Daunting task ahead

Ramping up capacity to meet the requirements of a vaccination programme covering the entire population will need to rely on private players

If 2020 has been a year of global suffering due to the coronavirus pandemic, 2021 is set to pose an unprecedented logistic challenge in the distribution of the Covid-19 vaccine. It is entirely possible that more than one vaccine will cross the finish line of regulatory approval after successfully passing the trials. The operational issues of vaccine production, procurement, supply chain, prioritisation for sequenced administration in the population and monitoring the impact would be the key challenges that will test the robustness of the system of healthcare administration. The task before India is particularly daunting in view of the size and diverse needs of the population. For India and many other low and middle-income countries, vaccines that require severe sub-zero temperatures for storage and transportation are impractical because of the grossly inadequate infrastructure. Other candidate vaccines, which use more conventional platforms for vaccine development, can be preserved and transported in less stringent cold chain systems that are already available for ongoing routine immunisation programmes involving other vaccines. The universal immunisation programme in India has well established and time-tested vaccine distribution systems. However, the cold chain for the existing vaccines does not require super-freezing sub-zero temperatures. Even when an approved vaccine becomes available, countries will have to prioritise the order in which different population groups will receive the vaccine as supply will be limited for several months. Global manufacturing capacity will be put to test by the demand for vaccines. India will be a major contributor to vaccine production, whether indigenously developed or internationally licensed. This should provide early and high volume access to affordable vaccines.

It is a testimony to the human ingenuity that the global scientific community has responded to the pandemic challenge with an unprecedented speed and dedication, virtually racing against time. The challenge before the nations now is to ensure equitable distribution of the vaccine across the world. For India, vaccinating over 1.3 billion people will require massive scaling up of the cold chain and distribution capacities. The present workforce under the universal immunisation programme is inadequate to meet the challenge. There is a need to rope in the private sector to carry out the mammoth task. According to the official data, the government-run national immunisation programme currently targets 26.7 million newborns and 29 million pregnant women every year. While the existing cold chain is funded and managed through public finances, ramping up capacity to meet the requirements of a vaccination programme covering the entire population will need to rely on private players. The air cargo industry will also have a key role to play in the vaccine delivery chain given the nature of the cargo, need for speedy delivery with temperature compliance for safety and efficacy.

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