Express Healthcare

The missing informal workers in India’s vaccine story

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Ranjana Das, lead specialist-private sector engagement, Oxfam India opines that neither the Centre nor most states, nor the private sector, have paid heed to vaccinating the 450 million informal sector workers, who constitute 90 per cent of our workforce

The June 7 address to the nation by the Prime Minister on centralising the vaccination drive and providing vaccines for free to the state came on the day when India’s COVID cases in the second wave were on a decline and cities were beginning to open up after the lockdown.

The central government will now procure 75 per cent of the vaccines manufactured in the country and supply to states for free, while 25 per cent of the vaccines will be open for bidding by private players such as private hospitals and companies.

It is a welcome move, but in the announcements there has not been any mention of informal sector workers on whose shoulders rest the economy of the nation. Perhaps the centre could have taken this leaf out of the West Bengal book if it was serious about its 450 million informal sector workers, which constitute 90 per cent of our workforce.

While the centre was evasive at best, the Mamta Banerjee government, in mid-May, during the peak of second wave, announced her plan to vaccinate volunteers, journalists, vegetable sellers, and hawkers on a priority basis. The state’s government planned to vaccinate those ‘forcibly exposed to public mingling’ including COVID-19 volunteers, taxi and auto drivers, rickshaw pullers, sex workers and transgenders.

Neither the state’s free vaccination drive nor the private’s paid ones prioritised informal sector workers. India’s informal workers have borne the worst brunt since the outbreak of the pandemic in 2020. Last year they were left without jobs, money or social protection. This year the second deadlier wave with a crumbling health system meant that they neither had the money nor access to quality and affordable health care to tide over the pandemic. And, now vaccines.

India’s vaccine story so far has been one of inequitable distribution — consider this, nine private hospitals cornered 50 per cent of doses. According to Oxfam, since the beginning of the coronavirus pandemic — Moderna, BioNTech and CanSino — the makers of successful COVID-19 vaccines, have created at least nine new vaccine billionaires with a combined net wealth of $19.3 billion.

India started with vaccinating frontline health workers, then the elderly and those over 50 with co-morbidity, followed by the over 45 population, and then for 18 to 44 years. While in the beginning it was walk-in, the registrations soon moved on the CoWin app making it impossible for millions of workers to be able to register or book a slot. If anything, the pandemic has shown how the digital divide has exacerbated inequality— last year it was education and this year health.

From the taxi driver who drives you around to the house help who works at your place, from the delivery guy who brings your food to the janitor who cleans your buildings— they either have no access to the app or have no idea how to book a slot. If by any luck they could, the app showed slots for private hospitals which were vaccinating at prohibitive costs making it impossible for informal sector workers, who have been struggling to go back to their pre-COVID earnings, to afford it.

While my first dose was at a private hospital at Rs 250, my second dose arranged for in my residential society cost me four times. While I could pay it was impossible for the house helps in the society to shell out Rs 1050 per dose per family member. Vaccines are now distributed through myriad channels — from government hospitals at free of cost to private hospitals at an exorbitant price, from agents for a service charge to drive-in in shopping malls — most of these are inaccessible and unaffordable for the informal sector workers. In fact my house help knew of a government vaccine centre an hour away but did not go as she could not leave her kids alone.

We are the privileged class but the 90 per cent on which the economy is riding on is devoid of any protection. The dilly-dallying by the Centre has put lives at risk. Vaccines that would safeguard the public from the pandemic and should have been the responsibility of the government was left to become a commercial product only to be accessed by a certain privileged class. The 450 million informal workers who should have been government’s priority to keep them safe and the economy up and running did not figure in their scheme of things. They don’t even now.

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