For more than over a month since last week of April, when the Supreme Court took suo moto cognisance of the Covid 19 situation, the apex court is seeking a detailed road map to fight Covid 19 from the central government. In its May second week affidavit the central government defending its stand, told the Supreme Court, “In the context of a global pandemic where the response and strategy of the nation is completely driven by expert medical and scientific opinion, there is not even a little room for judicial interference.”

The central government went to the extent that the Supreme Court does not have competence when the affidavit says  “ Any overzealous, though well meaning judicial intervention may lead to unforeseen and unintended consequences, in absence of any expert advice or administrative experience, leaving the doctors, scientists, experts and executive very little room to find innovative solutions on the go”. It is obvious that the Supreme Court is not amused by the contentions of the government. The June 2, 2021 directive of the Supreme Court giving a months’ time to the central government to clarify how Rs. 35,000 crores earmarked for procuring the vaccine have been spent so far compels us to take a fresh look at the budget papers once again.

Nirmala Sitaraman, right from her days as spokesperson of BJP is known for her oratory skills. Through her 2021-22 budget speech, the central government bolstered its image by informing the House, “Today, India has two vaccines available, and has begun medically safeguarding not only her own citizens against COVID-19, but also those of 100 or more countries.” amidst the cheers of the usual drum beaters. She also told Parliament, “38. I have provided `35,000 crores for Covid-19 vaccine in BE 2021-22. I am committed to provide further funds if required.”

The budget speech had not stopped here. It went on to state, “39. The Budget outlay for Health and Wellbeing is `2,23,846 crores in BE 2021-22 as against this year’s BE of `94,452 crores, an increase of 137 percentage. The details of the same are at Annexure I of the Speech.” The said Annexure 1 clearly mentioned Rs. 35000 crores for vaccination. But surprisingly the same is not reflected in the final budget documents. A detailed presentation of allocation for the Ministry of Health and Family Welfare is given at pages 155 to 172 in the expenditure budget volume. The summarised table given below is drafted from the budget papers itself where we cannot find a single mention about the allotment against vaccine procurement.

But under the Central Sector Schemes/ projects subheading, there was a new entry titled COVID -19 Emergency Response and Health System Preparedness Package – EAC we find three entries in the revised budget 2020-21. An amount of 11756.97 crores under three components (Rs. 95 crores for National Institute of Communicable Deceases, Rs. 4724 crores against Central Procurement of Supplies and Materials for Covid 19 and another Rs. 6937.36 diverted from National Rural Health Mission grants to meet the requirements of Covid 19 Emergency Response Package. Surprisingly, the same was prematurely discontinued in the 2021-22 budget estimates, which clearly indicates the mood in the establishment that India had not only reined in Covid 19 and developed sufficient protective walls but was also supplying vaccine for more than 100 countries ! In such a situation where will the supposedly allocated Rs. 35,000 crores for vaccine procurement comes from? This can only explained by believers of Advaita philosophy which can be summarised Gajam Midhya – Palayanam Midya (There is no elephant and hence there is no question of attempting to escape).

The Centre’s great numbers game does not stop here. In the annexure to the budget speech the Finance Minister had stated on the floor of the house that other than the allocations for department of Health and Family welfare, the allocations for vaccination are presented as two separate entries which totals 1.06 lakhs crores ! In a post budget interview the secretary for department of Expenditure stated that this allocation is sufficient for vaccinating 50 crores population for free. But the same is not reflected in the Demands for Grants budget.

Even after the central government was caught red handed for faking budget allocations, this bluffing has not been stopped. The Union government resorted to a blatant lie to cover-up its disingenuous unethical practice of spreading fake news. In such an attempt, responding to the criticism about zero allocations for vaccine procurement, the ministry of finance stated that the said amount is mentioned under the subhead ‘Transfers to States’. Moreover the statement says, “Firstly, because expenditure on vaccine is one-off expenditure outside the normal Centrally Sponsored Schemes of the Health Ministry, separate funding ensures easy monitoring and management of these funds. Also, this grant is exempted from the quarterly expenditure control restrictions applicable to other demands. This helps to ensure that there is no hindrance in the vaccination programme,”

The transfers to state governments were present in previous budgets as well. Even the budget documents for 2021-22 have clearly mentioned about the Transfers to States allocations that the allocations which earlier used to be known as Grants in Aids to States / UTs have not been changed to Transfers to State/UTs as per the recommendations of Finance Commission. This is not a new subhead opened up under the Modi regime.

