Jharkhand CM Asks PM for Free COVID Vaccine for 18-44 Age Group

In the letter sent on Monday, Soren said the state was battling a deadly second wave of COVID-19 with its limited resources.

Ranchi: Jharkhand chief minister Hemant Soren has written to Prime Minister Narendra Modi seeking free COVID jabs for the 18-44 age group, saying the state was unable to incur nearly Rs 1,100 crore on it due to stressed resources.

In the letter sent on Monday, Soren said the state was battling a deadly second wave of COVID-19 with its limited resources.

“The financial burden on the state for vaccination of the age cohort of 18-44 years is likely to be more than Rs 1,100 crore considering 1.57 crore eligible beneficiaries.

“With vaccine being available for age cohort of 12-18 years and below, the mentioned financial burden will further increase by around Rs 1,000 crore. It will be extremely difficult to spare as much resources from the resource pool of the state which is already stressed during COVID times,” the letter mentioned.

He said the abysmal supply of vaccines as compared to the state’s requirement is the foremost impediment to the ongoing vaccination drive.

Father of Manipuri Teen Climate Activist Licypriya Kangujam Arrested in Delhi

Kanarjit Kangujam has been arrested on the charges of forgery and cheating.

New Delhi: The Delhi Police’s Special Cell arrested the father of teen Manipuri climate activist Licypriya Kangujam on the charges of forgery and cheating, officials said on Monday.

The arrested person has been identified as Kanarjit Kangujam, they said.

The Manipur Police had put in a request with the Delhi Police for help to arrest Singh, officials said.

He was arrested in the national capital by a team of the Delhi Police Special Cell and handed over to the custody of Manipur Police, a senior police officer said, adding that a reward of Rs one lakh had been announced on information leading to his arrest.

Police said that he was wanted in three cases of cheating and forgery.

Centre Should Procure Vaccines For All. Anything Else is Contrary to Efficiency and Equity

Whose needs are greater: that of the Centre or the private buyer? How did the Centre arrive at such an arrangement?

The Centre must immediately adopt a policy of national uniform pricing of COVID-19 vaccines for procurement by the Government of India. They must accept the primary responsibility of purchasing and making available vaccine supplies to all states, enabling universal free vaccination.

The reasons are the following.

Firstly, vaccines against infectious diseases have positive externalities, i.e. with positive effects on the entire citizenry, the economy and reduced costs of morbidity and mortality. Nowhere in the world is a ‘public good’ priced for the public. It is free, available to all, because it is good for everyone. One person not vaccinated is a risk to others. It is, therefore, in the interest of the state and each citizen to be vaccinated. Globally, public financing ensures access to vaccines. Leaving it to market forces, or even competing forces among state governments within a large country, with millions of poor people (whose incomes have fallen after COVID-19), is both inequitable and inefficient.

For healthcare and essential service workers, and then for >60 years olds and for >45 year olds with comorbidities, GOI was procuring vaccines and supplying states. However, the GOI  changed its policy mid-stream (as per announcement on April 24, “Liberalised Pricing and Accelerated National Covid Vaccine Strategy”). GOI procured vaccines for the first two groups. Then, when it came to the turn of 18-45 year olds (around 600 million people), from May 1, the government allowed states and private purchasers to negotiate the price, and procure on their own.

Continued Central procurement is the preferred option. Price competition between states will be avoided. On the other hand, if individual states procure individually, as do private parties, manufacturers have already raised purchase price increasing cost to the tax payer. States and the GOI need every paisa to improve health infrastructure and human resources to meet citizens’ needs.

The Centre can reduce procurement price when bulk buying from few suppliers (who have oligopolistic power). That is why the continuation of Central procurement is the obvious strategy, which the Centre has abandoned, thus abdicating responsibility.

The fiscal capacity of states varies, so Central procurement will avoid inter-state inequity in access to vaccines. We already know that eight states account for 75% of vaccines administered. Some states have announced that they will provide free vaccinations to all adults. It may be possible for some states, but other states may have less fiscal space. This is already a cause of inter-state inequity, which will become worse, in the absence of Central procurement.

States could be edged out by private hospital chains and large corporate employers, since the latter will have a stronger ability to pay. Meanwhile, corporate manufacturers of vaccines will prefer to supply to private buyers, who will be paying a higher price. This can cause supply constraints for state governments.

There is no logic or basis for the Centre deciding that the 50% of vaccines that the Centre will not buy, will be divided equally between states and private buyers. Whose needs are greater: that of the Centre or the private buyer? How did the Centre arrive at such an arrangement?

Under current arrangements, states have had to internationally tender for vaccines. This would mean that states are competing with each other not only domestically but also internationally. This raises costs for states.

For the private sector, which is entitled to purchase 25% of vaccine supplies, there will be a greater buying power with corporate bidders, who will bid up price for all private sector bidders. So the current arrangement favours corporates hospital chains within the 25% private sector allocation, compared to smaller private players.

While contributing to inequity, it will lead to great inefficiency; in fact, compound it. First each state procures independently, then each state and each private chain will make logistical arrangements independently to enable distribution, raising costs and losing time, to get the vaccines and distribute them. At a time of a national health emergency, a once in century pandemic, when we need to achieve speed and efficiency, the GOI is compounding its own delays in placing advance orders on manufacturers (as the US and European governments did), by delaying vaccine delivery to citizens. This is like doing the groundwork for the third wave to arrive – after the prime minister already on January 28 announced to the world: we won the war against COVID-19. This is like rubbing salt into the wounds of citizens – while the second wave rages on, especially in rural areas.

The GOI already provides, under the Universal Immunisation Programme (since 1977), free of cost immunisation against 12 vaccine preventable diseases (plus sub-nationally for three diseases). The UIP is fully funded by the GOI. At the state level, the GOI funds them with the management of the cold supply chain as well as injection safety and waste disposal. Similarly, the National Vaccine Policy 2011 has the same objective (including technology transfer from multinational companies to develop products, use of Indian patent law to permit compulsory licensing in special situations). So clearly the GOI change in policy in 2021 in respect of COVID-19 vaccines – at a time of national emergency – is in violation of the National Vaccination Policy of the GOI 2011. It has to be revoked.

Multiple pricing – one price for the Centre, another for states (Covishield of Serum at Rs 400 and Covaxin of Bharat Biotech at Rs 600 for state governments; and Rs 600 and Rs 1,200 respectively for private hospitals) – is contrary to any logic or principle. It is totally at variance with anything the GOI has adopted for vaccinations before. To do it now, at a time of a national emergency, is to allow manufacturers to earn super normal profits, and smacks of suspicious motives on the part of the two parties that negotiated the deal.

The Centre invoked the Epidemic Act, the Disaster Management Act and the Essential Commodities Act, which gives the Centre overriding powers over state governments. Hence, it is the responsibility of the Centre to assist the states.

The Centre cannot suddenly claim that health is a state subject. If the Centre can without notice impose nationwide lockdown, without asking the states, then surely it can procure vaccines for all citizens.

