Will pressure from Supreme Court and states cause Modi to turn around on vaccines?
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The big story: Around
A month and a half ago, the Union of India government introduced sudden changes in its vaccination policy that it said would liberalize and speed up India’s campaign to vaccinate all adults. At the time, we called some of the moves baffling and explained how they seemed to be a panic reaction to an unexpected second wave.
Over the past two weeks, a few other opinions on politics have emerged.
The Supreme Court of India concluded that the Centre’s decision not to vaccinate Indians between the ages of 18 and 44 free of charge was “prima facie, arbitrary and irrational. “
A number of chief ministers of various states called on the EU government to return to the previous approach of getting all vaccines, instead of the piecemeal approach it has chosen in the new policy.
And NITI Aayog, the Centre’s think tank, made it clear that the Union government knows how misguided some elements of the new strategy are, giving the impression – as I write here – that he chose these policies just to upset the states.
Does this combination of circumstances mean that the “liberalized and accelerated” policy of Prime Minister Narendra Modi is about to be reversed, at least in part?
Let’s look at each of the elements separately.
NITI Aayog’s statement is, in some ways, the most infuriating of the developments. In the original press release, the Union government presented its new policy, it gave no indication that it had arrived at these decisions on the basis of some kind of compromise with the states, or that he reluctantly accepted a political recommendation.
Instead, characteristically, The version April 19 was laudatory and gave the impression that “liberalized and fast-track policy” was the natural next step.
“The Indian government has involved the private sector in the vaccination campaign from the start. Now, as capacities and processes have stabilized, the public sector as well as the private sector have the experience and confidence to grow rapidly. In phase III, the national vaccination strategy aims to liberalize the pricing of vaccines and extend vaccination coverage. “
Now read what the NITI Aayog said May 27.
“States were well aware of the country’s production capacity and the difficulties in obtaining vaccines directly from abroad. In fact, the GoI ran the entire vaccination program from January to April and it was administered quite well compared to the situation in May.
But states, which hadn’t even achieved good coverage of health workers and frontline workers in 3 months, wanted to open up the immunization process and wanted more decentralization. Health is a matter of state, and liberalized immunization policy is the result of relentless demands by states to empower states. ”
In other words, the Center is now saying, via NITI Aayog, that it knew it was bad policy. And yet he claims – dishonestly, as we highlight below – that he was pressured to implement this bad policy.
States push back
The Center now wants to present its much-criticized policy as the result of erroneous demands by opposition states. Madhya Pradesh Chief Minister Shivraj Singh Chouhan hinted that the Center had abandoned “perfect politics” due to pressure from the state, a claim that says more about his Bharatiya Janata party than the opposition.
But there is little indication here that Prime Minister Narendra Modi’s notorious centralizing government suddenly uncovered its federalist principles on vaccine policy and began to listen to states.
Admittedly, there was a clamor to open the vaccines for the 18-44 band, despite a small percentage of the more vulnerable population of 45+ having been covered. There have been many more sporadic calls for a greater state voice in vaccine procurement. Instead, chief ministers primarily demanded the freedom to distribute as they wished.
And no head of state was asking for a confusing system in which states would compete with the private sector, the Center itself would negotiate a cheaper rate than states, and the private sector would be allowed to charge whatever price it wanted while being made responsible for covering 50% of the 600 million Indians between 18-44.
Rather than a sudden injection of federalism, the Centre’s new policy obviously seems to be a panic reaction to allay the barrage of criticism following a brutal second wave that it absolutely did not anticipate. The changes meant that the titled rich of all ages could now be vaccinated, although few other aspects of the policy made sense.
Now the states are fighting back. Chief ministers from opposition states like Kerala and Jharkhand have called on the Center to procure vaccines for all, as have most central governments around the world.
Even the chief ministers of Odisha and Telangana, who tended to vote with the Bharatiya Janata party in parliament, spoke out against fragmented supply – although, generally, they addressed their concerns. comments to other chief ministers, rather than Modi.
Will the Center respond to these demands to reverse its misguided strategy, for which it has also sought to blame states?
Among others, the Supreme Court most recent judgment in his suo moto case – that is, he started hearing on his own, without any petitions – on issues related to Covid includes several paragraphs passed to tell the Center that his website for vaccine registration needs drop-down menus and keyboard shortcuts to help disabled users. It is difficult to answer the question of why the country’s supreme court should spend its time giving basic website design instructions to the Center, which took a whole year to create the site.
The court also announces its perplexity over the Centre’s changes in vaccine policy, particularly the confused decision to negotiate a different price for itself and the states and the choice to give private hospitals the freedom to charge as much as they do. they want it for the doses, while expecting them to cover 50% of the 600 million Indians between 18-44.
For example, after the Centre’s previous affidavit asserted that even the “liberalized” vaccine policy did in fact give states no freedom in terms of volumes or price, but forced them to pay more despite admitting that the government Union could get better rate with larger order. , the court said:
“At first glance, the only room for negotiation with the two vaccine manufacturers concerned the price and quantity, both prefixed by the central government. This casts serious doubts on UoI’s rationale for allowing higher prices as a competitive measure. In addition, the central government justifying its lower prices because of its ability to place large purchase orders for vaccines raises the question of why this justification is not used to acquire 100% of the monthly doses of CDL.
The order continues the trend of the court asking simple questions to the Center for information on vaccine policy that it should have provided to the public anyway, months ago. He asks :
- How does the Center control the distribution of vaccines to private hospitals? How does the Center monitor whether private hospitals are distributing doses proportionately to the state’s populations, as the government claims?
- Did the Center do a “means test” of state demographics to conclude that 50% of the 18-44 year old population would be able to pay for two doses of a vaccine? If not, why did he give private hospitals the responsibility of covering 50% of the 18-44 year old population?
- How will the Center and the States ensure equitable distribution of vaccines to all segments of society?
- Does the Center regulate the final price charged by private hospitals at all, especially since it regulates the number of doses they can receive?
- How was the Rs 35,000 crore set aside for vaccines in the budget spent?
Finally, as mentioned above, he considers that the Centre’s approach to the entire 18-44 age group is “prima facie arbitrary and irrational”, strongly suggesting that it should either be amended, or defended with a radically different legal argument.
The court is due to hear the case the next time on June 30. Will he consider a radically different vaccine policy by then?
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