Covid-19: Advocates urge India’s prime minister to remove barriers to vaccine production and access

A group of 567 prominent figures in India have called on Prime Minister Narendra Modi to tackle inequalities in vaccine supply to ensure vulnerable populations get the protection they need and to ramp up manufacturing to tackle shortages.

In an open letter,1 public health practitioners, doctors, economists, unions, human rights groups, student groups, civil society organisations, and concerned citizens in India called on Modi to outline a time bound and transparent vaccine action plan to speed up rollout and ensure that everyone can access the covid-19 vaccine free of charge.

The group said that at the current pace, India’s vaccination drive will take 2.4 years to complete, while global epidemiologists have warned that the virus may mutate in under a year, making it difficult for current vaccines to contain the spread.

India’s vaccination programme initially allowed anyone over 45 or a healthcare worker to book a vaccination appointment online. After only reaching 9% of the population with a first dose, however, the government announced it was no longer committed to free universal vaccination coverage with distribution based on need and risk. Instead it said anyone over 18 was eligible for vaccination and removed price controls on vaccine manufacturers. This decision, coupled with stock shortages, has stalled the programme.2

New cases of covid-19 in India rose to nearly 400 000 at the beginning of May as part of a large second peak. More than 25 million cases and 278 000 deaths have been reported in the country so far.3

The group has suggested that India could achieve universal coverage if intellectual property rights, patents, and other provisions were temporarily relaxed.

Amitabh Behar, chief executive officer of Oxfam India, said, “The support for India’s global ask for a patent waiver at the World Trade Organisation is growing. India’s government needs to show leadership domestically by lifting patents to its own vaccine and follow its own national vaccine policy by ensuring equitable access for everyone but prioritising the vulnerable and excluded.”

The letter—which has been signed by organisations from 22 states and union territories across India—has also urged the government to take a more bottom up approach when rolling out vaccines, to ensure centres are closer to where people live, and to make sure that vaccinations are easily accessible in high prevalence areas.

It said the government should ensure the vaccine is purchased at true cost and there is fair allocation which prioritises at-risk groups and is sensitive to the digital divide. Currently, the vaccine programme relies heavily on an online system, which has led to fears that those without internet access could be left behind. Only 15% rural households can access the internet and less than a quarter (24%) of the country’s population has smartphones.

Vaccines must also be procured on a large scale and by the central government, with regulated prices which do not cripple the finances of the country’s states or force them to fight against each other for stock.

Finally, the government must “do what it takes to make the above happen through all possible steps including compulsory licensing of vaccines and ramping up public sector vaccine manufacturing capacity.”

Sunita Sheel, secretary general of the Forum for Medical Ethics Society, said, “The government of India’s approach to covid-19 vaccine policy is a mockery of Indian federalism and will be remembered for decades to come for its lethal consequences to common people of India, particularly those at the margins. Given the current global order and deeply interconnected world, lack of access to vaccines anywhere around the world implies threat to global health security agenda. This can be averted only if the government puts people first, that is, people over profit and power, now.”