Major developed countries which moved faster than India in ordering COVID-19 vaccines, have adopted a Central procurement model, with varying distribution mechanisms. Britain, Canada, the United States and the European Union have all followed similar strategies, pre-ordering doses — more than enough to inoculate everyone — from multiple makers, hedging their bets in case some vaccines are not approved or some manufacturers have production breakdowns. No country in the world has adopted the procurement strategy the GOI has adopted.

The African Union created an African Vaccine Acquisition Trust to make available up to 220 million doses of the vaccine produced by Johnson and Johnson to the African Union’s 55 member states starting July 2021. But the GOI has decided to leave India’s states to negotiate with both domestic manufacturers as well as international ones to acquire the vaccines for its people. Then the Central government has the audacity to defend its position in the Supreme Court of India.

Therefore, the GOI should revoke its April 24 announcement, and procure vaccines Centrally at the price it secured for itself. It should then distribute, in accordance with its own National Vaccine Policy to states, on a transparent basis. The health ministry’s secretary has said that 29,000 cold chain points, 240 walk-in coolers, 70 walk-in freezers, 45,000 ice-lined refrigerators, 41,000 deep freezers and 300 solar refrigerators are ready for use for the COVID-19 vaccine storage. The states will take responsibility for vaccinating its population.

Santosh Mehrotra is a former professor of economics, Jawaharlal Nehru University.

Centre to Study Feasibility of Single Dose Covishield Regimen

The proposed study comes even as a study by English health officials said only two doses of Covishield provide strong protection against the B.1.617.2 variant of the coronavirus.

New Delhi: As preparation for a new COVID-19 vaccination strategy that hopes to scale up India’s daily administered doses to 1 crore by mid-July, the Centre plans not only to conduct studies on mixing different vaccines but also test the feasibility of giving just a single dose of Covishield, instead of the current two-dose regimen.

Previous reports had already suggested that the Centre plans to study a mix-and-match regimen, after trials conducted in Spain and other countries showed encouraging results. Now, NDTV reports that the study will “likely be completed in two to two and a half months”.

According to the report, the Centre will also assess vaccine data recorded on a new app which will make it easier to report adverse events after immunisation (AEFIs). The platform will be linked to the Co-WIN portal and allow people to report any concerns after they receive a shot. A district officer will follow up on these cases.

The other, more surprising, development is that the Centre is considering the possibility of prescribing only one dose of Covishield, the Oxford-AstraZeneca product produced by Serum Institute of India. The government has already stretched the gap between the two doses to 12-16 weeks, in a move that was seen as a way to tide over the shortage in vaccine supply.

NDTV reports that the government will first review the “impact of its decision to extend the gap” between the Covishield doses, which will “also help decide on a possible single-dose plan”.

“Single dose vaccination will help the government cover a much wider base of the population,” the report says, quoting unnamed sources, suggesting this move is also motivated by a desire to overcome potential supply-side issues. Over the past few weeks, there have been several reports of people who have received one dose of a vaccine unable to get a second dose.

Watch | India to Ignore UK Efficacy Data on 1-Dose Covishield for B.1.617.2, Stick to 12-16 Week Gap

Another assertion made by these same sources gives cause to doubt the wisdom behind the proposed plan. They said that the AstraZeneca vaccine candidate “started out as a single dose option before effectiveness studies recommended two shots”. However, these sources added that there is a view that a “single shot is enough protection from the virus”.

“Vaccines like Johnson & Johnson and Sputnik Light, which are based on a similar principle as AstraZeneca, are single dose, sources point out, so Covishield should work as one too,” the NDTV report says.

However, the scientific foundations of these assumptions is not known. A recent study by Public Health England (PHE) on the B.1.617.2 variant of the novel coronavirus, first identified in India, found that only a double dose of Covishield could provide strong protection against COVID-19. The study said:

“Two doses of the AstraZeneca vaccine were 60% effective against symptomatic disease from the B.1.617.2 variant compared to 66% effectiveness against the B.1.1.7 variant [first identified in the UK]… Both vaccines [AstraZeneca and Pfizer] were 33% effective against symptomatic disease from B.1.617.2, 3 weeks after the first dose compared to around 50% effectiveness against the B.1.1.7 variant.”

In light of this study, experts had raised concerns about the government’s decision to expand the gap between two Covishield doses to 16 weeks, saying it might not help in reducing symptomatic infections. If the Centre decides to adopt a single dose regimen, it is likely that these concerns will be further heightened.

However, Narendra Kumar Arora, chairperson of one of India’s COVID-19 working groups, recently told Karan Thapar in an interview to The Wire that the Centre will ignore the results of the UK study, highlight issues such as small sample size and the uncertainty band surround the 33% efficacy estimate.

India has so far administered just over 21 crore vaccine doses, of which 88.94% are Covishield. While Bharat Biotech’s Covaxin represents a majority of the remaining doses, a small fraction of Russian made Sputnik V has also been administered.

As of Monday morning, the country had recorded over 2.80 crore confirmed cases of COVID-19 and has reported 3.29 lakh deaths.

How the Delhi High Court Dismissed Concerns Over the Central Vista Project

The high court, without citing any evidence, held that ‘public is vitally interested in this project’.

New Delhi: On Monday, the bench of Delhi high court Chief Justice, D.N.Patel and Justice Jyoti Singh dismissed the public interest litigation petition, filed by well-known translator and interpreter Anya Malhotra and historian and documentary filmmaker Sohail Hashmi, seeking a halt to the Central Vista Avenue Redevelopment Project in the capital, which allegedly poses a serious health hazard to its workers and Delhi’s citizens in view of the current pandemic.

What is likely to surprise most observers is not the dismissal itself, but the manner the bench chose to dismiss it.

In their submissions during the hearing of the plea to halt the Central Vista Avenue Redevelopment Project before the Delhi high court, even the Central government and the Respondent No.4, the Shapoorji Pallonji Group which had secured the project contract, did not make any claim that the public is vitally interested in the continuation of the project, let alone back it up with evidence.

Obviously, a claim of this nature is difficult to prove in a court of law, as it has to be backed up with instances of sections of the public demanding the initiation and completion of the project, either in the media or in the public fora. With no instance of open public support for the project’s initiation or continuance, the respondents wisely refrained from making such a claim in their oral or written submissions before the court.

On the contrary, as there are several instances of stakeholders and members of the public expressing serious concerns over the project and its continuance in the public domain, it was expected that the respondents would seek to allay the concerns of the petitioners.

In other words, the high court might have been satisfied why the project is important and cannot be interfered with at this stage, because it felt that – even if it did so on erroneous grounds – its timely completion is of the essence.

Also read: ‘If People Can’t Breathe, What Will They Do With a New Parliament?’

But that doesn’t explain whether the public is equally interested in the project, unless the high court makes a clear distinction between its “inference” of “public being interested” and the actual public interest in the timely completion of the project, despite its concerns over public health. The high court, instead of making such a distinction, has chosen to mask its inference of the “public being vitally interested” in the project as its finding, in order to dismiss the petition.

Since the workers are staying on-site, there is no question of issuing directions to suspend the work of the Central Vista Avenue Redevelopment Project, the bench has held. Construction activity is not prohibited under paragraph-8 of the order of the DDMA dated April 19, 2021 issued under section 22 of the Disaster Management Act, 2005, where workers are residing on-site, contrary to the stand of the petitioners, the bench has added.

