COVID-19 Nepal

Boosting the Vaccination Drive

The best shot to mitigate the profound risk of health crisis and move beyond the COVID-19 pandemic is by expediting the vaccination drive and ensuring that everyone is vaccinated.

However, in Nepal, merely ten percent of the population have received a complete dose of the vaccine and an additional fifteen percent have received the first of the two doses. Almost all of these are concentrated inside the Kathmandu valley whilst inoculating people residing elsewhere has taken a back seat. 

As of 13-August, Nepal has received a total of 6.7 million doses of vaccine as donations procured 5 million doses, and is preparing to procure additional doses from different countries. The COVAX facility has promised an additional donation of vaccines, enough for 20 percent of the population.

While procurement of vaccines has already proven to be a daunting task for Nepal, an even bigger challenge is seen in efficiently managing the drive. Previously, while administering the Vero cell vaccine, only 23 immunization centers were allowed to operate. With the centers unable to hold large influx of people, many individuals ended up in queue for more than 5 hours and returned home unimmunized as the supply for the day abruptly ran out. On the other hand, 0.5 million doses were lying idle in government stock. Additionally, nepotism that resulted in unfair vaccine distribution whereby friends and families of the influential people were prioritized over the ones who arrived at the centers much earlier, discouraged individuals to get vaccinated altogether. Despite the inefficacy, after the arrival of J&J vaccine, the same mechanism was adopted by assigning 22 vaccination centers for delivery.

Continuation of the practice is bound to delay the immunization process throughout Nepal. Moreover, vaccinating 30 million people is simply not enough. In light of new variants and booster doses, vaccination is going to be a long-term business.

The question is, will the current system be sustainable enough to supply uninterrupted vaccination for a prolonged period effectively?

The major problem associated with the current system is the centralized control – from procurement to distribution of vaccines. To address the same, involving private sector and local governments can definitely help overcome the current inefficacy whilst ensuring greater coverage and affordability.

Swift and effective vaccination programs are possible if avenues for profiteering are created for the private sector. The incentive created will not only increase the number of vaccine suppliers in the country but also will ensure competition and innovation in vaccine delivery mechanisms, corroborating greater efficiency at reduced cost. Many individuals will preferably choose to pay for the vaccine in expectation of swift service. 

While at that, it is important to acknowledge that all Nepali do not have the capacity to afford the vaccines distributed by the private sector. In this scenario, it is prudent for the government to roll out subsidized vaccination programs as the situation demands prompt immunization against the virus. However, the program needs to be designed deliberately as much thought needs to be concentrated on identifying the eligible target group. More important is greater transparency to mitigate corrupt activities whilst ensuring accountability towards taxpayers. For the longer run, the government can channel the mandatory CSR requirement of corporate houses towards vaccination programs. However, in return, it is important for directing benefits like tax rebates and national recognition towards the private sector.

These developments will certainly open avenues for local governments and the private sector to coordinate and import vaccines for respective localities. This could help boost the vaccination drive more proficiently. The distribution efficiency of these local bodies has already been demonstrated in the past. While administering the second dose of Verocell, the engagement of local governments resulted in efficient administration whereby use of different spaces like schools and ward offices for inoculation enabled people to access vaccines from almost their doorsteps. Moreover, it took a mere 2-5 minute for the entire vaccination to complete as opposed to the 5-6 hour process. If the local bodies can move forward in a similar manner by leveraging local resources, vaccine delivery throughout Nepal can run at a smooth and rapid pace.