The government’s focus on covid-19 and routine immunisation programmes was palpable as finance minister Nirmala Sitharaman allocated gave a massive ₹35,000 crores exclusively for the vaccines to bring an end to the pandemic, and more for routine vaccination programmes, infrastructure to develop vaccines, among others in the Union Budget.

What were the announcements?

The ₹35,000-crore for covid-19 vaccine procurement was the headline number as far as immunisation went. The spend is marked in finance ministry’s budget as a transfer to states to support covid-19 vaccinations.

Also Read | How India can fight vaccine hesitancy

Significantly, this amount was over and above the ₹6,273 crore of net spend the government estimates to make in 2021-22 under National Rural Health Mission (NRHM), which includes routine immunisation programmes, according to Budget documents.

Other low-key but significant announcements for vaccine and disease research was setting up of One Health, a regional research platform with World Health Organization’s South East Asian Regional Office, nine bio-safety level III (BSL-3) laboratories, and four regional National Institutes for Virology (NIV) in line with the NIV at Pune.

BSL 3 laboratories are labs with the second highest level of biocontainment facilities in a four-tier system, and typically deal with microbes that can cause serious or potentially lethal disease through inhalation.

What are the implications?

The government had procured the first lot of 11 million doses of Serum Institute of India’s Covishield vaccine for ₹200 per dose, excluding taxes, and another 5.5 million doses of Bharat Biotech International Ltd’s Covaxin, with a 70% of it at ₹295 per dose.

While prices of vaccines will differ, the allocation of ₹35,000 crore could procure roughly 150 crore doses of covid-19 vaccines, which can be given to 75 crore people. This is enough to cover more than half of India’s 1.3 billion population.

The estimates are based on the assumption that prices will be an average of Covishield’s price, which is around ₹220 per dose, inclusive of taxes, and the entire cost will be borne by the Centre, as done for healthcare and frontline workers. Generally, logistics and cold-chain cost are accounted for in the cost of the vaccines, according to an industry executive.

However, it is widely expected, including by SII chief executive officer Adar Poonawalla, that price per dose of the vaccine will fall as other vaccines like Russia’s Sputnik V and Zydus Cadila’s ZyCoV-D are available. Sputnik V is expected to be priced at less than $10 (around ₹730) per dose in non-Russian markets, including India, according to its co-developer Russian Direct Investment Fund, while Zydus Cadila has not given details on its pricing.

Setting up of the regional research platform ‘One Health’, BSL-3 laboratories and NIVs is also significant because it would give an impetus to research in vaccines and for diseases.

“It’s encouraging to note the creation of 9 Bio Safety Lab-III (BSL-3) in this Budget, that will boost research & scientific discoveries,” Bharat Biotech joint managing director Suchitra Ella said. “The allocation to vaccines signals a shift to preventive health care, a validation of the fact that vaccines are the most cost-effective health care interventions.”

What is the context?

India is in the process of inoculating 3 crore healthcare and other frontline workers, with the cost being borne entirely by the Centre. After that, the government will start vaccinating another 27 crore people, which comprise of all those over 50 years of age as well as those below 50 who have severe co-morbidities. The intention to vaccinate these groups is to protect these high-risk groups first so that normalcy might resume, which will give a fillip to the economy.

By allocating a sum as large as ₹35,000 crore for just covid-19 vaccinations, the government can potentially vaccinate more than the high-risk groups. The government has earlier indicated that it intends to vaccinate as many people as possible to achieve herd immunity through vaccinations. While Prime Minister Narendra Modi had in October assured that it plans to provide covid-19 vaccine to every Indian, the government has not provided clarity on how that will be funded. Even after finance ministry announced the allocation, the health ministry has not provided a clarification on vaccinations for how many people will be funded by the government.

In terms of research, there are several BSL-3 laboratories in India, including those at Indian Institute of Science at Bengaluru as well as Bharat Biotech.

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