A firm hand

One of the important things this pandemic has taught the world is that the 'big government' approach can be critical in times of public crisis. Across the world, governments are taking a more direct role in steering the Covid response of their respective nations and driving forth their economic recoveries. As evidenced by the massive proposed spending bills that US President Joe Biden has put forth, increased government intervention seems to be in style. A major area of intervention is in the development, procurement and distribution of vaccines during the pandemic. There is a real struggle worldwide between the forces of the free market that wish for vaccines to be sold like other commodities, without excessive government intervention and more importantly, with considerations of profit and loss. It should be obvious that in times like this, vaccine makers walk a thin line between traditional considerations of profit and the possibility of being accused of profiteering in a time of crisis. Science is not cheap, particularly in regards to complex research that goes into the development of vaccines. But this reason isn't exactly likely to win much favour with the public. This is especially true when you consider that most, if not all vaccines being used during this pandemic are at least partially funded by public spending, even if the vaccine makers themselves would prefer to be vague about such details. This is where 'big government' is supposed to step in. The government centrally procures the vaccines from vaccine makers according to a fixed contract which allows for some profits while subsidising or even providing the vaccine for free to the public. This is what most governments are doing worldwide. Yet, this is not what the Indian government has chosen to do. Its recent guidance on vaccine procurement has deregulated vaccine prices and increased the burden on the states to procure a large part of the necessary shots they require. The new 'liberalised' guidelines in essence will force states to compete to procure vaccine supplies with not only each other but private players as well due to the fact they will be buying them from the open market. While the regulations do note that private players and state governments have to purchase new vaccines at a price declared in advance by the manufacturers, this does not guarantee that prices will remain stable. States may choose to partially or wholly subsidise these vaccines they buy but that cost will come out of their own coffers. 24 states so far have announced plans to do this. What about the rest? Are states expected to compete for life-saving supplies now? Will different states eventually have different pricing points for the same vaccines depending on supply and level of subsidisation? And what effects will these factors have on determining the level of vaccine coverage in the country? Even if one does not consider the humanitarian angle of giving free vaccines for the sake of equity, there is a practical enough reason to do so as well. The easiest way to ensure universal vaccination, after all, is to give the vaccines for free. Therefore, there is merit to the idea that the Centre must be the one to keep procuring the vaccines at fixed rates and then setting up a centralised system of vaccine distribution which not only allocates doses but also helps states set up infrastructure to administer the vaccines. From the highest to the lowest levels, the Centre should be involved in ensuring that the vaccination process is not only prompt, efficient and safe as it needs to be but also equitable in who can access it and at what cost. As several leaders of the Indian opposition have pointed out, while the cost of setting up such systems of mass government involvement may be initially significant, there is a lot more to be lost if the government stays on the sidelines and allows the free market to take over.