“Several facilities have been provided by the company to workers/labourers working onsite, such as residence/accommodation, medical facilities, covid-19 care centres, etc. Respondent 4 has ensured that Covid-19 protocols and Covid-19 appropriate behaviour like social/physical distancing, thermal screening, masking, sanitization etc. are scrupulously adhered to and implemented at the project site,” the bench has held, clearly ruling out the risks involved in considering construction activity as essential during the second wave of the pandemic.

Petitioners have not been able to substantiate the allegations made in the writ petition and/or the alleged breach or violation of the DDMA orders, the bench has held. This clearly ignores the petitioners’ explanation why they could not do so, citing the restrictions imposed following the surge in cases. That is why the bench was expected to stay construction pending an impartial enquiry to facilitate the finding of facts to address the petitioners’ concerns, rather than uncritically accept the respondents’ claims regarding health and safety at the project site.

On the contrary, the bench found that the challenge to the on-going construction activity with regard to one particular project, is a pointer to the ill-intent and lack of bonafides of the petitioners in filing the present petition (emphasis by the court).

Again, the high court has completely ignored the contention of the petitioners in this regard. They asked the court to separately take up other construction projects currently going on in the capital, and seek accountability, as the petitioners are unable to collect facts of such projects on their own. They chose the Central Vista Project because partial information about it is available in the public domain, triggering concerns. It does not mean that they are not concerned about the consequences of continuing other similar projects during the pandemic.

Watch: Nero’s Pride: Not Even a Pandemic Can Stop the Central Vista Project

“The project is a vital public project. It is obvious that petitioners have selectively chosen only one project which of national importance at a vital place where Republic Day celebrations are held in Delhi, and which is to be completed within a time bound schedule, that is, on or before November 2021,” the bench has observed. It is clear that for the bench, meeting the deadlines of what is considered as vital public project are of more significance than protecting the citizens’ right to life and liberty, which subsumes the right to health, and to avoid superspreader events during a pandemic.

“The whole Central Vista Project is an essential project of national importance, where the sovereign functions of Parliament are also to be conducted. Public is vitally interested in this project. Construction activity of this project cannot be stopped especially when the conditions imposed by the order of the DDMA dated 19th April 2021 as mentioned in paragraph 8 thereof are not flouted or violated,” the bench observed. It is unfortunate that on the question whether the conditions imposed by the order of the DDMA are flouted or violated, the high court has simply accepted the claims of the respondents, without corroborating them through independent reviews.

“We are of the view that this is a motivated petition preferred by the petitioners and not a genuine public interest litigation. The petition is dismissed with costs of Rs.1 lakh to be deposited by the petitioners with the Delhi State Legal Services Authority within four weeks from today. The amount shall be utilised for the programme, Access to Justice,” the bench has concluded.

Ironically, while shooting the messengers, the bench has not bothered to even hint their probable motives. The bench’s silence on the Supreme Court’s suggestion to advance the hearing of the case from May 17 to an earlier date in view of the petitioners’ concerns and its failure to accept it makes one wonder whether the bench’s attribution of motives to the petitioners is disproportionate.

UN Experts Ask India for Clarifications on Human Rights Violations Against 3 Kashmiri Men

The independent experts say they are concerned about “allegations of arbitrary detention, extrajudicial killing, enforced disappearance and torture and ill-treatment committed against” related to Waheed Para, Irfan Ahmad Dar and Naseer Ahmad Wani.

New Delhi: Raising concerns about violations of international treaty obligations, independent United Nations human rights experts have asked the Indian government to provide details about the continuing detention of a politician, the alleged custodial killing of a shopkeeper and the two-year-old disappearance of a teenager in Kashmir.

The communication from five experts, dated March 31, was recently publicly uploaded on the website of the Office of the High Commissioner for Human Rights.

“These allegations are part of what appears to be an ongoing pattern of serious violations of human rights by police, army, security agencies and the judiciary in the Jammu and Kashmir region, warrants in our view the most serious attention on the part of the highest authorities,” said the letter to the Indian government.

It was undersigned by special rapporteur on torture and other cruel, inhuman or degrading treatment or punishment Nils Melzer, vice-chair of the Working Group on Arbitrary Detention (UNWGAD) Elina Steinerte, chair-rapporteur of the Working Group on Enforced or Involuntary Disappearances Tae-Ung Baik, special rapporteur on extrajudicial, summary or arbitrary executions Agnes Callamard, and special rapporteur on the promotion and protection of human rights and fundamental freedoms while countering terrorism Fionnuala Ní Aoláin.

The UN experts, who received their mandate from UN Human Rights Council, said they had received information related to “allegations of arbitrary detention, extrajudicial killing, enforced disappearance and torture and ill-treatment committed against” related to Waheed Para, Irfan Ahmad Dar and Naseer Ahmad Wani.

According to the information received by the UN experts, Para, the People’s Democratic Party youth wing president, was arrested on November 25, 2020, three days after he filed his nomination to run for district development council elections.

Also read: Explained: The Controversy Around PDP Youth Leader Waheed Para’s Detention

Para also had participated in a closed virtual meeting with “current and future members of the UN Security Council” in July 2020, where he had raised concerns about the Indian government’s actions in Jammu and Kashmir, treatment of minorities and border tensions with China.

Following that meeting, Para allegedly received threats from officials of the National Investigation Agency (NIA) that if he didn’t stop speaking against the Indian government, action would be taken against him.

In the allegations made public regarding Para’s case, the UN experts noted that there were complaints that the PDP leader was kept “in a dark underground cell at subzero temperature, was deprived of sleep, kicked, slapped, beaten with rods, stripped naked and hung upside down”. All this has apparently been recorded, and Para was examined multiple types by a government doctor and psychiatrist.

Para, a former journalist, got bail from an NIA court in January this year. But within a few hours of his release, Para was arrested by Counter-Intelligence in Kashmir (CIK) under a different charge related to providing financial support to terrorist groups. He remains in custody.

“Our concern in the case of Mr Waheed Para is heightened by the fact that his arrest and detention appear to be linked to his interaction with UN Security Council members, which would amount to acts of reprisals for such cooperation,” said the UN experts.

Last September, members of the northern Kashmir by Jammu and Kashmir Police Special Operations Group (SOG) raided the house of a 23-year-old shopkeeper, Irfan Ahmad Dar, in Sopore and detained him. The next day, his family learned that Dar had died.

The police claimed that he died while trying to escape from custody. Dar’s family contested that he died in police custody. The family also filed a petition in the high court seeking a copy of the magisterial inquiry report and FIR into the alleged custodial death.

Also read: J&K: Killing of 2 Young Men by Unknown Gunmen Stuns Anantnag Village

Two years ago, 19-year-old Naseer Ahmad Wani’s house was raided by a team of 44 Rashtriya Rifles (44 RR). The complaint was that Wani’s phone was allegedly being used by militant organisations.

He was beaten and taken to the police station. Since then, has family has had no news of him. The army told his family that Dar had been released, but he never returned home.

Among the eight points on which India’s clarifications were sought, the UN experts sought urgent information “on the fate and current whereabouts of Mr Naseer Ahmad Wani”.