The fact is that to comply with the Supreme Court directives and submit the details of expenditure of Rs. 35,000 crores, the government appears to be indulging in “file notings” and other back end exercises to “make good” its unethical budgetary practices.

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The Rajasthan High Court has asked the State Government to explain their reasons for excluding the Pakistani minority migrants for vaccination against Covid-19, despite court orders.

At the last hearing on May 28, the court had granted time to the Additional Advocate General, K.S. Rajpurohit, to furnish details regarding the steps taken by the Government in every District for “Covid-19 Vaccination of Persons without prescribed Identity Cards through CoWIN”. But the Bench of Justices Vijay Bishnoi and Rameshwar Vyas noted that the government failed to file a compliance report in this regard.

The Court observed that after its order on May 28, a letter had been written by the National Health Mission, Medical, Health and Family Welfare Department, Government of Rajasthan to the Health and Family Welfare Ministry, Government of India requesting them to include the Pakistani minority migrants in the Standard Operating Procedure which deals with “Covid-19 Vaccination of Persons without prescribed Identity Cards through CoWIN.”

To this, the court remarked, “It is noticed that once this Court in its order dated 28.05.2021 has already opined that SOP dated 06.05.2021 is not excluding the Pakistani Minority Migrants, who are eligible for Covid-19 vaccination, then it is difficult to understand that why the State Government is seeking further clarification from the Central Government and requesting it to include the Pakistani Minority Migrants in the SOP dated 06.05.2021.”

The Amicus Curiae in this case, Sajjan Singh, appearing for Pakistani minority migrants, informed the court that even those Pakistani minority migrants, who have been declared as Indian citizens are not getting vaccinated because they don’t have Aadhaar cards. As far as the ration/food packets are concerned, the same are being made available to groups residing only in Jodhpur. In other districts such as Jaisalmer, Barmer and Jaipur, no such ration/food packets are available.

The Bench took cognisance of this and said, “We are forced to direct the Chief Secretary, Government of Rajasthan, Jaipur to submit a detailed affidavit regarding the steps taken by the State Government in every District as per the procedure given in Clause-5 of the SOP dated 06.05.2021 and also to explain that why the State Government is not treating the Pakistani Minority Migrants, who are not having prescribed identity cards, eligible for Covid-19 vaccination though this Court vide order dated 28.05.2021 has already clarified that such Pakistani Minority Migrants are eligible for Covid-19 vaccination as per the SOP dated 06.05.2021.”

The Bench has also asked for a report regarding availability of ration kits. The matter has been listed for hearing on June 10.

The order may be read here: 

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Speculation that a person can get their second shot of a vaccine different from their first shot, has been nipped in the bud by the Union government. There has been no change in the vaccination SOP, the Centre has clarified. Thus  no mixing of Covid-19 vaccine doses in India is allowed, until enough scientific evidence on its effectiveness is gathered. The government had to make an official statement after it was being reported that senior officials had “indicated” that the government “may consider doing away with the second dose of Covishield” or in some cases even “mixing doses” of the two available vaccines. 

According to news reports it was none other than the Chairman of Covid-19 working group, Dr NK Arora who said ‘India may begin testing the feasibility of mixing doses of two different Covid-19 jabs in the next few weeks’. There was wide speculation after that if such a mix would “give better immunity against Covid-19.”

However, on Tuesday Dr VK Paul, Member (health) Niti Aayog and a key member of the government’s Covid-19 task force, clarified that the government has not made any change in the vaccination schedule for Covishield and Covaxin at all. Thus it is still protocol to get two doses of the same vaccine.

Recently a dangerous “oversight” resulted in the mixing up of the two vaccines in second doses of 20 people in Uttar Pradesh’s Siddharthnagar district. The “mix-up of doses” was reported from the Barhni block of the district. Officials told media-persons that 20 people were injected with Covaxin doses, “more than a month after they received the first dose of the Covishield vaccine”. The nearly 20 villagers of Siddharthnagar are now being monitored closely.

