Introduction
The coronavirus has affected every country in the world. It has disrupted our daily life, forcing us to remain under a lockdown. We are well past the ease of lockdown, but the common fear among many of us is the fear of infection and resurgence of the virus. Everyone knows that none of us are safe until all of us are safe, and we are expectant of an early vaccine that can get us out of this predicament.
But, developing a vaccine and getting it to the public are entirely different challenges. How many doses of vaccine will get manufactured? Will it be available to me? How much would it cost? All these are common questions going through the minds of many of us. Let us see if we can find a solution to at least some of the concerns.
India is one of the largest manufacturers of vaccines by volume. We produce around 2–3 billion doses a year (~40% of the total world production), of which, one billion we use internally and export the remaining. So, it is not far-fetched to say that India will play a significant role in achieving global immunity for the coronavirus.
But, just because we have the capacity, can we produce so many doses of the coronavirus vaccine in a year? The hard answer is no. Just because Covid-19 is in the spotlight right now, doesn’t mean that it is sensible to shift the whole workforce to develop a vaccine for one virus. We have polio and other equally important things to fight, and we need to continue developing vaccines for them.
So, how many coronavirus vaccines doses can we manufacture? It turns out that India currently has three major COVID-19 vaccines under development — Bharat Biotech’s COVAXIN, Oxford’s COVDSHIELD and Zydus Cadila’s ZyCoV-D, and they have promised to manufacture 50-60 crore doses collectively by mid-2021. Each person needs two doses of the vaccine (first dose as a primer), so effectively, we will only be vaccinating ~25 to 30 crore people, ~20% of our population.
Based on priority factors of occupation hazard/risk of exposure to the virus and the risk of developing severe disease/risk of increased mortality, frontline health care workers, military, people above 50 years age and people below 50 years age (with comorbidities such as diabetes, lung disease, kidney failure, and cancer) will be given priority, the total number being approximately 28 crore. The Indian government plans to vaccinate these identified priority people in the first phase.
The Problem And Possible Solutions To The Problem
Distribution is one of the main concerns once a vaccine is available in the market. Vaccines, in general, require to be kept at a below-normal temperature to preserve it. Transporting vaccines needs a cold supply chain. Given the vast area of India and the necessity to take the vaccine to all corners of the country, it is vital to plan distribution channels.
The existing channel of distributing medicine in India is through medical centres and regional government hospitals. Using this channel will have a few challenges. Given the population density and the anxiety among people to get the vaccine, this traditional channel will only overcrowd people at the distribution centres. It will just increase the spread of the virus. India should look at alternative solutions to avoid this.
India’s e-commerce and online retail have successfully established door-delivery services to most of the urban areas in the country. And they have a lot of infrastructures that the government can take advantage of to speed up the distribution of the vaccine in the country, especially to urban areas. Urban areas in India have a lot of e-commerce services that can support distribution. Many e-commerce platforms are already working in the delivery of medicine to the doorstep like 1mg, Pharmeasy etc. By sending a trained person to administer the vaccine and using the infrastructure of delivery, India will be able to distribute the vaccine quickly by using the existing private infrastructure.
Distribution of the vaccine in rural areas is the other issue left now. The government can use the polling infrastructure to deliver and administer the vaccine to the rural population. It can use government officials who are already vaccinated to administer the vaccine in rural areas. The alternative is to use postal services to distribute and use Anganwadi staff and other medical practitioners to administer the vaccine.
Issues With These Solutions
The solutions mentioned, if implemented, provide a high scope of vaccine distribution success. But they would be effective if the following economic challenges have been taken care of. The challenges include:
1. The capability of the distribution channels in India is low to medium. So, given the constraints of the channels, distribution to villages and towns is a major challenge.
2. Implementation of supply by distributors is a challenge as strong distribution channels are owned by commercial companies so they seek for incentives.
3. After a vaccine is given to a household, especially in villages, it needs to injected immediately as the favourable temperature for the vaccine cannot be maintained at homes where there is no refrigeration.
4. There is no monitoring platform for tracking the supply of the vaccine penetration so it would be very difficult to monitor how far the distribution has penetrated, which could help us to improve the supply process efficiently.
5. Training should be given properly to those responsible for injecting vaccine since there are a set of vulnerabilities if the vaccine is given in inappropriate conditions and by a person without proper training. Hence, the costs associated and effectiveness of the training is a challenge.
Conclusion
There will be a lot of demand once the vaccine is released, but providing it to the identified priority people in the first phase would be utmost priority. To meet these demands, a robust supply chain network should be built. The supply chain needs to reach India’s extreme geographies by keeping in mind the fast delivery and cold storage facilities. For this proper planning to discover the right workforce, availability of distribution warehouses with cold storage facilities and timely delivery of the vaccines should be worked upon to handle the logistic challenge.
Existing door-to-door delivery services of e-commerce vendors can be used in urban areas as they are experienced and have tackled some of the challenges faced to prioritise and deliver the orders. In rural regions, the availability of vaccines at polling booths can be made. Implementation of technology to find the priority audience in the first phase and tracking each vaccine’s status should be done.