They also asked for details of investigations into allegations made about the treatment of the three Kashmiri men. “If no investigation has been initiated, please explain why and how this is compatible with the international human rights obligations of India,” the letter said.

The UN experts also asked for information on the factual basis “justifying the recourse to terrorism related charges levied against Mr Waheed Para, and how this is compatible with the obligation to pursue counter-terrorism obligations consistent with international law as set out inter alia the United Nations Security Resolution 1373”.

They asked for clarification on whether the move was compatible with the “reasonable understanding of the definition of terrorism in international law norms including the United Nations Security Council Resolution 1566 (2004) and the model definition of terrorism provided by the mandate of the Special Rapporteur for the promotion and protection of human rights and fundamental freedoms while countering terrorism”.

In the letter, the UN experts observed that these allegations are part of an “ongoing pattern of serious violations of human rights by police, army, security agencies and the judiciary in the Jammu and Kashmir region, warrants in our view the most serious attention on the part of the highest authorities”.

The UN experts cautioned that they might publicly express their concerns soon, as the public “should be informed about the implications of these allegations on the exercise and enjoyment of their human rights”.

When a Vaccine Maker Asks for Indemnity, Does the Government Debate Pennies?

Granting indemnity to Pfizer against claims for injury or death would reduce the purchase price of the vaccine for the government since Pfizer would no longer have to take the risk of payment of compensation.

The Indian government and Pfizer have been in discussions about an agreement for importing Pfizer’s COVID-19 vaccine. Unfortunately, a satisfactory conclusion to these discussions does not seem likely any time soon.

Pfizer, as best as we can tell, has taken the position that it will supply vaccines on terms that are similar to agreements it already has with other countries. These terms include an indemnity against any claims for injury or death caused by the vaccine.

Indemnity seems like an onerous and ominous provision – it is not. Indemnity simply means protection from legal liability arising from one’s actions. When you purchase car insurance, for example, you are indemnifying yourself against the losses that might arise from an accident that occurs while you are driving the car.

Pfizer is simply saying this: if there were to be adverse effects for having taken Pfizer’s vaccine, Pfizer will not be liable to pay damages that any court may award.

Why, one may well ask, should we agree to this? If they have made the vaccine, and if they are selling it to us, shouldn’t they be responsible for any adverse effects? Well, as with everything else in life, it comes down to who has greater negotiating power. And the global market for COVID-19 vaccines is very much a seller’s market. There is a global scarcity for these vaccines, and if we choose to be picky about the terms of the contract, Pfizer will simply move on to the next prospective buyer. Of which, remember, there are plenty.

Our recommendation, therefore, would be to treat this just like any other business contract, and secure a supply of these vaccines as quickly as possible. If that means giving in to their request for granting indemnity, so be it.

Pfizer has clearly stated its preference for negotiating with the central government alone. It is unlikely that they will change their stance anytime soon. There is then only one way that vaccine procurement and distribution will work: the Centre procures from Pfizer for an agreed price, and then gives or sells these vaccines to the state governments. Our personal preference would be for the Centre to pay, but that remains an issue separate from our central argument in this article.

Also read: Pfizer Demands Governments Gamble With State Assets To Secure Vaccine Deal

What if Pfizer were to not get indemnity from the Centre, and it still wishes to sell to the Indian government? Although we do not think this to be likely, for reasons explained above, here is what might happen next. Pfizer will either buy product liability insurance against claims in India and overseas or it will self-insure.

An insurance company with experience of insuring against product liability claims, especially in the pharmaceuticals sector, is best placed to handle such risks. The insurance company could easily add this to its existing basket of insured risks and the cost of such insurance should not be a significant addition to the cost of the vaccine. If such an insurance product is either unavailable or if the premium turns out to be too high, Pfizer could simply self-insure. This would mean setting apart a sum of money to pay out as compensation.

A healthcare worker administers the Covishield vaccine to a woman in Bikaner. Photo: PTI

In either case, these costs of taking on the risk will have to be added to the negotiated price for vaccines. Creating a whole new financial (and if done in-house, organizational) structure to deal with this issue of handling claims and compensation is a disincentive for Pfizer to sell vaccines in India.

This is not a problem for Pfizer. Many other countries are willing to buy these vaccines without imposing indemnity clauses. It is, however, a problem for India, since it leaves us with one less major supplier for vaccines – a position we can obviously ill-afford right now.

On the other hand, if the Centre grants an indemnity to Pfizer against claims for injury or death caused by the vaccine, then the purchase price of the vaccine would be lower for the Indian government. Pfizer no longer has to take the risk of payment of compensation for injury or death caused by the vaccine, and this will be reflected in the price.

One of the most important functions of a contract is risk allocation. How much risk should the seller assume, and should the seller, therefore, get a higher price? Or should the buyer assume the risk, and therefore get a lower price?

In this case, Pfizer believes that compensation for injury or death caused by the vaccines is a risk that is best handled by the Indian government rather than itself or an insurance company. And in this seller’s market, we have no choice but to go along.

If the government grants an indemnity to Pfizer, it would still be able to assess the risk of any injury or death when the vaccines are tested at CDL, a government laboratory based in Kasauli. If the vaccines meet the standards that the Indian government sets, they should be safe and efficacious to use and the risk of causing injury or death should be low. It would be easy to argue that even if there were compensation claims, the Indian legal system is capable of dealing with them effectively. We know this from the limited number of successful medical negligence and product liability claims in India.

Also read: India and Pfizer at Impasse Over COVID Vaccine Indemnity Demand

The data on clinical trial compensation payments doesn’t give potential victims any hope either. Even if there is injury (or worse), it is unlikely that any significant compensation will ever have to be paid out. As a benchmark, the US has a compensation fund created by a “cess” which ranges from $0.75 to $4.50 on each vaccine dose which may cost anything from $12 – $220 per dose. An indemnity by the Indian government would therefore not cost much and could well get India the vaccines that it desperately needs.

Let us be very clear: we are firmly against a scenario in which the government imports the vaccines and then applies the 50-25-25 formula for allocation to the central government quota, states and multiple private entities. This seems like a complex arrangement for the small quantities that are to be imported in 2021.

But that being said, what if the government were to “help” private entities purchase these vaccines from Pfizer? The Indian government could purchase these vaccines from Pfizer after granting them indemnity, and sell them on to these private entities. These entities could in turn be required to undertake all liability for injury or death caused by the vaccine.

It is important to note that none of what we are suggesting takes away the right of any person injured or killed by the vaccine to be compensated. In the first scenario, the Indian government will pay up and in the second, the private entities who purchase the vaccine from the government will do so. The liability to compensate does not diminish and no one gets immunity from liability in either scenario.

A phial of the Pfizer/BioNTech COVID-19 vaccine concentrate is diluted with 1.8ml sodium chloride ready for use at Guy’s Hospital. Photo: Victoria Jones/Pool via Reuters

A criticism of our suggestion could be that the government is discriminating between domestic and foreign vaccine manufacturers. Our response is that the government is already paying different prices to domestic vaccine manufacturers. This would suggest that the government is willing to negotiate independently with each manufacturer.