On Tuesday, Union Health Ministry stated that India reported 1.27 Lakh cases, the lowest in in 54 days; the active caseload is now at 18,95,520, for the first time going below 20 lakhs in 43 days and the daily positivity rate is now at 6.62%.

Sputnik V has landed

On Tuesday, three million doses of Russia’s Covid-19 vaccine, Sputnik V, landed at the Rajiv Gandhi International Airport in Hyderabad, reported Indian Express. The Dr Reddy’s Laboratories is in a pact with Russian Direct Investment Fund to sell the first 125 million people doses (250 million vials) of Sputnik V in India after approval from the Indian drug regulator for restricted emergency use of Sputnik V.

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Prakash Javadekar, who heads three powerful Union Ministries: Environment, Forest & Climate Change; Information & Broadcasting; and Heavy Industries & Public Enterprises, has announced that India will be fully vaccinated against Covid19 by December 2021.

Reacting sharply after Congress MP Rahul Gandhi said that less than three per cent of the country’s 130 crore people had received both doses of a vaccine, Javdekar replied that the Union Health Ministry had issued a “blueprint” which will ensure that 108 crore people will be vaccinated with 216 crore doses by December. According to Javdekar, “India is the second-fastest in vaccinating its people.

He then lashed out at Gandhi for raising the issue of a low vaccination rate, something many state governments have also raised with the Centre, about the unavailability of vaccine stocks. “Rahulji… if you’re concerned about vaccination then pay attention to Congress ruled states… there is a mess. They are not taking the quota given to them for 18-44 year old beneficiaries from May 1,” said Javadekar took it a step further and accused Gandhi of “questioning the vaccine” and creating “confusion in the minds of people.”

.@RahulGandhi जी अगर आपको वैक्सीन का महत्त्व आज समझ आ रहा है तो जब कोवैक्सीन आयी थी तब उसपर आपने प्रश्नचिन्ह क्यों लगाया था। लोगों के मन में भ्रम ना उत्पन्न करें। प्रधानमंत्री जी ने खुद कोवैक्सीन ली तब भी आपकी नौटंकी बंद नहीं हुई। pic.twitter.com/JS7t6xjIMN

— Prakash Javadekar (@PrakashJavdekar) May 28, 2021

This reaction came after Congress leader Rahul Gandhi said the Centre, and the Prime Minister have “failed to understand Corona”. Gandhi raised questions on the Centre’s Covid-19 vaccine strategy, and played videos from a year ago when he is heard “predicting” the devastation that Coronavirus has unleashed till now. He also played clips of the PM’s “thaali, taali” message, and a year later a message in early 2021 where the PM said India had handled Covid-19 pandemic better than most nations globally. Gandhi said a “permanent” solution to fight Coronavirus was vaccination, and warned that moves Covid-19 waves may attack due to the Centre had “no vaccination strategy” for its own people while indulging in “vaccine diplomacy. 

“You have left the door open [for Covid-19], there are different rates [for vaccines], business is going on…” he said adding that “unfortunately, the Prime Minister is an event manager. We cannot have an event manager in such times. We need effective and speedy administration. 

LIVE: My interaction with members of the Press about GOI’s Covid vaccine disaster. https://t.co/YbC8iSe4aw

— Rahul Gandhi (@RahulGandhi) May 28, 2021

According to official data, India has recorded 1.86 lakh new Covid-19 cases in a 24 hours period ending on Friday. The active caseload, stated the government data, has now declined to 23,43,152, and 3,660 fatalities have now taken the death toll is now over 3.18 lakh. However, Gandhi warned that the worst was not over yet. “The second wave is the Prime Minister’s responsibility… he did nautanki [dramas],” Gandhi was direct in his critique, adding that the “government was lying about the death rates”. The Opposition is not the enemy, said Gandhi. 

However, the Union government also put out a detailed “myth and facts” document reportedly by Member (Health) in NITI Aayog and Chair of the National Expert Group on Vaccine Administration for Covid-19 (NEGVAC) Dr Vinod Paul. A key “myth” it sought to explain was “Centre has abdicated its responsibility to the states.” According to the government note, “Central Government is doing all the heavy-lifting, from funding vaccine manufacturers to giving them quick approvals to ramping up production to bringing foreign vaccines to India.” Another “myth” was that the ‘Centre is not giving enough vaccines to the states’, to which the government stated it was “allotting enough vaccines to the states in a transparent manner as per agreed guidelines. In fact, states are also being informed in advance of the vaccine availability. Vaccine availability is going to increase in the near future and much more supply would be possible.”

