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Supreme Court of India

IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND SERVICES DURING PANDEMICversus.

Citation
2021 INSC 302
Decided
31 May 2021
Disposal
Directions issued

Holding

The Liberalised Vaccination Policy, as presently framed, fails to meet constitutional standards of reasonableness and non‑arbitrariness and must be clarified and revised by the Union of India.

Summary

The Supreme Court, hearing a suo motu writ petition concerning the management of the COVID‑19 pandemic, examined the Central Government's Liberalised Vaccination Policy, which shifted free vaccination for the 18‑44 age group to State/UT governments and private hospitals and introduced differential pricing. The petitioners raised concerns that the policy was arbitrary, violated Articles 14 and 21, created a digital divide, and placed an undue financial burden on poorer citizens and financially distressed states. The Court affirmed its jurisdiction to review executive policies during a public‑health emergency, emphasizing that policy‑making remains the executive's domain but must satisfy standards of reasonableness and non‑arbitrariness. It held that the policy’s lack of clear criteria for pro‑rata allocation, pricing justification, and logistics monitoring rendered it constitutionally suspect. Consequently, the Court directed the Union of India to file a detailed affidavit addressing vaccine procurement, distribution, pricing, logistics, digital access, and related issues, and ordered State/UT governments to file affidavits confirming their free‑vaccination policies. The order is a set of directions rather than a final disposal of the petition.

Issues considered

  • The constitutionality of the Liberalised Vaccination Policy under Articles 14 and 21 of the Constitution
  • Whether the differential pricing and pro‑rata allocation of vaccines to State/UT governments and private hospitals is arbitrary or unreasonable
  • The adequacy of the digital registration system (CoWIN) in light of the digital divide
  • The extent of judicial review over executive decisions in a public‑health emergency
  • The obligations of the Union and State/UT governments regarding free vaccination and vaccine logistics

Legislation cited

Subjects

COVID-19vaccination policyLiberalised Vaccination Policyjudicial reviewseparation of powersessential suppliespublic health emergencydigital dividedifferential pricingvaccine procurementright to lifeArticle 14Article 21

Judgment

268                       [2021]
               SUPREME COURT     5 S.C.R. 268
                              REPORTS                         [2021] 5 S.C.R.


A         IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND
                     SERVICES DURING PANDEMIC
                 (Suo Motu Writ Petition (Civil) No. 3 of 2021)
                            MAY 31, 2021
               [DR. DHANANJAYA Y CHANDRACHUD,
B          L NAGESWARA RAO AND S RAVINDRA BHAT, JJ.]
            COVID-19 pandemic:
             Suo Motu writ petition – Cognizance of the Management of
      the Covid -19 pandemic during the second wave –Gradual recession
      of the second wave – In view thereof, issues as regards Central
C
      Government’s Liberalised Vaccination Policy, vaccine distribution,
      vaccine procurement process, and the augmentation of vaccine
      availability, taken up – With respect to the vaccine distribution
      between different age-groups, the policy of the Central Government
      conducting free vaccinations for persons above age of 45 years
D     and frontline/healthcare workers, and paid vaccinations by the State/
      UT Governments and private hospitals for persons between 18-44
      years, prima facie arbitrary and irrational – With regard to
      procurement process, the Liberalised Vaccination Policy, may not
      be able to yield the desired results, and the basis of pro rata allocation
      to State Governments also not clear, thus, Central Government to
E
      specify as to how they would deal with the concern – As regards
      augmentation of vaccine production/availability, Union of India to
      undertake a fresh review of its vaccination policy – In view thereof,
      issuance of direction to Union of India to file affidavit addressing
      the issues with regard to the vaccination policy: vaccine procurement
F     and distribution among different categories of the population, effects
      of vaccination by private hospitals under the liberalized vaccination
      policy, basis and impact of differential pricing, vaccine logistics,
      digital divide – Affidavit to provide information on the percentage
      of population that has been vaccinated with one dose and both
      doses; complete data on purchase of COVID-19 vaccines till date
G
      (Covaxin, Covishield and Sputnik V), and an outline for vaccinating
      the remaining population in phases 1, 2 and 3; and the steps taken
      by the Central Government to ensure availability of drug for
      mucormycosis – Further, direction to Union of India to attach copies
      of relevant papers and file notations perused while preparing
H
                                         268
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                        269
              SERVICES DURING PANDEMIC