We would support a significant reduction in the price that the Centre is paying for the vaccines if the domestic manufacturers would like to be indemnified. We believe that the domestic vaccine manufacturers would rather not reduce prices since the risk of paying any compensation is low given how the Indian legal system works.

The central issue here is a simple one: who pays for injury or death caused by the vaccine? Who buys insurance for Indians getting the vaccine? It boils down, ultimately, to risk allocation, and therefore price.

Also read: A Brief History of Pharmaceutical Profiteering

Will the Indian government walk away because it won’t pay a “market price” for the vaccines? Will it use national honour and national pride as excuses for being unable to negotiate a commercial deal? We certainly hope not.

“Hope” is the thing with feathers –
That perches in the soul –
And sings the tune without the words –
And never stops – at all –

And sweetest – in the Gale – is heard –
And sore must be the storm –
That could abash the little Bird
That kept so many warm

–  Emily Dickinson

Murali Neelakantan is the founder and principal lawyer at amicus. Ashish Kulkarni is an assistant professor at the Gokhale Institute of Politics and Economics, Pune. He blogs at econforeverybody.com.

My Experience of COVID-19, or Personal History as Data for the Sociologist

A glimpse into the COVID-19 ward which I inhabited with nine other women patients.

We are often afraid to tell our own life histories, though Cultural Studies commit us to collect the biographies of others, in order to tell a story, glean sociological facts, and produce with the aim of generalising data. How may we presume that other people’s lives are less sacred than our own? Feminism made it increasingly apparent that the personal was political, and those who tried to camouflage it by speaking of value neutrality had already climbed the precarious ladder to salaried jobs and professional mobility in the profession.

The bare-faced act of feminism to expose oneself to the general public was methodologically presented as the reason why genealogies could have women’s names in them, instead of presenting only the names of men. Patrilineality was by itself, a cultural trope, where women were ordinarily subsumed, socialised – made to matter if they conformed, and excluded if they did not. In a way, the narratives of women when documented, produced realities which were substantially different than the bureaucratic record.

The strangeness of the contemporary, the scope of survival strategies, the honour of everyday work responsibilities, and the tenderness and care that strangers provide is immensely potent. In the following account, I provide a glimpse into the COVID-19 ward which I inhabited with nine other women patients. When I was discharged on May 8, 2021, I had spent 12 days in a women’s ward for COVID-19 patients.

It all began with a low fever and a headache, and a terror that after 1.5 years of social distancing, attempts to keep the house clean, using a lot of soap to wash my hands every few hours and gargling with hot water, the virus had caught my youngest daughter and myself. Afraid to inform anyone, we lay in bed, hoping it would go away. After ten days, a friend phoned asking us where we were, as she had not met us for a while. As soon as she heard that we were ill, she got an oxygen measurement instrument, and left it with us.

On the third day of measuring my pulse and O2 levels, my daughter found the level of blood oxygen had dropped to 75. So she phoned her two older sisters, who then attempted to find me a hospital bed, as the doctor friend we had called the previous day had said I would die if I didn’t go to hospital. His remonstration that we had not informed anyone, or got a COVID-19 check, fell on deaf ears. The newspapers had been full of weeping relatives who could not find their kin in mortuaries, or had left them at hospital for treatment and then lost them forever. COVID-19 tests were also about queues and being told to return home, even if they had been booked to be administered.

Also read: Ebola, COVID-19 and the Moral Injury of Dignity

By great fortune, a private company agent came with the kit, and both my daughter and I were definitively COVID-19 positive. I was too ill to notice what was happening, as suddenly there was coming and going in the house, young people, friends of my daughter were there, friends of friends, all doubly masked, making phone calls. An oxygen cylinder appeared, but it seemed to be empty, so it was returned, and small aerosol-like containers were purchased.

“Please don’t send me to hospital, I will never see you again, I won’t know how to contact you,” I pleaded. The young people in the house, some of whom had had COVID-19 previously and were banking on the immunity that follows for a few months, were urgently making phone calls all the while, maybe trying to purchase more oxygen aerosols. My eldest daughter, who was living in another city with her family, lockdown having enforced them into a relatively pleasant stay for a year and a half, managed to find a hospital bed for me. It was a window to survival which few people had in those days. She used Twitter and Facebook, and innumerable phone calls, and someone sent an SMS saying, “There is a bed in Jamia Hamdard.” So at 7 pm, my youngest daughter, who lives in the Jawaharlal Nehru University campus, called the JNU ambulance which appeared at the door.

We reached the hospital very soon, given that there was little traffic. At the gate, we were told where to go, and the doctor we should meet. We walked to the entrance. A young doctor was waiting for us, who said with some alarm, “You should not have walked, you should have taken a wheelchair.” My daughter, who was also COVID-19 positive, quickly relinquished me to his care, and called a taxi to return home, where she self isolated for the 12 days I was away. Friends sent her food, and while she did not have severe COVID-19, the fatigue was immense.

The doctor who had greeted me had a ward boy bring a wheelchair and the bag with fresh clothes which my daughter had packed for me. I went into the ward, which was packed, all the beds taken. I didn’t have any feelings, I merely thought, “Here is a bed, now I can sleep.” I did have my cell phone, and called after an hour to see if my daughter had reached home safely. Thankfully, she had.

We were woken up every hour to have some test taken, and all of us submitted to this because we realised that when one is at death’s door, one really has no will. We were in a collective state of lassitude, none of us made eye contact, we lay there, in some physical pain, the magnitude of which depended on the severity of it. There were two 70-year-old women who wept with the agony they were feeling, which caused the rest of us some inconvenience, for as soon as we dropped off to sleep there was a heart-rending cry from one lady or another.

Dying in the loo was the greatest fear most of us had. There were attendants who would accompany us if we were willing to use the wheelchair, but most of us preferred to walk down to the toilets alone, though the nurses regularly shouted at us for doing so, saying we could have an accident if we were not accompanied. The first few days I got lost returning, there were only four rooms to pass, but I would keep walking and then have to ask my way. I had no sense of recognition spatially, but as I said, it was a short walk, and there were medical staff visible everywhere.

What was interesting was that over those eight days, several patients did recover, their blood oxygen reached 98, and they were sent home. We had not made eye contact, exchanged a word or tried to introduce ourselves. The ward boys were at attention, sympathetic to our terrible condition. We lay as if dead for a week, but it was their courtesy which was enormous. At night, it was a different story, as we would be woken up at all hours to have our temperature taken, a needle inserted into a vein or a lung scan. Anyone could die any time, so the medical machinery just went on functioning as if there was no tomorrow. Neither did we bother with courtesies, nor did the technical staff who had to drag huge X-ray machines or take blood samples. There was no morning and no night, time was an abstraction; the bright lights of the COVID-19 ward were on all the time.

Watch: Rural India Is in Deep Distress, Unemployment Is Rising and Incomes Wiped Out

At the end of eight days, the world looked a little approachable, as the fever had abated and so had the headaches. I noticed for instance that we were on the ground floor, and that when the green shade over the window was lifted, one could actually see cars and people. I started to listen to the phone calls that patients received, and learned about their lives and their difficulties. They, like people at railways stations and in long distance buses, had no problem discussing the most complex domestic issues. I made no phone calls, except a few to say I was alive, and getting better.