Hours after that release, Rahul Gandhi, made one of the sharpest attacks by an Opposition leader on the government’s Covid-19 strategy, rather the lack of it as he puts it, “I directly told the PM that if India does not sort out its vaccination strategy, there will be multiple waves since the virus adapts. The Prime Minister is the head of the country. He is responsible for its well-being. The buck stops with the Prime Minister.” According to Gandhi, the “PM is trying to repair his image but his image is gone…PM has to show leadership, don’t be afraid, be a leader.”

Delhi prepares to unlock

Meanwhile, Delhi Chief Minister Arvind Kejriwal has said that the National Capital will begin “to Unlock gradually,” and construction activities and factories will start work from Monday, May 31. However, he added that “if the Coronavirus cases increase again, we will have no option but to impose the lockdown again.” The CM said even though the city will gradually unlock people should not step out “unless absolutely necessary.”
 

The gradual unlocking from Monday was decided after a meeting of the Delhi Disaster Management Authority (DDMA). The city is perhaps the first to announce an unlocking as the devastating second Covid-19 wave is said to have slowed down for now. Thousands are still impacted directly by the disease, and even more are impacted due to the lack of work, and food security due to the lockdown. According to Kejriwal “labourers, daily wage workers, migrant labourers from Uttar Pradesh, Bihar, and the neighboring states come to Delhi to earn their livelihoods… So today it was decided in the meeting that both these activities will be open from Monday… for the next one week, construction activities and factories will remain open.”

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K’taka HC seeks govt’s plan of procuring oxygen and vaccines

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Experts have continuously been alerting that it is essential to get two doses of the same vaccine. There may be a choice between Covishield or Covaxin, but once a person gets a first dose of either, the second dose has to be of the same vaccine after the stipulated period. 

However, a dangerous “oversight” has resulted in the mixing up of the two vaccines in second doses of 20 people in Uttar Pradesh’s Siddharthnagar district. According to a report in Indian Express, the “mix-up of doses” was reported from the Barhni block of the district. Officials told media-persons that 20 people were injected with Covaxin doses, “more than a month after they received the first dose of the Covishield vaccine”. The nearly 20 villagers of Siddharthnagar were given ‘Covishield’ as dose 1 in April, and ‘Covaxin’ as dose 2 in mid-May at a rural govt hospital, reported NDTV. 

While this is being reported as an “apparent oversight” by the officials themselves, experts have warned against such mix-ups since the vaccines first rolled out. However, the district’s Chief Medical Officer Sandeep Chaudhary while acknowledging the ‘oversight’ told the media that “everyone who got this ‘cocktail’ is healthy.”

About 20 villagers in UP’s Siddharthnagar were given ‘Covishield’ as dose 1 in April and ‘Covaxin’ as dose 2 in mid May at a rural govt hospital. This is the district’s Chief Medical Officer acknowledging the ‘oversight’ . He also says everyone who got this ‘cocktail’ is healthy pic.twitter.com/uY4rKNoyKX

— Alok Pandey (@alok_pandey) May 26, 2021

Chaudhary told the media that, “This is a mistake as the central government does not have any standing guideline on mixing the two vaccines. Both vaccines have to be administered in two does. An inquiry was ordered and a report has been submitted. I have sought clarification from those who have erred,” he added that a team was sent to check on the 20 people who were given the wrong vaccine and “they were found to be in good health and haven’t faced any issues as yet. We will keep a watch on them.”

The IE quoted Siddharthnagar District Magistrate Deepak Meena saying, “The matter came to light after complaints were received from some of the recipients that they were administered the wrong vaccine as the second dose on May 14.” According to the report the recipients themselves complained that they were given two different vaccines at the Primary Health Centre. They were all over 45 years old and had been administered the first dose more than a month ago. 