vaccination policy – Also, the State/UT governments to clarify their     A
position and policies as regards providing free vaccination to the
population within their territories.
       Judicial review – Exercise of, over the management of the
COVID-19 pandemic – Held: Policy-making continues to be in the
sole domain of the executive – However, separation of powers does        B
not result in courts lacking jurisdiction in conducting a judicial
review of these policies – Constitution does not envisage courts to
be silent spectators when constitutional rights of citizens are
infringed by executive policies – Judicial review and soliciting
constitutional justification for policies formulated by the executive
is an essential function, which the courts are entrusted to perform –    C
Judiciary has also recognized that constitutional scrutiny is
transformed during such public health emergencies – In grappling
with the second wave of the pandemic, this Court does not intend to
second-guess the wisdom of the executive – However, it continues
to exercise jurisdiction to determine if the chosen policy measure       D
conforms to the standards of reasonableness, militates against
manifest arbitrariness and protects the right to life of all persons –
Court is presently assuming a dialogic jurisdiction – Hence, the
Court would, under the auspices of an open court judicial process,
conduct deliberations with the executive where justifications for
existing policies would be elicited and evaluated to assess whether      E
they survive constitutional scrutiny.
      Union of India vs Rakesh Malhotra and another SLP (Civil)
      (Diary) No 11622 of 2021; DDA v. Joint Action Committee
      (2008) 2 SCC 672 : [2007] 13 SCR 811; Gujarat Mazdoor
      Sabha v. State of Gujarat AIR 2020 SC 4601 – referred              F
      to.
      Jacobson v. Massachusetts 197 U.S. 11 (1905); Roman
      Catholic Diocese of Brooklyn, New York v. Cuomo, 592
      U.S., 141 S. Ct. 63; Calvary Chapel Dayton Valley v.
      Steve Sisolak, Governor of Nevada, et al, 140 S.Ct.                G
      2603 – referred to.
      Sandra Fredman, “Adjudication as Accountability: A
      Deliberative Approach” in Nicholas Bamforth and Peter
      Leyland (eds), Accountability in the Contemporary
                                                                         H
270             SUPREME COURT REPORTS                                       [2021] 5 S.C.R.


