Vaccine Rollout: Public-private-people partnerships will be the healthiest last-mile strategy

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Even though tremendous uncertainties, an economic fallout and widespread disruption hit us in 2020 with the Covid-19 pandemic, India managed the crisis ably through commendable collaborative efforts. Today, as we move to a post-pandemic phase, this collective spirit needs to continue. Our scientists, vaccine manufacturers, logistics and cold chain specialists as well as the government deserve high credit for launching two vaccines with emergency approvals in the shortest possible time. Now that we have the world's biggest vaccine-making capacity, we need to harness the capability of all key stakeholders to vaccinate all our people at the earliest.

India proved a lot of naysayers wrong when it managed to tackle the community spread of Covid-19 deftly and effectively. Our cases are among the lowest in the world; our deaths-per-million rate is by far the lowest amongst developing countries, and our tests-per-million are considerably ahead of others. According to the Health Ministry, till date, India has conducted 21.15 crore tests since testing opened up–it is a big achievement in a country where screening and testing have traditionally remained low. It was possible because all hands were on deck.

The first phase of vaccine roll out started on January 16, 2021, and hospitals have now started providing the second dose to health care workers. The target is to vaccinate 300 million people with both the doses by August 2021. To achieve this landmark milestone, daily vaccinations have to be above one million. So far, India has administered vaccines to over a crore people (1,11,16,854, or 11.16 million, till date as per the Health Ministry), however, other countries are doing much better in terms of the total number of doses administered per 100 people. In India, only 0.8 per 100 doses have been administered till date. We are the largest producer of vaccines; we have sent them to 13 countries, and it is now time to accelerate the pace of inoculation in our nation.

The urgency to ramp up is also important as the shelf life of both vaccines is only six months.

As Prime Minister Narendra Modi stated recently in the Parliament, the private sector has been integral to our health infrastructure, it is a pivotal contributor to national efforts. Clearly, there is no better time to forge a groundbreaking partnership model with the private health sector and set another fine example of PPP [public private partnerships] for the world. This partnership will allow us to move beyond one group at a time, an approach that is only relevant if there is a shortage of vaccines. The private sector could also follow up on low turnouts and address any reluctance or skepticism against inoculation.

A prudent approach would be to allocate doses to all large institutions and organisations, and then enable them to vaccinate their employees, customers and the larger ecosystem. India is already moving towards herd immunity in many places and resuming normalcy. There is a need to accelerate vaccination in the next three months, before the demand for vaccines falls. It might be increasingly hard to vaccinate people as the situation normalises further and the need for infection protection decreases.

How to leverage private healthcare infrastructure It is critical to leverage and empower the private healthcare sector, which has three key capabilities—technology, skilled manpower and customer marketing capability. The government can set up a task force of senior representatives and experts from the public and private sector as well as healthcare associations that can action and coordinate with organisations, allocate doses, manage supply chain, monitor and oversee reporting, conduct quality audits, and provide digital integration support.

An independent safety council of doctors, hospitals, scientists can further oversee patient and community safety measures. They can also create further outreach by involving all healthcare federations across the country. Hospitals, nursing homes, pharmacies, diagnostic labs, home care and senior care centres, mobile clinics and community health organisations can be contracted for training, and supply chain capabilities with appropriate incentives for safe coverage and community mobilisation. Most importantly, these institutions need not depend on only government-supplied vaccines but can be allowed to purchase directly from the market, in compliance with necessary guidelines. This will also enable people to choose their time, convenience, location according to their schedules and eliminate lags. The earlier people get to see vaccine efficacy, the faster will be the economic rebound.

The private sector can additionally contribute to several other areas apart from rapidly scaling up last-mile delivery. These would include supporting the logistics for transport, storage and distribution of vaccines involving cold chains; technology and data analytics to drive data integration with CO-WIN and also generate steady demand through effective community mobilisation. In addition, it could assist with building capacity, provide a surge in infrastructure and supply chain and requisite human resource skilling.

PM Modi has been stressing on the need to include the private sector in making India ‘Atmanirbhar’, and therefore we must quickly draw up a well-thought-out national PPP blueprint for vaccination. The charter must involve the central and state governments with clear objectives to take on the task with defined targets, quality criteria and budgets, and it should be designed in consultation with the private sector.

Budget 2021 provided a generous allocation for the Covid-19 vaccination. However, to inoculate every Indian, we could explore an innovative Citizen Contribution model. India has around 1.67 billion savings and current bank accounts and that translates into more bank accounts than citizens of our country. So, if we were to introduce a scheme that deducts Re 1 per day from every account, i.e., collecting Rs 365 per year from every Indian, then it adds up to a whopping Rs 61,000 crore a year, almost equal to the annual central allocation for healthcare, in the past.

As Covid-19 has shown us, a pandemic can shave off 7-8 percent of economic growth in a matter of months. Getting back the growth path calls for mass mobilisation of every available resource—people, machine, infrastructure and funding. There is no better time than now for policymakers, healthcare industry leaders as well as communities, to aggressively and seriously pursue inclusive healthcare support for all citizens, irrespective of their economic background, as every single individual has the right to be inoculated against Covid-19.

The writer is President of NATHEALTH & Executive Vice Chairperson of Apollo Hospitals

The thoughts and opinions shared here are of the author.