I also started reacting very abusively if people put on their loudspeakers after 7 pm. Till 7 pm, I had no problem with listening to the litany of messages about what was cooked for lunch, whose property was at risk, and what expat children said to old parents, who had been suddenly been left marooned. These overheard narratives were immensely interesting, and as they did not mind being overheard, from day 8, I started interacting with fellow patients, and got to know them a little better. Post 7 pm, I would get abrasive if they played religious music or talked to relatives. No one seemed to have brought their ear phones with them, so this explosive enquiry, “Who has their loud speaker on”, would be met by total silence. Then I would get up from my bed, and accost the person, and say, “It’s not your home, it’s a hospital ward, a public place.”

Sometimes, having got to know their names, I would start shouting, saying, “It’s night, and you have your phone loud speaker on” and the accused person would say, “It’s not me” in a weak voice. It was as if my hearing was more sharp during the night, and any noise could make my head spin.

By the 10th day, only three of us were left. The new entrant talked a lot, and ordered much tea with sugar from the canteen, but then she got sent off to ICU, and the ventilator.

The doctors and nurses were marvellously kind, and stopped to speak to each of us. It was the everydayness of their concern that showed me what warriors they were. The whole nation was in their debt. They came regularly, and they tried to communicate to us how important it was to lie on one’s belly, as that was as good as the ventilator. I tried to do it as often as I could, the belly had to be empty, so it was possible between 11 am and 1 pm, and 5 pm and 7 pm, as the rest of the time one would have eaten a meal or had water, tea or soup. The kitchen was excellent, they fed us well, as nutrition was a central part of the rehabilitation process. Two cats dropped by every day at lunch time, and would examine me from a distance, as if they were reincarnated hospital consultants. No one chased them away, they seemed to belong, without infringing on us. The sheets were changed every morning at 5 am and for the first week we stood precariously, hoping not to fall and die.

The cleaning staff came through the day, mopping the floors and keeping the toilets clean. Their work is so difficult, and yet they manage to communicate a certain valour. Sometimes one wondered why the men’s loo was next to the women’s ward, and the women’s loo was next to the men’s ward. Just a change of the name plate would have made life so much easier. As most patients were in the state where reading boards given the fever was difficult for them, they would take the lassitude of their condition to use the loo nearest to them. As near death, all is obtuse (all are Brothers and Sisters), no one complained as long as propriety was maintained, as the long sojourn in the COVID-19 ward was like being in the Jammu Tawi to Kerala, which takes five days, with unisex loos.

We had no idea when we could go home, and my anxiety about my blood oxygen not going up was finally solved when it reached 93 for three days running. The nurses said, “You will do better at home, ma’am, with the food that you are used to eating. And of course, you will have to stay in bed for another two weeks, even if you think you have been discharged.”

My middle daughter had come to Delhi the day after I had been admitted to hospital. Friends loaned her an empty flat, and she commuted to the hospital to liaison with the doctors regarding my treatment, and to ferry messages to the anxious family who had no news of me. She could not go home to JNU as my youngest daughter had COVID-19, and had arrived basically to make sure that I got clean clothes and fruit. She lived in the flat near the hospital, and the kindness of friends helped her to get through two weeks of solitude, as she could not meet anyone. COVID-19 rules of social distance made it very necessary that since she visited the hospital once a week, she did not come in contact with the family who had kindly offered her the use of a safe house.

When she came to collect me from the hospital on the 13th day, she seemed a little like a Martian, double masked with a glass visor. I was afraid to make eye contact, as I knew my days of isolation had somehow robbed me of speech, but she was completely at ease, saying, “Hi Mama!” and escorting me to the taxi downstairs. The ward boy, who had pushed my wheelchair to the ground floor, said, “Yes, it’s our job, but we find it interesting, I cannot tell you how much we learn about others, and the knowledge they have. We don’t look at the risks, it’s about learning about humans.”

Since my older daughter has two little girls of her own, she was not able to come to Delhi, and my youngest was in home isolation with COVID-19, the trio would have long conversations from their different residences, and take all decisions together. This close digital interaction was crucial for the mutual survival of the members of the family, who from one day to the next, as they did not know the survival chances of their mother, for the first eight days.

I remember the kindness of the medicos and the nurses, all of whom were about 25 years old. The senior doctors appeared only once a day, at 11 am, to look at the charts and to advise patients. For the rest of the time, we were completely in the care of the interns, each one so kind and alert. I felt as if the country was being run by young people, and that their love and patriotism was a talisman for the years to come. I was one of the lucky ones who survived. There was an old woman of 84, who had COVID-19, and who wept a lot. Of her they would say, right through the day and night, “Keep calm, mother. The less you speak, the less you exert, the easier it will be for your lungs.” To one another, they would say, “She has very little life in her (Bahut thodi jaan bachi hai)” and there would be patent anxiety about her chances of survival. They really wanted to heal her, and send her back to her family.

As patients, we felt traumatised by her suffering and her fear of death. We felt that her panic, screams and cries mitigated our own chance of survival, as we would be woken up from our endless slumber, day and night, by her constant speech. When she was sent up to the ICU after five days, we felt relief, and really thought that the silence that was given back to us was a huge gift to our own recovery. When I was allowed to return home, I knew that being in a public ward was as comfortable as travelling sleeper class or in local buses. I am just grateful that I had the opportunity to be with women who understood our common human drive to stay alive, and the gratitude I felt to my daughters who had made such an effort to get me on the side of the living.

Susan Visvanathan is a professor at the Centre for the Study of Social Systems, School of Social Sciences, JNU.

Tarun Tejpal and Curious Case of the Coerced Confession

The judge disregards his emailed apology – in which he admits to a sexual encounter with the complainant – on dubious grounds, even though this admission is certainly at odds with his defence, accepted by the judge, that what occurred was merely “drunken banter”.

This is the first part of an ongoing series which examines the Tejpal judgment from an evidence law perspective. Part 2 can be found here.

In the year 2013, a young journalist working at Tehelka accused Tarun Tejpal, the owner and editor-in-chief of the magazine, of sexually assaulting her on two occasions, on November 7 and 8, 2013, in the lift of a hotel in Goa. On November 18, 2013, she filed a complaint with Shoma Chaudhury, the magazine’s managing editor, asking that a sexual harassment cell be constituted to conduct an inquiry. Based on media reports, the Goa police took suo motu cognizance of the matter and initiated criminal proceedings.

Since Tejpal had apologised, I had assumed that he had confessed to the crimes he was charged with, and a conviction seemed imminent. Contrary to expectation, after over 7 years, the trial in this sensational case has culminated in Tejpal being acquitted of offences under Sections 376 [rape], 354 [assault or criminal force to woman with intent to outrage her modesty], 354A [sexual harassment], 354B [assault or use of criminal force to woman with intent to disrobe], 341 and 342 [wrongful confinement] of the Indian Penal Code.

The judgment itself is tedious to read, having no coherent structure, issue-wise discussion or even headings. The findings are meandering, repetitive and freely bleed into each other from the wounds they inflict on rape jurisprudence. Hercules himself may have preferred to tackle the polycephalous Hydra than this 527 page behemoth. Having accomplished this feat, I will refrain from commenting on the correctness of the acquittal itself, since it requires appreciation of evidence that I do not have access to. Instead, this is an attempt at unravelling whether Tejpal’s so-called confession was just a red herring or had any evidentiary weight under law.

