A transparent and robust Covid-19 vaccine registration and distribution policy is required to ensure equitable distribution of vaccine in Bangladesh
At last, the vaccine is here for Covid-19, one year after the worldwide outbreak of this virus shook the world. But still, universal and equitable access to the vaccine is a far cry around the world. One of the major causes is that not enough doses of Covid vaccine have been produced, compared to the world population.
Secondly, the pharmaceuticals or biotech giants are not disclosing the scientific information or not providing open license to produce Covid-19 vaccine. The third, and one of the most important issues is, the lack of equitable distribution of Covid-19 vaccines worldwide.
For Bangladesh, two million doses of Oxford-AstraZeneca vaccine has already arrived on January 21 as a gift from the Indian government. The first shipment of five million shots of Oxford-Astra-Zeneca vaccine arrived on January 25, out of the three crore doses the Bangladesh government bought from Serum Institute of India.
Besides, around 1.5 million doses of vaccine will be collected through private organisations. The biggest challenge for the Bangladesh government is the proper, efficient and equitable distribution of a limited number of vaccine doses among 160 million people.
According to different news sources, the Bangladesh government has planned to prioritise the doctors, healthcare workers, law enforcement personnel and other frontline fighters for vaccination, after which mass people will get the vaccine gradually. People will require registering through a government-developed mobile app to get a vaccine, which will take place in vaccination centres/booths set up all around the country, supervised by trained health workers. Non-digital means of registration will also be there should any complexity arise with the digital registration process.
This move for app-based registration is much appreciable because it would save time, effort, money and hassle to get registered for vaccination. However, no technology-based solution comes without challenges. Failure to get everyone registered through this system due to 'Digital Divide' might be a major challenge to this digital registration system. Digital Divide refers to the gap between people and the use of modern information and communication technology.
The problems of Digital Divide can be solved in the context of three factors:
1. Accessibility: ICT should be easily accessible to everyone
2. Utilisation: technology should be simple so that mass people can easily utilise them
3. Receptiveness: technology must bring some positive changes so that people can relate it to their daily life.
Otherwise, a mere introduction or forcible approach to technology without shrinking the Digital Divide gap might deprive or single out a person from/for the benefits of technology-based services.
As per the BRAC Institute of Governance and Development (BIGD) September 2020 report, nearly three-quarters of rural households in the country have low level digital access and skills. Forty-nine percent of the household have no computer access and 59 percent of the rural households have no smart phone access.
According to the 'The Mobile Economy 2020 Asia Pacific' report by Groupe Speciale Mobile Association (GSMA) in July 2020, the smartphone penetration in Bangladesh was only 40 per cent, as per the data of the year 2019. According to the Bangladesh Telecommunication Regulatory Commission, mobile phone subscribers have reached 170.137 million at the end of December 2020. As of July 2020, around 9.78 crore subscribers were accessing the internet through mobile phones and around 85.71 lakh through internet service providers and public switched telephone network operators.
According to the 'Digital Quality of Life Index 2020' by Surfshark, Bangladesh stands at the bottom 10 in terms of Internet affordability, Internet quality, electronic infrastructure, electronic government and electronic security. As per the Asian Development Bank Data, 21.8 percent people were living below the national poverty line in 2018. Around 9.2 percent employed people were earning below $1.90 daily and the unemployment rate was 4.2 percent in 2019.
Considering the above scenario, there is a potential risk that a considerable number of people, especially who are underprivileged, unemployed, low earning and living below the poverty line, might be victims of the Digital Divide if the government does not ensure an easily accessible, effective and efficient non-digital means of registration alongside digital registration.
Bangladesh has had remarkable success with the Expanded Programme on Immunization (EPI) in providing six conventional vaccines through nationwide health centres. Along with this EPI experience, the government can use the same method it used in disbursing cash aid to five million poor households through Mobile Financial Services in 2020 in order to identify and locate the most vulnerable who need a vaccine immediately.
However, in order to avoid the Digital Divide, the government should crossmatch data kept in different government organisations, e.g. NID server data, National Household Data kept in Bangladesh Bureau of Statistics, data from Social Welfare Ministry or the Health Ministry. Also, the government should collaborate with relevant national or international NGOs working in the health sector.
In light of Article 15 of the Constitution of Bangladesh, it is the responsibility of the State to ensure basic healthcare. As Article 32 of the Constitution recognises the right to life as a fundamental right, and as the right to life is meaningless without securing the right to health, universal vaccination for every citizen should also be considered a fundamental right.
Also, equality before the law and equal protection of law must be ensured in the distribution process of the vaccine as per Article 27 of the Constitution. It is to be noted that the Strategy 1.1.2 of National ICT Policy 2018 emphasises on developing the capacity of people to receive digital services from the government. Strategy 1.2 talks about maintaining transparency in government service delivery. Strategy 1.3 requires government agencies to develop proper infrastructure to deliver digital services. Strategy 1.6 talks about capacity building on healthcare-related digital services. Strategy 3.3 emphasizes on the distribution of government or non-government digital services without any discrimination.
Also Gavi, The Vaccine Alliance emphasises on global immunisation considering its multidimensional impact on achieving Sustainable Development Goals regarding eradicating poverty and hunger, maintaining good health and wellbeing, achieving gender equality, accelerating innovation and developing infrastructure, and strengthening the global partnership. Lastly, we can hope that Bangladesh will prove itself a role model in universal vaccination once again through a transparent, robust and equitable Covid vaccine registration and distribution policy.
Md Saimum Reza Talukder teaches Cyber Law at BRAC University
Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.