“Extremely disproportionate, not in touch with societal realities” — this is what the Supreme Court called the Union government’s vaccination policy across India. Taking suo motu cognisance of the COVID-19 situation in India, the apex court, on May 31, delivered its judgment, a copy of which was made available on June 2. The vaccination policy, which exclusively relies on the digital portal for vaccination could have serious implications on the fundamental right to equality and the right to health of persons, noted the bench of Justice DY Chandrachud, Justice L Nageswara Rao and Justice Ravindra Bhat.
The Supreme Court noted that when it comes to vaccine distribution, the Liberalised Vaccination Policy of the Union government has created a quota of 50:25:25 for the 18-44 age group — 50% of the COVID-19 vaccines for the Union government, 25% for state and union territory governments, and 25% for private hospitals. The Supreme Court pointed out that the fact that states have just 25% of the quota, which is the same as private hospitals, is “extremely disproportionate and not in touch with societal realities,” as a large number of people, especially those not financially well-off, may not be able to afford two doses of a vaccine from a private hospital.
“If state/UT governments are to bear the burden of vaccinating a majority of the persons in their states/UTs, the quota available to the private hospitals must be reduced,” the bench said.
The court noted that the poor and marginalised face yet another disadvantage. The current system — of allowing only digital registration and booking of appointment on CoWIN, coupled with the current scarcity of vaccines — will ultimately ensure that all vaccines, whether free or paid, are first availed by the economically privileged sections of the society, the Supreme Court said. It also acknowledged the shortage of vaccines that has forced state governments to pause the vaccination drives for the 18-44 age group. The SC said that members from the privileged class, who want to opt for a free vaccine, will travel to the areas where vaccines are available for free, even if it would entail travelling to far-flung rural areas.
Moreover, the Supreme Court also noted that private hospitals are not equally spread out across a state or a union territory and are often limited to bigger cities with large populations. As such, a larger quantity of the vaccines will be available in such cities, as opposed to the rural areas, the SC said.
“The monthly income of persons living below the poverty line in urban areas and rural areas is Rs 1,316 and Rs 896, respectively. However, to access internet data services, a minimum tariff plan would cost around Rs 49, which includes 1 GB data every 28 days. This would constitute 4-5% of the month’s income of such persons accessing data,” the court noted.
The court referred to three reports to point out the disparity in society that the CoWin portal exacerbates — the annual report of Common Service Centres (CSC) for 2019-20 published by the Ministry of Electronics and Information Technology, a report of the Telecom Regulatory Authority of India and also a survey on Household Social Consumption.
“It is clear from the above statistics that there exists a digital divide in India, particularly between the rural and urban areas. The extent of the advances made in improving digital literacy and digital access falls short of penetrating the majority of the population in the country. Serious issues of the availability of bandwidth and connectivity pose further challenges to digital penetration,” said the bench.
Even the digitally literate are finding it hard to find vaccination slots through the CoWIN portal, the apex court said. It said that it may not be feasible to require the majority of the population to rely on friends or NGOs for digital registrations over CoWIN, “when even the digitally literate are finding it hard to procure vaccination slots.”
The court asked the government to earmark certain vaccination centres for on-site registrations for the population aged between 18 and 44 years with a view to prioritising those with comorbidities, disabilities, or other socio-economic vulnerabilities. Alternatively, specific daily quotas may be introduced for on-site registration at each centre or specific centres, the court added.
Currently, states such as Kerala, Tamil Nadu and a few others are prioritising individuals with comorbidities and other factors for the vaccination drive for the 18-44 age group.
The court also directed the Union government to make the CoWIN platform and other IT applications like Aarogya Setu available in regional languages and asked for a timeline for ensuring the availability of the platform in multiple regional languages. The court noted that the CoWIN platform is not accessible to persons with visual disabilities and the website suffers from certain accessibility barriers, which should be addressed.