How a presentation by former Trai chief spurred vaccine talks within govt

Former Trai chief's presentation at the PMO in July got the ball rolling

India had just begun to unlock in phases when the first brainstorming meeting on the Covid-19 vaccine was held at the Prime Minister’s Office. It was July end. The country had witnessed a little over 35,000 Covid-related deaths and around 1.6 million cases. A vaccine was still a remote possibility.

According to people in the know, the meeting was called as R S Sharma, then chairman of the Telecom Regulatory Authority of India (Trai), wanted to make a presentation to Prime Minister Narendra Modi on what the government’s vaccine strategy should be, without which India would be in a mess.

Sharma, who retired as Trai chief in September, refused to comment on the matter. But his presentation, which had the PM’s attention, may have been the starting point of vaccine deliberations within the government as well as with the industry, an official told Business Standard.

The key people who steer the meetings in Covid and vaccine war rooms currently, including Niti Aayog member V K Paul, Principal Secretary to the PM P K Mishra and top health ministry bureaucrats, were among those who attended Sharma’s presentation.

The first director general of the Unique Identification Authority of India (UIDAI), Sharma made ample references to the usefulness of Aadhaar in making vaccine distribution a success in the country. ‘’We had scaled up Aadhaar enrolment numbers to 1.5 million a day with 1,500+ empaneled agencies, 40,000 enrolment stations, 200,000 trained and certified operators. These learnings can be used for creating a national vaccination platform,’’ a note that accompanied the presentation, and which has been reviewed by Business Standard, emphasised.

Sharma’s focus was on the steps that the government must take in vaccinating 1.3 billion people in India as quickly as possible, a source privy to the details of the presentation said. As India inches closer to getting a vaccine and the industry is being consulted for an efficient cold chain and delivery mechanism, some of the points highlighted during that July meeting are perhaps being looked at again, the source added.

According to Sharma’s presentation, cold chain, logistics, technology and payments are the four pillars of the complex vaccine process. The government should play the role of a regulator rather than getting into procurement, he highlighted. Also, the private sector should be roped in majorly for the procurement process as well as for enabling technology. To make it work, his vaccine plan focused on public-private participation (PPP).

As for payment, companies can issue e-vouchers to their employees for vaccine, for instance. In fact, the suggestion was that a combination of ways should be employed to pay: Those who can afford can pay on their own; some can use vouchers issued by their employers; some charitable organisations can come up with donations; and companies can use CSR (corporate social responsibility) money to fund vaccination. The government can pay for some target groups such as Ayushman Bharat beneficiaries.

‘’When one or more vaccines become available, India shall potentially need to inoculate a billion people in the shortest possible time, preferably within a few months. Any reduction in this timeframe will save lives and money,’’ according to Sharma’s vaccine note.

The note said that administering the vaccine may seem like a trivial task but a moment of reflection reveals that it could become a logistical nightmare, unless a carefully designed system is put in place in advance.

First vaccine proposal

• Go for a PPP model for procurement, distribution
• Involve private tech companies for a digitised process
• Payment must be through mix of ways, including e-vouchers from companies
• Focus on vaccinating in the shortest possible time in an orderly manner
• Use Aadhar learnings to set up a national vaccination platform

Working on the numbers, Sharma argued that even at the rate of vaccinating 10 million people per day, it will take 130 days to cover India’s population of 1.3 billion. ‘’This process can get derailed, if there is panic and crowd and everyone wants to get it first.’’

With this in mind, the former Trai chief advised the government that vaccination of the entire population must be done in the shortest possible time in an orderly manner. Also, steps should be taken so that nobody is left out. Besides this, care should be taken so that agencies carrying out the vaccination don’t fudge figures to show that the target has been achieved. According to Sharma, who had worked closely with Nandan Nilekani on Aadhaar, the operation should be conducted through multiple agencies to provide a choice to the people, without compromising on quality.

‘’For all this to happen, we will need to take help of technology and create a well-designed system,’’ the note stated. The system, Sharma’s note said, would include getting a digital vaccination certificate using Aadhaar authentication. ‘’This will ensure that only those people who have been vaccinated get the certificate and agencies providing vaccination are not fudging figures either to get more money from the government or to get credit without doing their work.’’

Till now, the government has not taken a decision on using the Aadhar model in the Covid vaccination process even as back-to-back high-level meetings on vaccine are keeping officials busy. Along with the vaccination process and the cold storage challenges, the cost to the government is a key issue under discussion ahead of the Union Budget where Covid and the vaccine for it are likely to be at the centre of discussion.