RS Sharma knows a thing or two about building and scaling platforms. As the former chief of Unique Identification Authority of India (UIDAI), the semi-government body tasked with rolling out the national identity project, called Aadhaar, he played a crucial role in its adoption by millions of Indians. Sharma, who also served as the chairman of telecom regulator TRAI, recently took charge as the CEO of the National Health Authority. As chairperson of an empowered committee for India's COVID-19 vaccine delivery tech platform Co-WIN, Sharma has a herculean task ahead as India expanded vaccination to cover senior citizens and those above the age 45 with comorbidities. Sharma spoke to Moneycontrol's Chandra R Srikanth on the initial tech glitches, the lessons in scale from Aadhaar, and how India can expand vaccinations to cover 1 crore people a day. Edited excerpts:
The new phase of vaccination has kicked off on a good note. Many prominent citizens have come forward to get vaccinated. Can you give us an update on how many have managed to register and how many have got the jab so far?I won't have the jab numbers but there have been about 24 lakh registrations until last night. Now, obviously, the numbers will depend on the hospitals publishing their timetable and making vaccine slots available. Because it was the first day, they may not have got the vaccines and they may not have published the timetable. But there is a lot of interest in terms of the number of people registering on the platform.
This is something that people are alluding to. That there are issues with the Co-WIN portal or the hospital addresses are not being published properly.
There is no issue with the portal because if there was an issue, 24 lakh people would not have been able to register. What is actually happening is because the whole thing started yesterday (March 1)—unless hospitals publish the timetable, people will not be able to make reservations. So, maybe there is a bit of an issue on the supply side but it was the first day and this should get better.
You have had a lot of experience dealing with scale, as the former chief of UIDAI. Are there lessons from Aadhaar that you can potentially use in scaling up vaccinations at the same pace? Nandan Nilekani recently said we need an Aadhaar type model and that is how we can get to 5 million to 10 vaccinations a day. So, what lessons can you draw from there?
Frequently Asked Questions
A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.
There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.
Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.
Well, actually, this is a very important question because there are a lot of learnings from Aadhaar and that is precisely what we are doing. Aadhaar was people-centric so we created multiple agencies so that people had multiple places to go for enrolment. Similarly, the idea here is to create choices for people to get their vaccinations. The number of people will increase once you have more choices, people have the flexibility of booking an appointment, then then it becomes a completely demand-driven approach. And in the demand-driven approach, no-shows will be much less and that will actually ensure that our capacity will be fully utilised. We are also using data-driven decision-making.
So, potentially how much do you see this scaling up to, in terms of the number of vaccinations a day?
It can go up to one crore a day, I have no doubt about that. Our platform is absolutely scalable.
By when do you expect this to happen?This will be limited by vaccine availability, logistics, people coming forward, and other factors. I am merely talking about platform scalability.
Will you also be seeking help from IT companies to strengthen the platform?
We will always be kind of looking for tech support from providers. I am one of those persons who keep things open source—open source, open API, and open standard. Once you have that it becomes a very good development platform where everyone can contribute. We are not going to have any proprietary components in the platform … we will have just open source and then probably put it up on GitHub and others. We have published our API on what is called API Setu and people can build their own applications.
There was this report in New York Times about how, you know, some Chinese hackers managed to get into India's power system. So, how are you really going about scaling this platform in a secure manner?That is an important question. Security of data is very important and we are taking all steps to ensure data is secure. We also need to ensure privacy—we are only collecting a person's name, photo, age, and gender. I don't think we are getting any sensitive data.