A           Constitution (Oxford University Press, 2013) – referred
            to.
            < h t t p s : / / w w w. m o h f w. g o v. i n / p d f /
            GuidancedocCOWIN2.pdf>; <https://pib.gov.in/
            PressReleseDetail.aspx?PRID=1701549>; <https://
B           pib.gov.in/PressReleseDetail.aspx?PRID=1712710>;
            <h t t p s : / / w ww. moh f w.g o v.i n / p d f /
            LiberalisedPricingandAcceleratedNationalCovid19VaccinationStrategy
            2042021.pdf.;                         <https://www.pib.gov.in/
            PressReleasePage.aspx?PRID=1721225\;<https://
            www.indiabudget.gov.in/doc/Budget_Speech.pdf>; <http:/
C           /mospi.nic.in/sites/default/files/publication_reports/
            R e p o r t _ 5 8 5 _ 7 5 t h _ ro u n d _ E d u c a t i o n _ f i n a l _ 1 5
            07_0.pdf; <https://www.trai.gov.in/sites/default/files/
            Wireless_Data_Service_Report_21082019_0.pdf>;
            <https://csc.gov.in/assets/events-report/Annual-Report-
D           2019-20.pdf> - referred to.
                                   Case Law Reference
      [2007] 13 SCR 811                        Referred to                      Para 14
      AIR 2020 SC 4601                         Referred to                      Para 16
E            CIVIL ORIGINAL JURISDICTION : Suo Motu Writ Petition
      (Civil) No. 3 of 2021.
            (Under Article 32 of The Constitution of India)
            Tushar Mehta, SG., Ms. Aishwarya Bhati, K. M. Natraj, Maninder
      Singh, ASGs., Anil Grover, Sr. AAG., Ms. Prachi Mishra, Arunabh
F
      Chowdhury, Krishnaraj Thaker,, Ms. Bansuri Swaraj, Ajay Bansal,
      AAGs., Amit Kumar Adv. Gen. (Meghalaya), Ashok Parija(Odisha),
      Vivek Kohli, Advs. Gen.(Sikkim), Rajiv Rangan, Mahendra Singh Singhvi,
      Ashok Sharma, Atul Nanda, Purushendra Kaurav, Advs. Gen., Sanat
      Kumar, Dy. Adv. Gen., Jaideep Gupta, Ms. Meenakshi Arora, Ms. Manish
G     Lavkumar, Anand Grover, Ms. Indira Jaising, Sidharth Luthra, S.K.
      Rungta, Dr. Maneka Guruswamy, Yatin Oza, Dr. Abhishek Manu Singhvi,
      Bikash Ranjan Bhattacharya, P.S. Patwalia, Manish Tewari, Maninder
      Singh, C.S. Vaidyanathan, Rahul Mehra, Salman Khurshid, Tarun Gulati,
      Vikas Singh, Pradeep Kumar Rai, Ms. Mahalakshmi Pavani, Arijit
      Prasad, Brijender Chahar, Ms. Sonia Mathur, Vikas Pahwa, Dr. Ashwani
H     Kumar, Sr. Advs., Kunal Chatterjee, Mohit D. Ram, Rajat Nair, Kanu
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                         271
              SERVICES DURING PANDEMIC

