In a move that has taken the medical fraternity by complete surprise, the Bharatiya Janata Party (BJP) in its Bihar poll manifesto on Thursday announced that the vaccine against Covid-19 would be delivered free of cost to the people living in the state, which has raised questions on "ethics".
Health Economist Rijo John tweeted saying "Is that an ethical allocation of a vaccine that will be most in demand?" He asked whether the priority should not be health care workers, elderly and the most vulnerable.
Speaking to News18, Professor Anant Bhan said, "Vaccination, including during a pandemic, is a core public health exercise. It should not be politicized. Any potential COVID-19 vaccine should go through thorough safety, ethics scrutiny. And if found useful on these parameters in a transparent manner, it should be made available to everyone who needs it through proper and due processes, and distribution systems. Given the impact of the Covid-19 pandemic, including economically, and it being a Public Health Emergency, the government should make available the vaccine for free in the interest of public health."
Sensing the manner in which the party had stirred a hornet's nest, IT Cell head of the BJP, Amit Malviya tweeted: "BJP’s manifesto promises free Covid vaccine. Like all programs, center will provide vaccines to states at a nominal rate. It is for the state Govts to decide if they want to give it free or otherwise. Health being a state subject, Bihar BJP has decided to give it free. Simple."
Here are the questions that need answers:
Will people living in other states — where the government is not in a position to provide a vaccine free of cost — not be at a disadvantage?
Is the state not duty bound to step in and provide free delivery of vaccine like it provides free testing during a pandemic? RJD's Naval Kishore, while speaking to News18, said, "It is the duty of a state to provide free coronavirus vaccine to the each and every citizen." Polls or no polls, should the attempt by all state governments not provide a vaccine free of cost to its people?
Free in Bihar — So is the vaccine now officially falling under the country's universal immunization programme?
Will the BJP-led central government also then not be obliged to give this vaccine free of cost to the entire country if they were to do this in Bihar? Why should the political dispensation in Bihar led by the BJP-JDU alliance (presuming they are returning to power) not replicate this model at the Centre? Will this then be brought under the Universal Immunization Programme? We don't know!
What about the prioritization plan?
The Centre hand holds the states in vaccination drives, health is a state subject but Centre steps in a pandemic. In this case, the Centre has asked states to submit a data base to all states to draw up a list of who gets the vaccine first. This includes healthcare workers and healthcare staff in allied services. This is the plan, anything else is politics!
Dilemma for other parties
If the NDA returns to power in Bihar, will they vaccinate everyone for free? If the state government has to bear the cost, who will be footing the bill if a private player's vaccine like Zydus Cadila's ZYCOV-D shows more promise than Bharat Biotech's COVAXIN, which is being developed in collaboration with the ICMR which is a government body. If not, then will the onus be on the RJD- Congress combine to do so?
Pressure on Other Poll-bound states — Will politics drive the vaccination prioritization strategy?
West Bengal too is going to polls. If announcements of this nature find their place in manifestos of political parties, will other political parties like the TMC in West Bengal also not be compelled to make this promise? Will political parties over promise and under deliver?
Is Bihar skipping the cue?
No, says the BJP, but because the BJP is at the Centre and in alliance with the JDU in Bihar, this has sparked off fears that the prioritization plan will go for a toss.
Where is the money?
If the onus is on the states and all of them for political compulsions have to foot the bill of a vast vaccination drive, where will the funds be generated? An estimate is that Rs 80,000 crore is needed to ensure the vaccination, the Centre doesn't agree with this figure but vaccinating the country against Covid-19 will be far from cheap.