Covishield's COVID-19 vaccine
A health worker inoculates a woman with a jab of Covishield's COVID-19 vaccine at a vaccination Centre in New Delhi Image Credit: AFP

Today, on October 21, 2021, India achieved the momentous feat of administering 1 billion doses of COVID-19 vaccines. For a democratic society, to be able to achieve this feat in such a short span of time — just over nine months — is a task worthy of not just admiration but also of deep analysis and case study for the world. So, what are the factors that made India achieve this feat?

Five different strands — Panch Amrit — that all came together into one beautifully woven thread, so emblemic of India, can be identified as the key drivers.

First, the science and the scientists. When the COVID-19 pandemic first started, it was an unknown entity except that the medical fraternity almost immediately recognised that it will have global repercussions.

The challenge was one which the world had never faced before, ever — create a vaccine against an unknown viral pathogen in just a few months else the world was looking at tens of millions of deaths!

Even as the global pharmaceutical companies raced to make a vaccine, Indian scientists and researchers, taking inspiration from ‘Aatmnirbhar Bharat’ mantra, undertook their own independent journey that culminated in the creation of two vaccines that would save the lives of not just millions of Indians but also millions of citizens across dozens of countries.

Doctors from the Rajawadi Hospital
Doctors from the Rajawadi Hospital pose for a selfie as a television broadcasts a live address by India's Prime Minister Narendra Modi before the start of the COVID-19 vaccination drive in Mumbai on January 16, 2021. Image Credit: AFP

In just a few weeks after the virus was first identified, Indian Council of Medical Research (ICMR) isolated and sequenced the SARS-Cov2 virus. In partnership with Bharat Biotech, India’s first indigenous Covid-19 vaccine — Covaxin — was developed by June 2020 itself and subsequently processed into various phases of trials.

In parallel, Serum Institute of India collaborated with a global pharmaceutical company to mass produce the Covishield vaccine.

By end-November 2020, Serum Institute was ready with interim Phase-III trial results for Covishield; by mid-December 2020, Bharat Biotech was also ready with interim Phase-III trial results of Covaxin.

Finally, on January 3, 2021, less than year before the virus was first notified, two “Made in India” vaccines were approved for emergency use!

Second, the front line workers. Inoculating a billion plus people, spread across a vast geography, settled in the remotest of places — from deserts to mountains and from coastal areas to deeply forested regions, was not going to be an easy task!

India’s administrative machinery

However, India’s administrative machinery was ready for the task.

A special task force comprising 19 Union ministries, 23 departments at the State and district level, and partners from associated fields came together to create the ‘COVID-19 Vaccines Operational Guidelines’.

The guidelines were released in December 2020 and detailed all aspects of the training of all health functionaries, preparing the eligible population lists, social mobilisers, vaccine storage, cold storage chain, up to the delivery of the vaccine.

Among other things, the document also laid out the training required for the handling of the vaccines and their transportation procedure by the health workers. Three dry runs were conducted nationwide before the launch of the vaccination drive and even before the first dose was administered, more than 170,000 vaccinators and more than 300,000 vaccination team members were trained, spread across the nation.

This end-to-end exercise trained officials and health care workers on all aspects of vaccination, including administering of the vaccine, dealing with adverse effects, and collecting and storing real-time data in the home-grown platform IT platform CoWin.

As the vaccination drive picked up, the front line and health workers, doctors, nurses, police and other security forces worked selflessly 24X7 to maintain the momentum!

Even during the peak of the second wave during April-May 2021, the commitment, the zeal and the spirit of selfless service of the front line workers did not diminish, and they carried out the vaccination drive with same vigour.

Think of the scale of what these front-line workers have been able to achieve — over 1 billion doses in just over nine months, multiple times administering more than 10 million doses in a day and also creating a world record of administering more than 25 million doses in one single day!

Logistics and administrative machinery

The “Whole-of-Government” approach, first pioneered by Prime Minister Narendra Modi during his Chief Ministerial stint in Gujarat, came in handy in mobilising the entire government machinery right down to the district and local block levels across 36 states and union territories. .

Representing India’s digital prowess, the Government also launched the indigenously developed CoWin platform. An end-to-end digital platform — the most advanced and transparent such platform in the world — CoWin enabled real-time monitoring of the vaccination process as well facilitating the people to book vaccination slots of their choice and download digital certificates at the click of a button.

Unlike paper certificates dispensed in many advanced countries, these digital certificates came equipped with unique QR codes and biometric authenticated data.

The planning was so complete that more than 300,000 Common Service Centres (CSCs) were activated to digitally help those who may have needed it any aspect of the end-to-end vaccination process.

However, the most crucial element of being able to ensure seamless vaccination was the planning of the logistics network. Transportation of millions of vaccines “From the Factory to the Field” in a controlled environment was not an everyday job.