A nurse from the Primary Health Centre was suspended over the incident, and action has been initiated against a doctor, who was in charge of the facility, officials told the media. The DM said, “We have sought action against the doctor as well. A report in this regard has been sent to the government. Further action will be taken on a higher level. Statements of the 20 people were recorded. We also checked vials of the vaccines and found that there had been a mix-up.”

But the big questions still remain unanswered, even though the vaccine recipients appeared healthy:

– Does getting jabs of two different vaccines mean that the entire vaccination process was ineffective, and the people will have to be revaccinated?

– What kind of complications can getting two different vaccines cause, and were specific tests performed to ascertain these impacts?

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The Madras High Court has raised concerns over the allocation of vaccine to the state of Tamil Nadu, and asked the Centre to revisit its policy. LiveLaw reported that the bench of Chief Justice Sanjib Banerjee and Justice Senthilkumar Ramamoorthy, orally remarked that it was not good for states to rival for obtaining vaccines, and that the Centre should allocate vaccines.

At the outset, the bench observed that both, Tamil Nadu and Puducherry, have managed to tide over the second surge of Covid and “the worst, it is hoped, is over”. The Bench further observed that daily case count was reducing and the fatalities in the state and the UT were among the lowest in the country.

The court raised a bit of concern over oxygen supply to the state from the east which could get disrupted due to the Cyclone Yaas. But the Additional Solicitor-General appearing for the Centre assured the Court that the possible disruption due to Yaas has been taken into consideration by the Centre and alternative arrangements may be indicated. Moreover, the state submitted that Maharashtra had agreed to supply 20 MT of oxygen as well.

The court directed Centre and the State to take measures to allay people’s fears with respect to the vaccine and educate them. The court also raised the issue of shortage of drugs for the black fungus disease and the Centre assured that those drugs were being produced in bulk while reducing production of other drugs.

Vaccine

The court raised serious concerns about the vaccine supply to the state. “The future allocation of vaccines for Tamil Nadu appears to be somewhat disappointing. Though the Centre maintains that the allocation is based on the population of a State, the positivity rate prevailing in such State and like objective factors, the allocation to Tamil Nadu, as indicated in the Centre’s affidavit, may require to be revisited. However, there is hope that vaccines would be available in greater numbers upon the various manufacturing units augmenting their production facilities,” the court observed.

The court left the matter with regards to prioritising vaccination of people involved in certain vocations considering current shortage, up to the state.

The order may be read here:

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The post Madras HC raises concern over shortage of Covid vaccine, Black Fungus drugs appeared first on SabrangIndia.

Thane Municipal Corporation (TMC) Standing Committee Chairman Sanjay Bhoir requested the Municipal Commissioner on May 5, 2021 to allow for Covid-19 vaccination centres at the society-level to avoid crowding at government centres.

“We appeal to the TMC to speak to the central and state government to allow for vaccination camps to be set-up in individual societies under TMC’s jurisdiction,” said Bhoir in the letter.

Earlier, the Brihanmumbai Municipal Corporation (BMC) allowed big societies, clubhouses, industrial parks, banks, big companies to tie-up with Covid-19 hospitals to carry out the vaccination drive. Bhoir argued that if the TMC can similarly provide such camps in Thane’s society and clubhouses then both people over 18 years and the elderly can benefit greatly.

“With the help of special nurses and doctors’ associations such an initiative can greatly further the vaccination drive. People won’t have to stand in long lines and avoid crowding. The complaints about a lack of vaccines will also cease,” he said.

Thane citizens of late have complained about the long lines outside Covid-19 centres that hinder the vaccination process. Bhoir stated that this matter needs to be addressed fast in face of a potential third wave of coronavirus as well as this year’s monsoon season.

Around two weeks ago, the TMC made preparations for two jumbo vaccination centres: one at Kausa stadium and the other at Vartak Nagar. Officials said the centres would follow the same model as the Bandra Kurla Complex (BKC) facility. But this does not negate the need for society-level centres.

On May 6, a stampede broke out at the BKC centre despite separate waiting areas and entry points for different age groups and citizens who registered via the Cowin app. People grew anxious as the day progressed with fights breaking out eventually resulting in pushing. As per a Newslaundry report, the unfortunate incident occurred due to a combination of vaccine shortage and unrest among citizens.

