The second wave of the COVID-19 pandemic is wreaking havoc in India, devastating especially on the not so affluent sections of our society. The intermittent lockdowns and the resultant economic fallouts have left the poor to fend for themselves. With the enormity of numbers that we are witnessing in the second wave, even the capacity to afford private healthcare is becoming increasingly immaterial. The entire system is getting crushed under the rapidly rising toll of the pandemic. Swift and widespread vaccination of almost the entire adult population could thwart this catastrophic wave of sickness and death. Though the Union government has allowed vaccinations of everyone above the age of 18 from May 1, there still linger some genuine concerns.
Allowing everyone above the age of 18 to get vaccinated and making the vaccines available on such a large scale is not the same thing. Furthermore, affordability is one of the major concerns. A survey conducted by Gaon Connection, a rural media platform, found that the paramount concern for a large section of the population in rural India was the issue of affordability, with about 36% of the respondents of the survey expressing their unwillingness to pay for the vaccine. Since the question of affordability is one of the primary reasons for vaccine hesitancy, it needs to be addressed with urgency.
Many states have announced that vaccinations will be provided for free through state funded hospitals and health centers. Whether they’ll be able to keep their word depends on whether they can procure sufficient doses. As for private hospitals, the Union government has taken a free-market approach, by allowing them to procure vaccinations directly from the manufacturers.
A single dose of vaccine could be free, or could cost anywhere between Rs 700 and Rs 1,500 depending on where you get your vaccination and which vaccine you choose. The lack of a holistic approach and a uniform strategy in terms of vaccination has resulted in chaos, and the system is breaking down under the stress of policy incertitude. There is no clarity on how the manufacturers will handle the supply chain distribution between the state governments and private hospitals. Most state-owned hospitals, where the vaccines can be administered free of cost, are facing a dire shortage of vaccines. This has put the poorer sections of our society at a distinct disadvantage in our fight against the pandemic. Apropos of this, there is an increasing debate on whether the right to such lifesaving vaccinations should be part of basic human rights.
If we look at the issue from a political perspective, it is evident that a modern day Welfare State should ensure the protection of basic human rights. It should provide social services to its citizens, including in the matter of public health. All citizens, irrespective of their financial status, must be beneficiaries of these services. Consequently, the political actions of the government should among other things, be aimed at facilitating social policies for disease prevention and cure.
International Jurisprudence also seems to tip the scales in favour of a human rights approach. The Universal Declaration of Human Rights (1948) emphasises that every person shall have the right to a standard of living necessary for one’s health and wellbeing (Art. 25). This includes a bundle of rights including medical care, as well as the right to security in case of unemployment, sickness, and other lack of livelihood in circumstances beyond one’s control. Similarly, the International Covenant on Economic, Social, and Cultural Rights (1966), provides for a right to health (Article 12) and imposes on the member states an obligation to take steps for preventing, controlling, and treating epidemic diseases.
In India, the right to health is not explicitly referred to under the Constitution as a fundamental right, but the apex court of the nation has many a time emphasised the importance of this right. Through its landmark judgments in cases like Bandhua Mukti Morcha v Union of India & Ors, Consumer Education and Research Centre v. Union of India, and Paschim Banga Khet Mazdoor Samity & Ors. v. State of West Bengal, the Supreme Court had interpreted the provision of Article 21 of the Constitution as including a right to health. Even from the economy’s point of view, there is a case to be made for providing free vaccinations. A healthy population is fundamental to a healthy economy. Perhaps this is the reason why even nations favouring free market capitalism like Switzerland are providing free COVID-19 vaccines for their residents.
The counterargument oftentimes is that India does not have the financial or economic means to execute such a large scale welfare program. This argument lacks substance, considering we as a nation have time and again in the recent past splurged sizable resources on several vanity projects. India’s poor track record of healthcare spending is well documented. It is estimated that the public spending of our country in the health sector has remained stagnant at just above 1% of the GDP for the past decade, which is one of the lowest in the world. The National Health Policy of 2015 estimates that more than 63 million people are faced with poverty every year due to healthcare costs. Surely, free vaccinations for all the citizens would be a bare minimum that is expected of the government to make amends to these derelictions.
In addition to the sickness many have contracted, the repercussions of the economic slowdown due to the pandemic in India have left scores of people without a means of livelihood. If the government aims to rehabilitate the general population and help them get back on their feet, the first step would be to ensure free vaccination for all its citizens.
Advocate Anup Menon V is Senior Legal Counsel with C. Mohanram & Associates Law Firm. Views expressed are the author’s own.