Prime Minister Narendra Modi is administered a COVID-19 vaccine at AIIMS, in New Delhi, on Monday, March 1, 2021.
Prime Minister Narendra Modi is administered a COVID-19 vaccine at AIIMS, in New Delhi, on Monday, March 1, 2021. Image Credit: PTI

Specialised containers, which could maintain desired temperatures for more than 72 during transportation were mobilised. While Commercial airliners were used for the majority of the transportation, the government also used the transport fleet of the Indian Air Force to plug in any gaps.

The Air Force also provided landing facilities to commercial airliners at the military airfields including in remotest corner of the country.

The Indian Railways closed the loop where air connectivity was not available. Cold storage trucks carried the vaccines inland in the last leg. Finally, health carried the vaccines in portable containers into the rural pockets — either on foot or using any mode of transport available.

Imagine, hundreds of planes flying to multiple airstrips across the country; thousands of kilometres of train travel; and lakhs of kilometres of road travel — this is what it takes to ensure that the vaccines reach even the remotest parts of India every day, day after day, every day!

Where none of the modes of transport was available, ICMR’s “Made in India” I-Drone was used to deliver the vaccines to the farthest corners.

Fourth, the spirit of the people of India. Unlike many democratic nations, including many developed countries, that have been forced to mandate COVID-19 vaccination, India’s fight against the virus has been entirely ‘people driven’ and absolutely voluntary!

Gujarat, Nov 28 (ANI): Prime Minister Narendra Modi reviews the development of COVID19 vaccine candidate ZyCOV-D at Zydus Biotech Park in Ahmedabad on Saturday. (ANI Photo) Image Credit: ANI

The great vaccination festival

“Tika Utsav” or Vaccination Festival became the buzzword as Indians collectively come forward in hundreds of millions to take part in the world’s largest vaccination drive.

Amid the staggering amount of global suffering, the story of India’s vaccination drive stands out! Every section of the society has contributed in this fight in their own way.

The Indian people imbibe the timeless spirit of India’s civilizational heritage of coming together as one in times of crisis with the resolve to fight and defeat the enemy — in this case the pandemic. This timeless spirit manifested itself during this latest crisis as well.

Fifth, the Leadership of Prime Minister Narendra Modi. As early as April 2020 itself, when the world was still struggling with the nature of the vaccine, the Prime Minister Modi, in a display of remarkable foresight, constituted a task force to conduct research on COVID-19 vaccines.

Administrative processes, bureaucratic approvals and financial supports were all fast-tracked to support the development of the vaccines. The mandate was that science will take its own time and that must not be short circuited. However, other processes that were in control of the government machinery must not become a hindrance but rather become facilitators.

More than $120 million were allocated in mid-2020 itself under the Covid-19 Suraksha Mission for Research & Development of an Indian covid vaccine. As the vaccines reached mass production stage, the Union Budget for financial year, 2021-22 made provision of almost $5 billion for the nationwide free vaccination programme.

Advanced financial support to the manufacturers, booking of vaccines in advance and fast-tracking approval processes were the systemic interventions mandated by the government. In a show of confidence and personal unstinted support to the scientists and researchers, Prime Minister Modi himself visited the facilities manufacturing the vaccines even before the first doses were administered.

21 meetings were held with Chief Ministers of the various states — the partners in this nationwide effort — that were chaired by Prime Minister Modi himself. Multiple other meetings were held at Health Minister levels and officials. Regular discussions with the States allowed the Central government to remove any roadblocks that would otherwise have arisen in the logistics and distribution chain.

As is his wont, a detailed plan was worked under Prime Minister’s guidance which sequenced the priority groups that would be vaccinated. Front-line and health workers first, then those above 60, then those above 45 with comorbidities, then all above 45 and finally all above 18.

Setting an example. Prime Minister Modi awaited his turn to take the first dose of the vaccine and only when he became eligible as per priority sequencing, did he get himself inoculated.

But the leadership mettle shown by Prime Minister Modi was not just during vaccination phase but during the entire one and half years of India’s battle against the COVID-19 pandemic.

From personally shunning Holi festivities in March 2021 to set an example, when India had just about 100 cases, to motivating a billion plus people to observe a voluntary lockdown during Janata Curfew on March 22, 2020 to appearing in public with a face mask in April 2020 itself, Prime Minister Modi has put himself firmly in the front in this battle.

It was a risky strategy from a political point of view. If the Covid-19 battle had floundered, as it did in many countries, he would have had to take the entire blame for he put himself in the front. But that is what leadership is about. Not bothering about personal risks but putting the larger national interest first.

Prime Minister Modi displayed empathy when needed, firm resolve when required, foresight and planning when it mattered and undertook the role of a motivator and shoulder of support when required. They say true leadership stands out in times of crisis and it would not be an exaggeration to assert that Prime Minister Modi has passed this test with commendably.

In the end, the story of India administering 1 billion doses at the fastest pace in any democratic society, is a story of India’s scientists, the front line workers, the humongous effort of the logistics supply chain, the voluntary spirit of Indians to come together and get vaccinated, and the story of the entire government machinery led by Prime Minister Modi displaying firm resolve, encouragement, support and unstinted leadership!

As Prime Minister Modi has himself said in a different context, but so apt in the vaccination story as well — “India has proved that democracy can deliver”!