Even in Thane, around 40 out of 56 vaccination centres are functioning regularly due to limited supply. Residents, in some areas, reported groups of 500 people crowding local centres even before the work hours began, eager to avail the 50-100 daily vaccines distributed.

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The United States has expressed support for waiving Trade Related aspects of Intellectual Property Rights (TRIPS) for Covid-19 vaccines. US Trade Representative Katherine Tai shared her country’s stand amidst World Trade Organisation (WTO) discussions on easing global trade rules to enable vaccine access to the developing world, saying, “The Administration believes strongly in intellectual property protections, but in service of ending this pandemic, supports the waiver of those protections for COVID-19 vaccines.”

This is significant because many pharma majors are reluctant to allow production of their vaccines in other countries or in facilities not owned or controlled by them. Pharma majors believe this would stifle innovation and disincentivise large investments into Research and Development (R&D). India has already been I the global crosshairs for its thriving generics market where Indian companies allegedly reverse engineer international drug formulations to produce cheaper variants. Thus, the anti-waiver stand of pharma countries and many wealthy nations had significantly reduced the quick and safe availability of high-quality vaccines at affordable prices to people in developing nations.

India has welcomed the Biden-Harris administration’s support for IPS waivers. In a statement released, New Delhi said, “We welcome the statement on US government on 5^th May announcing their support for the initiative. We are hopeful that with a consensus-based approach, the waiver can be approved quickly at the WTO.”

India and South Africa had originally proposed the IPR waiver in October 2020. If the waiver was granted, it would allow countries who are WTO members to choose to neither grant nor enforce patents and other IP related to all Covid-19 drugs, vaccines, diagnostics, and other technologies, including masks and ventilators, for the duration of the pandemic. This would provide countries with the policy space needed to collaborate in R&D, manufacturing, scaling up, and supplying Covid-19 tools. The proposed waiver would be applicable only to Covid-19. It does not suggest a waiver from all TRIPS obligations, nor does it suggest a waiver beyond what is needed for COVID-19 prevention, containment and treatment.

In November 2020, Eswatini, Kenya, Mozambique and Pakistan also backed this landmark proposal. But Australia, Brazil, Canada, EU, Japan, Norway, Switzerland, UK and US were opposed to it at that time.

Just hours after Tai’s statement, other nations too started showing support for the idea. European Commission President Ursula von der Leyen told media persons, “The EU is also ready to discuss any proposal that addresses the crisis in an effective and pragmatic manner.”  

Meanwhile, the EU is also sending medical aid to India in a humanitarian outreach program to help the country combat Covid that is spreading relentlessly. This includes medical equipment and medicines worth € 100 million.

The EU stands by India in these difficult times.

EU countries have channelled over €100 million worth of medical equipment & medication to India under the EU Civil Protection Mechanism.

We are ready to help further. I’m looking forward to the ???? Leaders’ Meeting on 8 May. pic.twitter.com/EEZLc8mnTK

— Ursula von der Leyen (@vonderleyen) May 6, 2021

Meanwhile, shortages of life-saving drugs and Covid vaccines continue in India where over 4 lakh fresh cases are being reported each day for the last one week, and as per government data, as of 8 A.M on May 7, there were 36,45,164 active cases of the disease.

#CoronaVirusUpdates:

?Total #COVID19 Cases in India (as on May 07, 2021)

81.95% Cured/Discharged/Migrated (1,76,12,351)
16.96% Active cases (36,45,164)
1.09% Deaths (2,34,083)

Total COVID-19 confirmed cases = Cured/Discharged/Migrated+Active cases+Deaths#StaySafe pic.twitter.com/ctRDmt3I8M

— #IndiaFightsCorona (@COVIDNewsByMIB) May 7, 2021

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The Karnataka High Court has brought its attention to the acute shortage of vaccines in the state, and has directed the state government to submit a requisition to the Centre and in turn directed the Centre to make a decision on it within 3 days.

The bench of Chief Justice Abhay Oka and Justice Aravind Kumar has been consistently hearing matters related to Covid management in the state. On May 5, it focused on shortage of oxygen and Remdesivir in the state, and issued directions to that effect. The bench directed the Centre to increase oxygen allocation to Karnataka to 1200MT with immediate effect, on an ad hoc basis until Centre reconsiders its decision. With respect to Remdesivir, the court gave the Centre two days to reconsider its decision on allocation to the state.