Agrawal, Digvijay Dam, Amit Sharma, B.V. Balaram Das, Gurmeet             A
Singh Makker, Amit Mahajan, Prashant Singh, Raj Bahadur Yadav, A.P.
Mayee, Ms. Rajeshwari Hariharan, R. Sathyanarayanan, Ms. Nupur
Kumar, Ms. Mantika Haryani, Ms. Astha Sharma, Nipun Saxena, Paras
Nath Singh, Umang Tyagi, Ms. Serena Sharma, Adit S. Pujari, Ms. Kajal
Dalal, Simranjeet Singh Rekhi, Sridhar Potaraju, Ms. Petal Chandhok,
                                                                          B
Gaichangpou Gangmei, M/S. Trust Legal, Avijit Mani Tripathi, Shaurya
Sahay, Ms. Rekha Bakshi, Prashant Bhushan, Ms. Cheryl D’souza,
Deepak Masih, Ms. Manreet Kaur, R.N. Keswani, Mrs. Ketaki
Goswami, Nitin Saluja, Ayush Kaushik, Anjag Gautam, Mahfooz Ahsan
Nazki, Polanki Gowtham, Shaik Mohamad Haneef, T. Vijaya Bhaskar
Reddy, Amitabh Sinha, K.V. Girish Chowdary, Shrey Sharma, Sumit           C
Pragal, Ms. Amita Singh Kalkal, Vishnu Shankar Jain, Ms. Manju Jetley,
Ms. Shobha Gupta, Ms. Medha Garg, Summer Sodhi, Ms. Simran
Agarwal, Chaitanya, Anilendra Pandey, Ms. Suchita Dixit, Sandeep,
Manish Kumar, Ms. Pragya Baghel, Kumar Anurag Singh, Ms. Pallavi
Langar, Govind Manoharan, Ibad Mushtaq, Ms. Aishwarya Murali, Victor
                                                                          D
Das, Ms. Ambika Mathur, Mrs. Shally Bhasin, Ms. Charu Ambwani,
Purvish Jitendra Malkan, Rasesh Parikh, Masoom Shah, Ms. Dharita
Purvish Malkan, Ms. Deepa Gorasia, Alok Kumar, Ms. Neha Ambashtha,
Ms. Nandini Chhabra, Ms. Bhavna Sarkar, J. Sai Deepak, Guruswamy
Nataraj, Ms. Pooja Dhar, V. Shyamohan, Surya Prakash, M/s. Kmnp
Law, Amarjit Singh Bedi, Raj Bahadur Yadav, Amit Bhandari, Sandeep        E
Kumar Jha, Abhay Nevagi, Amit Singh, Dhiraj Abraham Philip,
Pukhrambam Ramesh Kumar, Ms. Anupama Ngangom, Karun Sharma,
Ms. Anindita Mitra, Samim Ahammed, Ms. Supratik Sarkar, Arnab Sinha,
Ms. Sayanti Sengupta, Jamir Khan, S.P.M. Tripathi, Ms. Swagoti Batchas,
Satish Kumar, Karan Bharihoke, Ms. Neha Sahai Bharihoke, Yajur Bhalla,
                                                                          F
Deepak Samota, Rohit Kumar Pihal, Ashish Vajpayee, Siddharth
Srivastava, Shubham Bhalla, Pashupathi Nath Razdan, Palav Agarwal,
Sudhanshu Kaushesh, K.P. Jayaram, Astik Gupta, Ms. Maitrayee Jagat
Joshi, Arjun Garg, Aakash Nandolia, Ms. Shrutika Garg, Sunny Choudhary,
Pradeep Kumar Yadav, Abhay Singh, Ms. Shikha Yadav, Shreekant
Verma, Virender Kumar Mumwalia, Sanjeev Malhotra, Ramesh Babu             G
M. R., Abhay Panday, Ms. Manisha Singh, Varun Singh, K. V.
Jagdishvaran, Ms. G. Indira, Saurabh Kansal, Vikas Jain, Aviral Saxena,
Ashu Choudhary, Shantanu Kumar, Mohd. Azhar, Manjeet Rathor, Ms.
Ruchira Gupta, Shishir Deshpande, Anurag Sharma, Himanshu Chaubey,
Shuvodeep Roy, Ms. Diksha Rai, Ms. Ninmisha Menon, Gautam Narayan,
                                                                          H
272             SUPREME COURT REPORTS                           [2021] 5 S.C.R.


