a year since the world, and India, have been grappling with the Covid-19 pandemic. Many parents have not seen their children, living in different cities, in over a year. Grandparents have not seen their grandchildren. Teachers have not seen children in the classroom. Many have lost their source of livelihood, and several millions have been pushed back into poverty. With the second surge that we are currently witnessing, people are beginning to wonder when their lives will get back to normal.

There are many things we must do to fight the epidemic but a big part of this effort must be ramping up the vaccination programme. I have some suggestions in this regard. In making them I want to emphasise that I am putting them forward for your kind consideration in a spirit of constructive cooperation in which I have always believed and acted upon.

First, the government should publicise what are the firm orders for doses placed on different vaccine producers and accepted for delivery over the next six months. If we want to vaccinate a target number in this period, we should place enough orders in advance so that producers can adhere to an agreed schedule of supply.

Second, the government should indicate how this expected supply will be distributed across states based on a transparent formula. The central government could retain 10 percent for distribution based on emergency needs, but other than that, states should have a clear signal of likely availability so that they can plan their roll out.

Third, states should be given some flexibility to define categories of frontline workers who can be vaccinated even if they are below 45 years of age. For example, states may want to designate school teachers, bus, three-wheeler and taxi drivers, municipal and panchayat staff, and possibly lawyers who have to attend Courts as frontline workers. They can then be vaccinated even if they are below 45.

Fourth, over the past few decades, India has emerged as the largest vaccine producer in the world, thanks to policies adopted by the government and robust intellectual property protection. The capacity is largely in the private sector. At this moment of a public health emergency, the Government of India must proactively support vaccine producers to expand their manufacturing facilities quickly by providing funds and other concessions. In addition, I believe this is the time to invoke the compulsory licensing provisions in the law, so that a number of companies are able to produce the vaccines under a licence. This, I recall, had happened earlier in the case of medicines to deal with the HIV/AIDS disease. As far as Covid-19 is concerned, I have read that Israel has already invoked the compulsory licensing provision and there is an overwhelming case for India to do so as well quickly.

Fifth, since domestic supplies are limited, any vaccine that has been cleared for use by credible authorities such as the European Medical Agency or the USFDA, should be allowed to be imported without insisting on domestic bridging trials. We are facing an unprecedented emergency and, I understand, experts are of the view that this relaxation is justified in an emergency. The relaxation could be for a limited period during which the bridging trials could be completed in India. All consumers of such vaccines could be duly cautioned that these vaccines are being allowed for use based on the approval granted by the relevant authority abroad.

The key to our fight against Covid 19 must be ramping up the vaccination effort. We must resist the temptation to look at the absolute numbers being vaccinated, and focus instead on the percentage of the population vaccinated. Currently, India has vaccinated only a small fraction of its population. I am certain that with the right policy design, we can do much better and very quickly.

I hope the government will accept these suggestions immediately and act on them promptly.