Tejpal’s emails

The term “confession” is not defined in the Indian Evidence Act. In layman’s terms, a confession is an admission of guilt or of the substantial facts that constitute the offence. On November 19, 2013,  the day after the young woman’s complaint, certain e-mails were sent by Tejpal – one an unconditional ‘formal apology’, which was also circulated within the organisation, and the other a ‘personal apology’, sent to the woman alone. It was the prosecution’s case that these e-mails were tantamount to a “confession”.

The complainant was dissatisfied with the apologies since, according to her, they attempted to portray her sexual molestation as a consensual sexual liaison. Neither the complaint nor the apologies are reproduced in full in the judgment. The judge, who had the benefit of the entire correspondence, finds that “there is absolutely no admission or confession of any incriminating fact even remotely suggesting sexual assault” [Para 190]. On the basis of excerpts available online, which give a reasonably good notion of what was said, I find that there is no unequivocal acknowledgement of guilt. As such, Tejpal is entitled to the benefit of doubt and I would tend to agree that the apologies do not a confession make.

That does not, however, put a quietus to the matter. Admissions (as defined under Section 17), though they may fall short of a confession, are both relevant and admissible under the Evidence Act.

In the formal apology, Tejpal has apologised “unconditionally for the shameful lapse of judgement that led me to attempt a sexual liaison with you on two occasions on 7 November and 8 November 2013, despite your clear reluctance that you did not want such attention from me”.

In his personal apology, he claims that the “encounter” took place in a “frivolous, laughing mood” and that he had no idea that the woman employee felt that he “had been even remotely non-consensual” or had “imposed” himself on her. He states that he “read it all wrong” and even offers to apologise to her mother and boyfriend. Shoma Chaudhury, who was a prosecution witness, testified that Tejpal had told her that “he and the prosecutrix had a fleeting consensual encounter” [Para 146].

An admission of sexual encounter, not just banter

There is a tenuous finding that the formal apology was drafted by Shoma Chaudhury and sent out by Neena Tejpal [Tejpal’s sister and COO of Tehelka] and is therefore not incriminating against Tejpal [Para 194]. Admittedly, both the apology e-mails were sent from Tejpal’s e-mail account. There is no indication that they were subsequently retracted. On the contrary, the personal apology and a subsequent e-mail from  Tejpal recusing himself from editorship acknowledge the formal apology. For the purpose of this article, I have therefore assumed that the apologies were sent either by Tejpal himself or with his consent / authorisation.

It is plain as day that these apologies admit to, at the very least, a sexual encounter between Tejpal and the complainant. What acts comprised this encounter and whether it was consensual or not is a matter of evidence. Nevertheless, this admission is certainly at odds with Tejpal’s defence (which has been accepted by the judge) that what occurred was merely “drunken banter” during which the young employee allegedly regaled Tejpal with tales of “sex” and “desire”. The mind boggles to conceive of a situation where such “banter” could be interpreted as consensual or non-consensual.

Juxtapose this with the alacrity with which the conduct of the complainant has been misconstrued as an admission by her that Tejpal had done no wrong.

Since she did not respond to Tejpal’s messages on November 9, 2013 referring to the incident as “drunken banter”, the trial court held that “non denial by the prosecutrix at the first available moment, of the accused’s version gives rise to adverse inference against the prosecutrix” and that she “indirectly admitted the version of the accused by not replying” [Paras 141-143]. Pertinently, the complainant did send a text to Tejpal on November 16, 2013, stating that “It was not once Tarun, it was twice and I asked you to stop repeatedly. I was certainly not drunk and it was not banter. You did the most horrible things.” But the judge did not consider this important since it was not sent right away.

Similarly, the complainant’s reply to the personal apology insisting that she had been sexually molested is found to be wanting since “There is nothing in the response of the prosecutrix to indicate that she has denied flirtatious conversation…” and “the defence of drunken banter has been accepted by the prosecutrix in her e-mail response, wherein she claims the Accused always used to have such conversations with her”. On the other hand, the unconditional formal apology sent by  Tejpal, which did not deny any of the allegations in the prosecutrix’s complaint, is not seen to be an admission since it is “not a reply to any previous e-mail sent to the accused by the prosecutrix”. [Paras 147 & 190-191]

Judge discards apology containing admission of sexual encounter

Having held that Tejpal had made no admission or confession of sexual assault, the judge immediately contradicts herself by arriving at the astonishing conclusion that “…the personal apology was not sent voluntarily by the accused, but … was sent due to the explicit pressure and intimidation by prosecutrix on PW45 to act swiftly and also due to the inducement and promise made by prosecutrix to PW45, which in turn was communicated to the accused, that the matter would be closed at the institutional level, if the accused were to tender an apology” and is therefore struck by Section 24 of the Evidence Act. [Para 202 – PW45 is Shoma Chaudhury].

For the uninitiated, Section 24 reads as follows:

24. Confession caused by inducement, threat or promise, when irrelevant in criminal proceeding – A confession made by an accused person is irrelevant in a criminal proceeding, if the making of the confession appears to the Court to have been caused by any inducement, threat or promise having reference to the charge against the accused person, proceeding from a person in authority and sufficient, in the opinion of the Court, to give the accused person grounds which would appear to him reasonable for supposing that by making it he would gain any advantage or avoid any evil of a temporal nature in reference to the proceedings against him”.

There are three points to note here.

First, for any statement to fall within the bar of Section 24, it must necessarily be a “confession”, i.e. an admission of wrongdoing – which the judge has already said was absent. Needless to say, an apology containing an admission of a sexual encounter, which does not amount to a confession (as discussed above) is certainly relevant, admissible and does not fall foul of Section 24.

Secondly, the inducement / promise is itself doubtful, having reached Tejpal’s ears through Chinese whispers via Shoma Chaudhury [PW 45] and Neena Tejpal [PW 36], perhaps losing all semblance of its original nature in the process. The judgment paraphrases, rather than reproduce verbatim, the relevant correspondence and witness statements of Shoma and Neena on this aspect, muddying the waters further.

It is unclear as to which of the e-mails of the complainant acted as the promise of closing the matter at the institutional level. The reference to “act swiftly” in the finding extracted above, appears to stem from an e-mail dated November 19, 2013, which was sent by her after the apology e-mails had already been sent out [Para 192]. It is nobody’s case that any further apology/ admission was sent thereafter in the terms sought by the complainant so as to be induced thereby.

This only leaves the e-mail dated November 18, 2013 containing the woman employee’s complaint, asking for a sexual harassment inquiry and, “at the very least”, an apology from the accused [Para 36]. It is definitely a stretch to categorise the act of lodging a complaint itself, wherein certain remedies are sought, as an inducement to confess. In fact, the testimonies of Shoma Chaudhury and Neena Tejpal indicate that they were involved with the unconditional formal apology, not the personal one, and acted more out of concern for the reputation of Tehelka than any inducement or promise by the complainant [Paras 200-201].

