That’s not all. If vaccines from other manufacturers pass muster, India could expect an additional production of 710 million shots during August-December 2021.
The Needle of Challenge
Put together, therefore, if everything falls in place, India should have 2.166 billion doses of different Covid vaccines by December 2021. Excluding a 5% loss rate, that would cover over one billion citizens — a number that is monumental by any yardstick, and more than sufficient to create herd immunity.
I am not critiquing the production plan. India’s entrepreneurs have it in them to do what it takes to overcome a crisis, even one as mammoth as this. Instead, I want to highlight the real challenges of vaccinating our citizens. For that, see the table with this article. I have taken the population data from the 2011 census and assumed an annual growth rate of 1% to arrive at these estimates for 2021.
There will be fewer problems in vaccinating the 284 million who live in urban India. The real issues relate to rural India. To appreciate this, let me focus on India’s largest state, Uttar Pradesh (UP).
UP has 75 districts. The 2021 population of those who are 18 years and above is estimated at 221 million. Of that, 78%, or 172 million, live in villages. Rural UP, therefore, has to get some 361 million doses, including 5% wastage. Now consider the logistics of this operation.
The vaccines will have to be separately delivered month on month through cold chains to notified hospitals in each of the 75 district headquarters. From there, these will need to be sent to the 3,728 dispensaries across the state’s 822 development blocks ranging from Muzaffarabad in the district of Saharanpur in the north, to Lakshmipur in Maharajganj in the northeast, to Robertsganj in Sonbhadra in the southeast, to Jakhaura in Lalitpur in the southwest. The cold chain transportation logistics across UP is more challenging than one could ever dream of.
Each of these dispensaries will need adequate refrigeration and power supply and a team of nurses and doctors to administer the vaccines. Functioning not for a day or two, but for at least three months, so that both shots can be administered to each person. Besides, the data will have to be entered each day, either prior to or immediately after a person’s taking ashot, and uploaded on to the central CoWIN site. Hence, bandwidth.
We are, therefore, talking of flawlessly executed logistics and health management across 75 districts of India’s largest state with dismal health facilities. Ideally, the best strategy would be to saturate a cluster of geographically contiguous administrative divisions — such as Meerut, Moradabad and Saharanpur, covering 14 districts in the north and northwest — before moving on to the next. However, in today’s pandemic ridden atmosphere, that might be politically difficult to sell. As in, ‘Why aren’t we getting vaccinated in Varanasi or Jaunpur when they are in Meerut or Muzaffarnagar?’ So, it will have to be the second-best: a vastly complicated big push across all districts throughout this vast state.
has the Key
That requires outstanding management, controlled by a full-fledged war-room in Lucknow led by a topnotch administrator — a CEO, as it were — accountable to none but the chief minister. Like the way Iqbal Singh Chahal led the Brihanmumbai Municipal Corporation (BMC) during the second wave in Mumbai.
But that’s not all. Each of UP’s 18 administrative divisions covering the 75 districts and the district magistrates also must be committed beyond compare. Every bit of the chain —from logistics, to delivery, to vaccinations — must be monitored on a day-to-day basis, often hour-by-hour.
I can see some large states doing this well — Maharashtra, Gujarat, Kerala and Tamil Nadu. But what about UP? Or Madhya Pradesh? Or Chhattisgarh? Or Bihar? Or Jharkhand? Or West Bengal?
So, here’s the first test of Yogi Adityanath’s real leadership of the state. Can he appoint a best-in-class administrator to lead this vaccination effort? Can he give him the operational freedom that is vital for success, as the Maharashtra Chief Minister Uddhav Thackeray gave to Chahal? Can he oversee without interfering? Can he share the data transparently? Can he put aside sectarian discourse while dealing with this pandemic? Can he show that UP shall succeed? Can UP be Maharashtra, even once? The ball is in his court.
The writer is chairman, Corporate and Economic Research Group (CERG) Advisory