In financial markets, triple-A-rated bonds are considered the highest form of creditworthy instruments, as they carry a very low risk of default and the rating shows that the issuer is able to meet its financial commitment. Transposed to the economics of vaccines, the triple-A rating would be underpinned by the Availability, Access, and Affordability of vaccines.
When the world first got exposed to the pandemic in 2020, an early global medical consensus was that only vaccines against the Covid-19-causing virus would afford some degree of protection from death and destruction. But there was no clear path from this conception to ringfencing entire populations in every country in the world.
The vaccine conundrum was characterised by three dimensions:
Can the vaccines be produced at all? The Availability was not guaranteed.
Can every country, especially the resource-constrained ones, be able to get a sufficient number of vaccines? The Access would be marked by stony-hearted gatekeeping by those who controlled Availability.
What price would a country pay if vaccines were made available commercially? The crisis presented a huge business opportunity for those who controlled Availability and Access. The profiteering motive trumped the altruistic calls for Affordability.The true import of the success of India’s vaccination programme has been that the country was able to deliver on all three ‘As’ – Availability, Access, and Affordability. For a country home to one-sixth of the global population, but barely $2,500 in per capita gross domestic product (GDP), this has been no mean feat.
In each of these three areas, India’s achievements were either indigenous or involved leveraging a locally-perfected craft of rapidly scaling good global resources for India’s unparalleled scale and complexity.
Access to vaccines was facilitated by a combination of these two instrumentalities. The Serum Institute of India undertook mass contract manufacturing of the AstraZeneca vaccine at a staggering scale. Bharat Biotech on the other hand produced a local vaccine ground-up, with the Indian Council of Medical Research acting as a catalyst. Bharat Biotech also produced a nasal vaccine beating the global competition for this scientific breakthrough. Several other pharmaceutical firms worked on one or more of researching, developing and manufacturing other vaccines. This ensured that India did not have to become dependent on the scientific prowess of any other country to access vaccines that worked for the Indian context.
The policies on procurement, process facilitation, financial outlays, collaboration between the Centre and the states, all contributed to turning a just-discovered complex lab product into real-world effectiveness. Not that it was a natural outcome of domestic access – the vaccine Availability was backed by a robust technology platform without queue jumps and with full transparency to the society at large. Building this infrastructure to the vaccination superstructure was a result of hard yards put in collectively by the government, industry, and citizens collectively.
Finally, the Affordability of the vaccines was maintained. Any eventuality where India would have had to buy 200-crore doses at $ 20 a dose would have consigned the Indian economy to long years of obscurity. Instead, the vaccines in India were made available at price points, which did not wreck the government finances or burden the domestic finances of those who chose to pay themselves.
To top this triple-A win, India also ran a Vaccine Maitri programme, ensuring that several countries around the world benefited from Indian ingenuity and a do-good worldview. The Indian actions were not casting bread upon the waters – the philosophy of Vasudhaiv Kutumbakam (The world is one family) played out through actions and not through empty rhetoric. With this policy, India delivered an AAA+ performance, the plus earned for maintaining a global outlook even in the most turbulent of times.
The two years since the vaccination programme began have instilled a sense of confidence in the national imagination. Prime Minister Narendra Modi exhorted the nation to think of an Aatmanirbhar Bharat in May 2020, because capacities drive choices and a self-reliant India would be able to open new choice sets. The vaccination programme was the first instance and demonstration of this phenomenon – where Aatmanirbhar became self-belief. It is a programme that will long serve as a launch pad for future successes, bringing together political leadership, state capacity, corporate enterprise, and social resilience.
(Aashish Chandorkar is counsellor, Permanent Mission of India to the World Trade Organization, Geneva. Suraj Sudhir is a technology professional based in the US. They are the authors of the upcoming book Braving A Viral Storm: India’s Covid-19 Vaccine Story. The views expressed are personal)