LiveLaw reported that on the May 6 hearing, the bench observed that the scenario with respect to the vaccination is shocking. “Available doses of 7,76,675 will have to be given firstly to those beneficiaries who have taken the first dose and the requisite period of second dose as per notification of the Central government is likely to expire. Second priority can be given to health care workers and frontline workers. In short, in the situation that prevails today, it is virtually impossible in the state of Karnataka for citizens to get their first dose of vaccination unless they fall in the category of healthcare workers and frontline workers,” the bench reportedly said.

The court asked the state to ensure that it mentions in its requisition the number of beneficiaries who are likely to lose advantage of the first dose, if the vaccine is not administered to them immediately. Upon perusal of the state’s submission, the court concluded that there is hardly scope for administering the first dose of the vaccine. “We hope and trust that the central govt will consider this critical situation while dealing with the requisition made by the state government,” the bench said.

The state government informed the court that requisition has been made to private manufacturers on May 3, for supply of vaccine for the age group of 18 years to 44 years, and that so far vaccines have not been received for the same.

The court also directed the state government to ensure that assistance is provided to citizens in registration for the vaccine, especially the vulnerable sections, because unless they get registered, the object of vaccination will be frustrated. The court also questioned the state on how it plans to carry out targeted vaccination for class of workers such as sanitation and crematorium workers and sought a response by the next hearing.

Other issues

It was brought to the court’s notice by the counsels for one of the petitioners, that Covid was spreading unchecked in the slums of Bengaluru city. The court directed the state to file submissions with a scheme for preventing the spread in slums.

On being informed on the number of beds of various types in Bengaluru, the court deemed the situation to be grim. However, BBMP counsel assured the court that they were looking at each ward and monitoring availability of oxygen and said that 100 more oxygen beds were to be added in government run hospitals. The court sought to know all steps taken.

The court also questioned the state on the decisions taken to ensure food security of the vulnerable sections of the society.

The case will next be heard on May 11.

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If drastic step is not taken, Covid situation will worsen: Patna HC

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The Supreme Court has asked the Centre to revisit its vaccine policy so that it withstands scrutiny of Articles 14 and Article 21 of the Constitution. The three-judge bench of Justices DY Chandrachud, L Nageswara Rao and S Ravindra Bhat prima facie held that the Centre’s vaccine policy violated right to health, and suggested centralising procurement and decentralising distribution.

At the outset, the court made it clear that it did not wish to delve into the role of the executive and was only trying to ensure probity and transparency.

In its previous order of April 27, the court had directed the Centre to clarify: 

(i) the projected availability of vaccines and proposed steps to boost supply and distribution; and 

(ii) the vaccine pricing and distribution among states. 

The Centre, accordingly, filed the affidavit stating that as of April 26, as many as 13.5 crore vaccine doses were given to frontline workers and people of age 45 and above, covering about 9% of the population. The centre revised the strategy for vaccination of ages 18 and above allowing states and private hospitals to directly procure vaccines in order to accelerate immunisation.

Centre’s vaccine policy

The court however expressed its reservations prima facie on the validity of the revised policy under which the states and private hospitals are to procure 50% of the vaccines in order to immunise persons in the 18-44 years age group. The court observed that even in this age group there are people with vulnerabilities. The court opined that it would not be logical to impose the obligation to source vaccinations for the 18-44 age group on the State Governments as it will leave each State Government to negotiate supply schedules, delivery points and other logistical arrangements with the manufacturers.

The court held that the available stock of vaccine is not adequate to deal with the requirement and the central government has to take up the responsibility of providing guidance to every state on the quantities to be supplied to each state, the vaccine(s) being allocated, the period of delivery, and the number of persons who can be covered for vaccination, among other details.

