Challenging the new policy adopted by the Central Government to reserve 25% of the domestically manufactured COVID vaccines for private hospitals, an application has been filed in the Supreme Court.

The application filed by Rajya Sabha MP from Kerala and former mediaperson John Brittas and R Ramakumar,  Professor at TISS, says that this policy will in effect "cause a reservation for the rich and urban people alone".

Citing statistical studies, the applicants say that the contribution of private sector towards TB, DPT3, polio vaccinations have been very negligible. As per 2011 Indian Census Data and National Household Surveys (DHS/NFHS 2005-06 and UNICEF CES 2009), the private sector has contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage.

The application, filed through Advocate Reshmita Ramachandran, contends that there is massive under-utilization of vaccines given to private hospitals. It is said that the private hospitals have administered only 17.05 % of the vaccines allotted to them. As per the health ministry's 4th June data, the central government provided total of 7.4 crore COVID-19 vaccine doses to hospitals across the country in May, of which 1.85 crore doses( i.e., 25% of total vaccines) were earmarked for private hospitals.Of the 1.85 crore vaccines earmarked for private hospitals across India, 1.29 crore doses were provided to them in May, however, the government data showed that only 22 lakh doses were used.

"High predatory prices at private hospitals in comparison to government-run hospitals and vaccine hesitancy will continue to cause low vaccination at private healthcare institutes", the plea states.

In this context, the applicants question the logic and rationale of earmarking 25% of vaccines for private hospitals, when there is a pressing need to immediately vaccinate every Indian on a war-scale footing to control the pandemic spread.

Will create vaccine inequity.

The independent purchase of vaccines by the private hospitals will create huge vaccine inequity in the country, argue the applicants.  They cite a report of the Indian Express dated June 5, according to which just nine corporate hospital groups in big cities have cornered 50 per cent of the Covid-19 vaccine stock meant for the private sector in the month of May and the balance 50 per cent of the vaccine stock was procured by 300-odd hospitals, located mostly in the country's urban centres, with hardly any of them serving regions beyond the Tier-2 cities.

The applicants, who are seeking to intervene in the suo moto case taken by the Supreme Court on COVID issues(In Re Distribution of Essential Services and Supplies During Pandemic), voice the apprehension that this policy will only lead to "super-profiting" by private hospitals creating massive "vaccine inequity".

India has a total of 43,487 private hospitals. But only a very negligible number of large corporate-run private hospitals could get hold of the vaccine supply.

"This is in gross violation of the principles of social & economic justice and equality of status & of opportunity as embedded in the Constitution of India . Art.38 of the Constitution requires the state to secure a just social order for the promotion of the welfare of the people, minimise inequalities in facilities and opportunities, not only amongst individuals but also amongst groups of people residing in different areas" .

The Union of India, on June 8, fixed  the price caps as Rs. 1200+60(GST) +150 (Service Taxes) for Covaxin; Rs. 600+30(GST) +150 (Service Taxes) for Covishield and Rs. 948 +47 (GST) +150 (Service Taxes) for Sputnik V. Therefore a person availing2 doses has to pay Rs.2820 for Covaxin, Rs. 1560 if he avails Covishield and Rs. 2290 for Sputnik. This is in clear disadvantage to the people of India and to the excessive advantage for the vaccine manufacturers to create excessive profits, the applicants say.

"Unless the Centre takes over 100% procurement and makes doses available to all through private and public hospitals under the aegis of a proper regulatory authority with continuing mandamus from this Hon'ble Court , the Covid vaccination policy would continue to remain incomplete,inequitable, inefficient andopaque and the fundamental rights of the people to health...will be put to freezer . Therefore the immediate intervention of this Hon'ble Court is inevitable in making the vaccines accessible & available for all the people in India through a transparent procedure and thereby to enhance the trust of the people in their safety in the system", the applicant states.

It was on June 7 that the Central Government announced a revision in its vaccine policy, following sharp criticism from the Supreme Court. In an address to the nation, the Prime Minister said that the Union Government will also procure the vaccines for the State Governments, and will provide free vaccination to the age group of 18-44 years. It was also said that 25% of vaccines will be earmarked for private hospitals.

It is pertinent to note that this decision came after the strong criticism from the Supreme Court against the 'liberalized vaccine policy' of the Centre, as per which states get only 25% of the vaccine quota and the free vaccination benefit of the Central Government is restricted only to those aged above 45 years. The Supreme Court made a prima facie observation that the paid vaccination policy for the age group 18-44 years as prima facie "arbitrary and irrational", as it was this age group which got badly hit during the second wave of the pandemic. A bench comprising Justices DY Chandrachud, L Nageswara Rao and S Ravindra Bhat flagged several issues with the vaccination policy and urged the Central Government to revisit the same, by saying that the policy was detrimental to right to life and health.

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