On the occasion of the celebration of 75 years of India’s Independence, Azadi Ka Amrit Mahotsav, the Government of India under the leadership of PM Narendra Modi was able to inoculate over a billion people with more than 217 crore vaccination doses across different age groups, diverse communities and regions within the span of 18 months after the general availability of vaccines.
The task to vaccinate a billion Indians was enormous, especially when it took decades to vaccinate Indians against polio. India’s ability to achieve this is an indicator of the continued focus on technology, public interest and innovation in addressing public health concerns on a national level and offering the digital solution and know-how to the international community built on the digital public infrastructure approach.
How were we able to do this? It is a testament to the spirit of resilience, action, thoughtful leadership and comprehensive policy planning. Despite various hurdles and teething troubles, as well as experiments that did not get sufficient traction, the way India handled its covid vaccination is positive learning in itself.
India has a rich experience conducting elections across diverse geographic segments and linguistic variations. Coupling this project management expertise and technical expertise for social inclusion, the Covid-19 vaccination program got into execution mode. Using the digital framework that India had invested strategically with AadhaarStack, it has been smoother to manage the eligibility, dosage, delivery, after-effects, and certification in the vaccination process.
As of date, India has delivered over 217 crore vaccines to its residents. India has strongly advocated the principle of equity in the WHO regarding Covid vaccines. It has proposed, along with South Africa, a TRIPS waiver at the WTO for Covid vaccines, diagnostics and medicines, to ensure accessible and affordable vaccines for everyone. Under the vaccine diplomacy initiative, with low-cost global-quality-production capabilities, India has exported over 17 crore Covid vaccine doses to 96 countries.
Yet all along with the pandemic, we had seen cynicism about and maligned the official efforts taken to address pandemic-induced socio-economic pressures, livelihood issues, and even fundamental survival challenges. Why do we doubt everything, we crib, and we don’t want data, as we suspect it too?
Why do any emotion-laced narrative and sentiment-based opinion take cover as expert opinions? And especially when many emanate from so-called developed markets and social media learning institutions.
Why, why not?
When the vaccine was approved for distribution, initial public disbelief and scepticism over the efficacy and false narratives were observed. The perceptions and myths had to be unshackled with public communication and by offering vaccination drives, including public figures taking vaccination on camera. The larger question of “why do I need vaccination” had to shift to “why not”. Vaccine hesitancy was another challenge that the policymakers had to solve.
The AAA of vaccination was Access to vaccine, Affordability & widespread Availability. These were met on time and with smooth processes. The vaccine was made available across the country; but for a nation to deliver at such a mass scale and with complicated logistics, the constraints and challenges included:
- Availability and cost of the vaccine
- Access to vaccination facility
- Access to booking a slot
To maintain their efficacy, the vaccines need cold storage right from the production unit until the time that the actual vaccination that the patient is administered. Hence, it is impossible or difficult to deliver this vaccine to citizens’ doorsteps.
Also, most vaccines need a second dose, which means additional logistical handling and stricter adherence to the timelines. India has handled complexities of the scale of distribution reach, rugged geographic terrain, and different weather conditions and yet delivers vaccines efficiently and on time.
Logistics support is highly critical to immunisation delivery to ensure accuracy and speed of delivery. The entire value chain covering cold chain infrastructure, transportation management, vaccine management, training for all relevant stakeholders involved in this process, and the safety of vaccines and people working in the program are essential planning components.
Utilising Tech for citizenry impact
Technology has been the backbone of this Indian vaccination drive. It brought many learnings that India has offered to share with its global colleague nations.
- CoWIN is a portal created to enable accessibility and accountability for COVID-19 vaccinations. It stands as the global standard for an Open Source Vaccine Booking System. It provides open-source standards-based QR code-based vaccination records that can be verified without any connection to central servers. India has been offering the CoWIN platform as a digital public good, free of cost, to countries worldwide, with over 50 showing interest.
Cluster Vaccination Strategy
- Division of all villages into three categories based on first dose vaccination levels
- Honouring COVID secure villages and honouring headmen
- ASHA and Aanganwadi workers visited villages to identify people left out of the campaign
- Organised webinars for the community to talk and discuss their concerns with the doctors
- Popularised Social Media Campaigns relating to vaccination benefits.
Har Ghar Dastak Campaign
- The campaign addressed the Institutional, Access, & Affordability Barriers for populations without being administered any vaccine dose.
India has used low-cost, high-impact trust-based tech to deliver better citizenry outcomes during covid. Like any large-scale project, it also has had its share of learnings.
Comparison with developed nations on their vaccination is as follows:
With the pandemic crisis, as a nation, we could leverage our technology expertise to deliver low-cost, innovative mass covid vaccination. While it was a wake-up call for investing higher and better into our public health care initiatives, it has also been a message to the public about hygiene and preventive healthcare. PM Modi’s holistic vision is taking the learnings from Covid vaccination and extending it to universal vaccination coverage.
Arvind Gupta is Head, Digital India Foundation and Srinath Sridharan is Corporate Advisor. Views expressed are personal.