Thirdly, the law requires the inducement / promise to proceed from “a person in authority”, which has not been examined at all. Ironically, the only issue on which the trial court found in favour of the prosecutrix is that Tejpal was “in a position of trust or authority towards the prosecutrix and was in a position of control and dominance over the prosecutrix” [Para 25]. Further, both Shoma (the managing editor) and Neena (the COO) were superiors of the complainant, and she reported to Shoma. It is therefore painfully obvious that the complainant was not a “person in authority” vis-à-vis any of these persons.

To wrap up, Tarun Tejpal’s Coerced Confession is something of a Schrödinger’s cat, existing paradoxically both as a non-confession, so as to preclude him from incriminating himself, and also as a confession, so as to preclude it from being admissible as evidence.

Bhabna Das is a lawyer practicing in various courts in Delhi with over 10 years work experience, and a qualified Advocate-on-Record in the Supreme Court of India

India’s Large Informal Workforce Must Be Prioritised in Our COVID-19 Vaccine Strategy

Informal workers are less likely to be vaccinated due to multiple barriers in the existing vaccination framework.

The COVID-19 pandemic and consequent lockdowns have had a devastating impact on India’s informal sector, which employs a vast majority of the country’s workforce. Even as India struggles to extend vaccine coverage amid severe shortage and a deadly second wave, it is critical that this process prioritises the millions of informal workers who are at risk of exposure to the virus and also face loss of livelihoods.

While healthcare workers and other frontline workers were inoculated in the initial drives in January and February this year, at present, the eligibility for vaccination is based on age. Given the acute shortage, most states continue to prioritise those above 45 years. Aside from poor planning hampering its production, India’s flawed strategy to inoculate its population is driven by technology. This approach has excluded millions of informal workers from the vaccination drive.  

It is estimated that approximately 70% of the urban workforce is employed informally, including migrant workers. The precarious nature of their work exposes informal workers to unsafe work conditions that increases their risk of exposure to COVID-19. Given the density of and lack of isolation facilities where workers live and work, containing the risk of transmission is a challenge.

Informal workers such as those who work at construction sites or garment factories are known to have other co-morbidities like tuberculosis, which makes them even more susceptible to the virus. If infected, they do not have recourse to paid leave, social protection or health benefits that are available to workers in formal employment. Yet, they continue to work as they cannot afford wage loss nor are they able to work from home. 

Also read: ‘Are You Asking States to Compete for Vaccines?’: SC Raps Centre Over Dual Pricing Policy

The COVID-19 vaccine can provide critical protection and reduce the risk of mortality and is seen as a key antidote out of this crisis and a bulwark against an anticipated third wave. And yet, informal workers are less likely to be vaccinated due to multiple barriers in the existing vaccination framework.

A vaccination centre wears a deserted look due to shortage of vaccines in New Delhi, May 24, 2021. Photo: PTI/Manvender Vashist

Digital divides 

First, the vaccine strategy is heavily dependent on technology and restricted by age. Online registration is mandatory for those in the 18-45 age group. This benefits urban dwellers with resources, but a large proportion of workers lack digital literacy and do not have access to devices or internet.

Moreover, a bulk of the informal workforce are in the 18-45 age group due to the arduous nature of work. Priority by age group and technology driven-vaccination programmes have led to vaccine disparities. In households where no one has received vaccination, it is imperative to vaccinate earning members of the family, regardless of age and access to devices, so they are protected and can continue to work.

Employer responsibility

Second, wherever possible, employers must be roped in to help vaccination reach a larger population of workers. Like several private corporate organisations that have made commitments to vaccinate employees and their families, in some sectors it may be possible to extend vaccination to informal workers through the channel of employment.

The build up to a vaccination drive should focus on strong public health messaging. Photo: PTI

For example, in the construction sector or in large manufacturing clusters and garment factories, employers can play an active role in facilitating this process. Similarly, in cities like Mumbai, where the municipal corporation is planning to conduct vaccination drives in residential areas, those employed as domestic workers, drivers, gardeners and security guards must also be able to avail the same. The threat of contracting the virus is higher for those whose place of work is others’ homes.   

In March, the Confederation of Real Estate Developers Associations of India (CREDAI) announced on Twitter that the incoming president of the body had committed to vaccinate 2.5 crore construction workers free of cost. While there have been no updates thereafter, industrial hubs or worksites seem to be optimal venues for vaccination drives. It may be worthwhile to use CREDAI’s network or even explore the possibility of the Building and Other Construction Workers’ (BOCW) Welfare Board organising vaccination for workers. However, the cost of procuring and administering vaccines or any related expenditure should be borne by the employer or the authority facilitating the same and not transferred to the worker.

It may not be viable for smaller employers who do not have enough capital or are struggling to recover from last year’s production losses to support such initiatives. In several other types of informal work – self-employed; domestic workers who work under multiple employers; those who are part of larger supply chains without clear employer-employee relationships — routing vaccination through employers might not be possible.

Decentralised and free walk-in facilities that are located either in informal settlements or near clusters of small units can benefit workers. These centres must also operate at hours that are most conducive to workers so that they do not lose productive work time.

Effective messaging 

Third, the build up to a vaccination drive should focus on strong public health messaging. Since many workers do not have access to news media or social media, it is necessary to explore other modes of communication to bust myths around vaccination. This is important to make sure the process of consent is not compromised.

Also read: The Least the Centre Can Do for People Now Is Provide Free COVID Vaccines

There is vaccine hesitancy as it is associated with possible side effects. The need for rest after vaccination also implies wage loss. Employers and contractors are hesitant to encourage vaccination since it may disrupt production cycles. There is also a fear of being held accountable in case of any mishaps.

Clearly communicating the benefits and necessity of the vaccine as well as assuaging employee concerns regarding loss of pay may help garner support. Vaccination is a right and a necessity, needed to protect lives and livelihoods.  

 Inclusive vaccination

Fourth, owing to the high cost of vaccine acquisition and delivery, state governments are beginning to restrict vaccination by domicile status. For instance, the Uttar Pradesh government recently declared that first preference will be given to locals. This is ironic considering that UP sends out more migrants than it receives. 

Migrants, who have arrived from Surat in Gujarat, walk to board buses to reach their native places, in Prayagraj. Photo: PTI

A large section of migrants belong to disadvantaged caste groups that already experience poorer health outcomes. Exclusion from the vaccination programme can push them into a deeper health crisis. The experience of 2020’s nationwide lockdown tells us that migrant workers are often the last to receive any form of relief, ration or cash transfers. The same must not be repeated in the case of vaccines. Migrants must be able to take the doses irrespective of their location.

Informal workers are already struggling to cope in an altered labour market with fewer opportunities and reduced wages. Hence, vaccinating informal workers must be considered a priority not merely because they build and sustain our cities, but also because it is the only way to reduce vaccine disparities. As noted by ‘Women in Informal Employment: Globalizing and Organizing’ (WEIGO) access to vaccines is inseparable from economic justice and “critical to ‘soften the blow’ of a triple health-economic-care crisis.” 

Divya Ravindranath is a researcher at the Indian Institute for Human Settlements. Vikas Kumar is a labour policy analyst at Aajeevika Bureau.

The authors would like to thank Mahesh Gajera of Aajeevika Bureau for his inputs.