NEW DELHI -- India's federal government will provide free coronavirus shots to any adult starting later this month and take back control of the country's vaccination drive, marred by delays and shortages, Prime Minister Narendra Modi announced Monday.
The changes reverse a policy launched in April that tasked states and the private sector with vaccinating those between the ages of 18 and 44. The federal government will now procure 75% of all doses directly from the manufacturers and provide them to the states for free, while the remaining 25% will be purchased by the private sector.
Under the earlier policy, the federal government gave free shots to people above 45 years of age and front-line workers, leaving states and private hospitals to administer inoculations to those between 18 and 44.
Although most states vaccinated those in this age group for free, they were competing for doses with the private sector. Experts say vaccine makers reaped more profits by selling at a higher price to the private sector, causing many states to scramble for supplies.
Modi's announcement in a nationally televised speech came as pressure was mounting on his government to speed up vaccinations and ensure equity. Last week, the Supreme Court called the previous vaccination policy "arbitrary and irrational."
Modi's speech came against the backdrop of a near breakdown in health infrastructure over the past two months, with major Indian cities running out of oxygen and hospitals flooded with patients, while crematoriums struggled to keep pace with the number of those who died of covid-19. His administration has come under intense criticism over its handling of the second wave and the vaccination rollout and its popularity ratings have fallen from 75% in 2019 to 51% this year, according the Local Circle polling company.
India has administered just over 222 million vaccinations so far and less than 5% of the country's population has been fully inoculated.
The government has said over 2 billion doses will be available by December -- enough to vaccinate the adult population -- but there is no indication the main vaccine manufacturers in India will be able to ramp up production to meet that goal, nor whether India will be able to purchase doses from overseas to make up the shortfall.
Meanwhile, businesses in two of India's largest cities were reopening as part of a phased easing of lockdown measures in several states now that the number of new infections in the country is on a steady decline.
India's capital, New Delhi, allowed businesses and shops to reopen with limited hours on Monday and its Metro, which serves the city and adjoining areas, resumed operation at 50% capacity. Last week, authorities in the capital allowed some manufacturing and construction activity to resume.
"Now the corona situation is under control. The economy must be brought back on track," New Delhi Chief Minister Arvind Kejriwal said on Sunday.
The strict lockdown measures had been in place since April at the start of a devastating surge in infections that lasted well into May and overwhelmed health care facilities in many parts of the country.
Some health experts fear the restrictions are being eased too soon and there are concerns that the virus is still spreading unchecked through India's villages, where testing and medical care are limited.
Kejriwal warned that any new surge in infections could be more severe and said the administration will build new oxygen production facilities and expand the capacity of intensive-care units.
In the coastal state of Maharashtra, home to the financial hub of Mumbai and one of the worst-hit states, malls, movie theaters, restaurants and offices reopened in districts where the test positivity rate has fallen below 5%. The state's huge rail network will, however, remain closed for the public.
Other Indian cities also started to gradually lift lockdown rules.
Modi last addressed the nation on April 20, when he urged states to avoid lockdowns even as the country was heading toward record daily infections of more than 414,000. Soaring new cases and a spike in daily deaths forced both India's financial and political capitals to impose restrictions on movement, as citizens took to social media in a desperate search for oxygen and lifesaving medicines.
After registering a peak of more than 400,000 new cases a day in May, new infections and deaths have declined and the government hopes the reopening could resuscitate an economy that grew at only a 1.6% annual rate in the January-March quarter.
On Monday, new infections fell to their lowest point in two months.
The 100,636 cases added in the past 24 hours pushed India's total to nearly 29 million, second only to the United States. The Health Ministry said 2,427 more people died in the previous 24 hours, driving the overall toll to 349,186. Both figures are believed to be vast undercounts.
HOW MUCH IS ENOUGH?
Separately, a top World Health Organization official estimated Monday that covid-19 vaccination coverage of at least 80% is needed to significantly lower the risk that "imported" coronavirus cases like those linked to new variants could spawn a cluster or a wider outbreak.
Dr. Michael Ryan, WHO's emergencies chief, told a news conference that ultimately, "high levels of vaccination coverage are the way out of this pandemic."
Many rich countries have been moving to vaccinate teenagers and children -- who have lower risk of more dangerous cases of covid-19 than the elderly or people with comorbidities -- even as those same countries face pressure to share vaccines with poorer ones that lack them.
Britain, which has vastly reduced case counts thanks to an aggressive vaccination campaign, has seen a recent uptick in cases attributed largely to the so-called delta variant that originally appeared in India.
Ryan acknowledged that data wasn't fully clear about the what percentage of vaccination coverage was necessary to fully have an impact on transmission.
"But ... it's certainly north of 80% coverage to be in a position where you could be significantly affecting the risk of an imported case potentially generating secondary cases or causing a cluster or an outbreak," he said.
"So it does require quite high levels of vaccination, particularly in the context of more transmissible variants, to be on the safe side," Ryan added.
Maria Van Kerkhove, WHO's technical lead on covid-19, noted the delta variant is spreading in more than 60 countries, and is more transmissible than the alpha variant, which first emerged in Britain.
She cited "worrying trends of increased transmissibility, increased social mixing, relaxing of public health and social measures, and uneven and inequitable vaccine distribution around the world."
WHO Director-General Tedros Adhanom Ghebreyesus, meanwhile, called on leaders of the developed Group of Seven countries to help the U.N.-backed vaccination program against covid-19 to boost access to doses in the developing world.
With G-7 leaders set to meet in England later this week, Tedros said they could help meet his target that at least 10% of the populations in every country are vaccinated by the end of September -- and 30% by year-end.
"To reach these targets, we need an additional 250 million doses by September, and we need hundreds of million doses just in June and July," he said, alluding to the summit involving Britain, Canada, France, Germany, Italy, Japan and the United States.
"These seven nations have the power to meet these targets. I'm calling on the G-7 not just to commit to sharing those, but to commit to sharing them in June and July."
At a time of continued tight supply of vaccines, Tedros also called on manufacturers to give the "first right of refusal" on new vaccine volumes to the U.N.-backed COVAX program, or to commit half of their volumes to COVAX this year.
He warned of a "two-track pandemic," with mortality among older age groups declining in countries with higher vaccination rates even as rates have risen in the Americas, Africa and the Western Pacific region.
Information for this article was contributed by Sheikh Saaliq and Jamey Keaten of The Associated Press; and by Bibhudatta Pradhan of Bloomberg News (WPNS).