HEALTH officials across the world, including Pakistan, keep saying that following the standard operating procedures of handwashing, wearing a mask, social distancing, and not going to crowded places can keep the Covid spread at bay but the only way to return to normality is by carrying out mass vaccinations and/or the development of herd immunity.

Most countries, as a result, have started large-scale vaccination programmes. Hundreds of millions of doses have been administered and some of the countries where vaccination programmes are at a more advanced stage have started seeing the number of cases, especially of serious disease and in older populations (they were given the vaccine first), beginning to drop significantly. A number of countries have now moved to the point where after vaccinating the more vulnerable segments of the population — the elderly and the front-line workers — they are opening up vaccine programmes for the general population.

In Pakistan, we have only had a ‘gift’ of a couple of million doses. It seems some purchase orders are in transit and under negotiation. But all told, these are still no more than a few million doses. Total administered doses are less than one million to date. And our population is some 220m. Even if we say that almost half of our citizens are young and consequently less vulnerable to the disease (though they can be carriers) that still leaves us with a population of some 100m people who need vaccinations. Where are we going to get vaccinations for all of these people? When are we going to get them? If we are going to progress at the rate at which we are currently, how much time will it take before we are able to bring the disruptions caused by Covid-19 under control?

On March 31, we had 4,794 new cases, the total number of active cases was 53,127, and 96 people lost their lives. The third wave has been particularly punishing in terms of the spread as well as fatalities. The government has been imposing restrictions, but the third wave is still going strong.

It does not appear to be a story of good management or decisive and effective leadership.

There is a huge cost to restrictions. The prime minister keeps making the point that we cannot afford complete lockdowns. Partial lockdowns are also very costly. Much more costly than buying and administering vaccines.

The area I live in in Lahore was shut down on Sunday morning. The nearby market has also been shut down. Other than restaurants, pharmacies and bakeries, all shops have been closed. This is expected to continue for another week or so. What is this going to cost the people who had their offices and businesses in this market? Our lanes are closed and many from our area cannot continue the work we were doing. What is this going to cost the people living in the area? Yes, the health of people is important. And no one is arguing that we should not protect their health. But there is a cheaper way to provide that protection: large-scale vaccination! When there was no other option but lockdowns to prevent the spread of the disease, lockdowns were tolerated, but now that we have a cheaper option, why is this not being opted for?

Comment: Covid-19 vaccines: public health, private interests

Did the government delay the purchase of vaccines? Were they too comfortable thinking that there will be either large donations or that herd immunity will develop to the point that we would survive without undergoing a large-scale vaccination effort? Was it miscalculation, incompetence or was it a plan to not spend money on vaccination (outright expenditure) and let people pay the price through individual business or other losses and a higher loss of life and health?

It would be wonderful if the National Command and Operation Centre were to come out with a statement on this and if an independent body can look at the explanation they come up with — and if there have been delays, some ways are found to speed things up and not keep justifying the delays that seem to have happened.

The government said quite early on that they had no objection to the private sector importing the vaccine as well. There were many equity and rights issues at stake but the government addressed them, at least in principle, by saying that they would be providing vaccines to all who wanted them at no cost. If people still wanted to switch to private providers and get the vaccine from them, it was up to the consumers to make that decision for themselves. And some private parties did import a certain number of vaccines. But these vaccines have been lying in storage for almost a month now. The government has failed to come up with a price at which the suppliers as well as the government is happy. The result is that 50,000-odd vaccines have been in storage for about a month whereas people are falling sick every day. There have also been a number of deaths in the past month and hundreds of thousands have been bearing the cost of partial lockdowns. This does not seem to be a story of good management or decisive and effective leadership.

Where do we go from here? We will have to live with lockdowns and disruptions for quite some time even if we today decide to get a much larger number of vaccines as quickly as possible for the simple reason that getting vaccines will not be quick or easy now. But, if we do not start bringing urgency to our vaccination effort and do not increase the speed of administration and the size of the programme, the lockdowns and/or disruptions to business and life might have to continue for longer. This will cost us a lot more in terms of money and lives than spending on vaccines. Will the government have a rethink and recalibrate?

The writer is a senior research fellow at the Institute of Development and Economic Alternatives, and an associate professor of economics at Lums.

Published in Dawn, April 2nd, 2021