India has made plans to launch the world’s largest COVID-19 vaccination programme.

The pandemic, raging worldwide since early this year, has so far afflicted more than 72 million people and taken more than 1.6 million lives.

India is the second worst hit country, with close to 10 million cases and more than 143,000 deaths. The United States tops the table with 16.7 million cases and more than 306,000 deaths.

India has had a better recovery rate than the US. This prompted President Donald Trump to accuse India of fudging figures. But, then, the media in many countries, including the US, have cast doubts on casualty figures put out by their governments.

 Since co-morbidities contribute to death it is easy to keep the Covid casualty figures low.

Eight vaccine candidates, including those of foreign origin, are scheduled to be manufactured in India, according to Health Minister Harsh Vardhan. Three vaccine makers, Pfizer, AstraZeneca and Bharat Biotech, have applied for emergency use authorisation of their products and are awaiting approval of the proposal by the independent drug regulator.

The government’s plan envisages giving two shots each to 300 million most vulnerable people in the first phase. That is almost the size of the US population, which is 328 million.

Those chosen to receive the vaccine in the first stage will include 30 million frontline health workers who have been taking the brunt of the pandemic for months.

Another priority category comprises an estimated 10 million who are below the age of 50 years but have serious co-morbidities. The remaining 260 million will be people above the age of 50 years.

The government has not spelt out how the beneficiaries will be selected. Who will decide how many people from each state should be included in the 300 million? And what are the criteria to be followed in making that decision?

These matters need to be clarified in view of the general lack of transparency in decision making by the Narendra Modi administration. There is no word yet on the price of the vaccine.

Modi’s Bharatiya Janata Party unabashedly played politics with Covid vaccination in recent election campaigns. In its manifestoes for the Bihar Assembly elections and the Hyderabad city corporation elections it promised free vaccine.

 Now state governments appear to be competing in announcing they will provide the vaccine free of cost. Tamil Nadu, Madhya Pradesh and Kerala, all three ruled by different parties; have already said they would supply the vaccine free.

Instead of allowing the issue to become one of political contention, the Centre must make it clear that the vaccine will be distributed free across the country.

In retrospect, it appears the Centre had erred in not providing for free testing and treatment when the pandemic struck. While government hospitals provided free testing and treatment, private institutions were allowed to charge heavily for testing and treatment.

Free testing would have helped to detect cases sooner and check the spread of the disease better.

The Centre has released a free mobile app Co-WIN to enable people to register for the vaccine. Those with co-morbidities can state that and their medical history will be checked to make sure that they are indeed eligible for preferential treatment.

An upgraded version of Electronic Vaccine Intelligence Network (eVIN), which was introduced earlier, Co-WIN will link vaccine administrators, vaccinators and vaccine seekers. Use of new technology should not result in exclusion of digital have-nots.

The states were told to make arrangements for storage of vaccine by the middle of this month. This is a daunting task.

Pfizer’s vaccine candidate which is awaiting approval needs to be kept at an extremely low temperature of minus 70 degrees Celsius or below. Most cold storage facilities lined up by the government can only keep the vaccine at between 2 and 8 degrees C.

It may not be possible to equip primary health centres at short notice to stock large quantities of vaccine. Consequently the mass vaccination programme may be largely limited to urban India.

It has been estimated that six to eight months are needed to complete the first phase of the vaccination programme. When it is over, there will be one billion people still waiting for their turn. At least three more rounds   will be required to cover all of them.

In other words, the programme will have to continue at the same pace for two years.   

Travel agents have reported a rush of airplane bookings to Britain to get vaccinated there, beating the long queue in India.