The court sought more answers from the Centre on the following points:

(i) Whether the Central and State Governments have introduced any initiatives for ensuring the immunization of persons who do not have access to internet for registering on Cowin portal

(ii) Whether walk-ins will continue for 45+ age group after May 1

(iii) Whether the Central or State Governments propose to undertake targeted vaccination drives for persons who are providing on-ground assistance during the second wave of the pandemic – such as crematorium workers, who were not considered as Frontline workers

(iv) efforts being taken to ensure vaccine outreach in rural areas and remote areas through mobile vans, vehicles and railways to vaccinate such people near their doorsteps. Efforts must also be made that a lack of an identity proof does not create a hindrance in the process of immunization of all individuals, specifically, the underprivileged

(v) Whether the Central government will revisit its policy by procuring 100% of the doses which can then be equitably disbursed to the State Governments;

(vi) Since the vaccine administration is now to be a shared responsibility of the Union and the States, the Central Government and the State Governments shall provide- (a) a breakup of the current and projected availability of vaccine stocks for the next 6 months; and (b) a timeline for achieving immunization of the newly eligible 59 crore persons who are aged between 18-44 years.

The court held these to be issues of vital importance as vaccination is an important strategy to combat the pandemic.

Pricing of vaccine

On the pricing of the vaccine, the court held that compelling the State Governments to negotiate with manufacturers on the ground of promoting competition and making it attractive for new vaccine manufactures will result in a serious detriment to those in the age group of 18 to 44 years. The court observed that in this age group there are also people belonging to Scheduled Castes or marginalised communities, and they may not have the ability to pay for the vaccine and each state government will have to decide on its own finances, whether to offer them for free or with subsidy. As per the court, this would create disparity across the country.

“Discrimination cannot be made between different classes of citizens who are similarly circumstanced on the ground that while the Central government will carry the burden of providing free vaccines for the 45 years and above population, the State Governments will discharge the responsibility of the 18 to 44 age group on such commercial terms as they may negotiate,” observed the court.

The court held that the best way to navigate through this would be “in a manner consistent with the right to life (which includes the right to health) under Article 21 would be for the Central Government to procure all vaccines and to negotiate the price with vaccine manufacturers. Once quantities are allocated by it to each State Government, the latter would lift the allocated quantities and carry out the distribution.” Basically, the court suggested centralising procurement and decentralising distribution.

The court refrained from deeming the constitutional validity of the Centre’s vaccine policy but held that it would “prima facie result in a detriment to the right to public health which is an integral element of Article 21 of the Constitution.” Thus, the court has asked the Centre to revisit its vaccine policy so that it withstands scrutiny of Articles 14 and Article 21 of the Constitution.

Differential pricing for Centre and States

The Centre’s justification for such differential pricing was to create an incentivised demand for the private vaccine manufacturers in order to instill a competitive market resulting in increased production of vaccines and market driven affordable prices for the same. Basis this justification, the court sought some clarifications:

(i) Whether any other alternatives were considered by the Central Government for ramping up the immunisation drive in India, particularly in light of its initial strategy of a centralised free immunisation drive;

(ii) The methodology which the Central Government was envisaging to procure adequate vaccine doses for the population prior to the revised strategy

(iii) Whether any studies and figures were relied upon in order to arrive at the conclusion that decentralised procurement would spur competitive markets to incentivise production and eventually drive down the prices. Whether these studies are of relevance in a pandemic when vaccines are a scarce and essential commodity which is being produced by a limited number of manufacturers for a limited number of vaccines.

The court has also sought to know in a bid to maintain transparency, whether the Centre has made any grants to Bharat Biotech or the Serum Institute of India in the past. This query was made after the Centre informed the court that Rs. 3,000 crores of credit has been sanctioned for SII and Rs. 1,500 crores to Bharat Biotech in addition to Rs. 65 crores to Bharat Biotech’s production Center at Bangalore.

The court has questioned the Centre on whether the current procurement prices for the Central Government account for infusion of funds for production, infrastructure and other aid provided by it, and why the same benefit is being denied to states which will equally service the needs of the citizens.

The court has also sought to know the extent of direct and indirect grant/aid provided for research, development and manufacture of all existing vaccines and future vaccines that the Centre proposes to authorise.

In a detailed order, on April 30, the Supreme Court dealt with other issues such as the Disaster Management Act, medical infrastructure, oxygen allocation, essential drugs and augmenting health workers.

The Court has directed the Centre to rectify the deficit of oxygen supply to Delhi within 2 days (before midnight of May 3); to prepare a buffer stock of oxygen, to formulate a national policy on admissions to hospitals and so on.

The next date of hearing is May 10.

The complete order may be read here:

Related:

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