A     Satyakam, Ms. Asmita Singh, Adithya Nair, Avinash B. Amarnath, G.
      M. Kawoosa, Ms. Taruna Ardhendumauli Prasad, Parth Awasthi, Ms.
      Lubna Naaz, Ms. Kunika, Zafar Khurshid, Akhand Pratap Singh Chauhan,
      Tungesh, Ms. Nupur Kumar, Chirag M. Shroff, Ms. Disha Jham, Ms. B.
      Vijayalakshmi Menon, Devashish Bharukha, Rajiv Shankar Dvivedi, Niraj
      Kumar, Mrs. Jaya Bharukha, Ravi Bharuka, Ms. Sarvshree, Justine
B
      George, Ms. Shrishti Agarwal, Ankit Agarwal, Ms. Taniya Bansal, Rohit
      Anil Rathi, Balaji Srinivasan, Ms. Garima Jain, Ms. Pallavi Sengupta,
      Ms. Lakshmi Rao, Ms. Aishwarya Choudhary, Ms. Aakriti Priya,
      Mohammed Sharukh, Prateek Yadav, Ankit Goel, Shibashish Misra,
      Deepak Prakash, Manoj V. George, Ms. Shilpa Liza George, Panmei,
C     Amit Kumar, Sriram P., Ms. Pallavi Pratap, Dr. Monika Gusain, Suhaan
      Mukerji, Vishal Prasad, Ms. Deepeika Kalia, Nikhil Parikshith, Abhishek
      Manchanda, Kapish Seth, Mrityanjai Singh, Savandeep Pahari, M/s. PLR
      Chambers & Co., Annam D. N. Rao, Dr. A. P. Singh, Sadashiv, V. P.
      Singh, Ms. Geeta Chauhan, Ms. Richa Singh, Sharwan Kumar Goyal,
      Jai Gopal Saboo, Jaswant Singh Rawat, Meenesh Dubey, Ms. Ritu
D
      Bhardwaj, Anupam Mishra, Ms. Nina Gupta, Ms. K.V. Bharathi
      Upadhyaya, Mukesh Kumar Singh, Ms. Sasmita Tripathy, Prashant Singh,
      Ms. Prerna Kumari, Ms. Seema Patnaha, Ms. Nandini Gupta, Rahul
      Kaushik, Sameer Abhyankar, S. Udaya Kumar Sagar, Ms. Sweena Nair,
      Abhimanyu Tewari, Ms. Eliza Bar, V. N. Raghupathy, Sharath Nambiar,
E     P. Venkat Reddy, Prashant Tyagi, P. Srinivas Reddy, M/S. Venkat Palwai
      Law Associates, Mrs. K. Enatoli Sema, Amit Kumar Singh, Apratim
      Animesh Thakur, Ms. Prachi Hasija, Siddhesh Kotwal, Ms. Manya Hasija,
      Ms. Ana Upadhyay, Nirnimesh Dubey, Gaurav Yadava, Ms. Veena
      Bansal, Sushil Kumar Anand, Sanjay Kumar Visen, Ms. Raushan Tara
      Jaswal. Advs. for Appearing Parties.
F
            Sachit Jolly, In-person, Devasish Garg, Parvesh Sahib Singh Verma-
      Applicants-in-Person.
            The following Order of the Court was passed:
                                       ORDER
G
             This order has been divided into the following sections to facilitate
      analysis:
            A      Introduction
            B      Submission by Counsel
H
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                                273
              SERVICES DURING PANDEMIC

       C      National Vaccination Policy                                        A
       D      Separation of Powers
       E      Issues with the Liberalized Vaccination Policy
              E.1 Vaccine Procurement and Distribution among
              Different Categories of the Population                             B
              E.2 Effects of Vaccination by Private Hospitals
              under the Liberalized Vaccination Policy
              E 3 Basis and Impact of Differential Pricing
              E.4 Vaccine Logistics
                                                                                 C
              E.5 Digital Divide
       F      Conclusion
       A. Introduction
       1. Proceedings in the present suo motu writ petition were initiated       D
on 22 April 2021, when this Court took cognizance of the management
of the COVID-19 pandemic during the second wave. Subsequently,
hearings were conducted on 23 April 2021, 27 April 2021 and 30 April
2021 when submissions were heard on behalf of the Union of India1,
States/Union Territories2, learned Amici appointed by this Court and some
of the intervenors.                                                              E

       2. On 30 April 2021, this Court passed a detailed order in relation,
inter alia, to the following issues: vaccination policy, supply of essential
drugs, supply of medical oxygen, medical infrastructure, augmentation
of healthcare workforce and the issues faced by them, and issues of
freedom of speech and expression during the COVID- 19 pandemic. In               F
its order, this Court had noted that its observations and directions were
in consonance with a bounded-deliberative approach 3 and hence, the
UoI was directed to re-consider its policies on the above issues, taking
into account this Court s observations.
                                                                                 G
1
  “UoI”/interchangeably referred to as the “Central Government”
2
  “UTs”
3
  Sandra Fredman, “Adjudication as Accountability: A Deliberative Approach” in
Nicholas Bamforth and Peter Leyland (eds), Accountability in the Contemporary
Constitution (Oxford University Press, 2013)
                                                                                 H
274             SUPREME COURT REPORTS                            [2021] 5 S.C.R.


A            3. Following the order dated 30 April 2021, another two judge
      Bench of this Court heard a Special Leave Petition4 against an order of
      the High Court of Delhi in relation to the supply of medical oxygen to the
      National Capital Territory5 of Delhi. During the course of the proceedings
      in that matter, the Bench primarily issued directions in relation to the
      supply of medical oxygen to the NCT of Delhi. However, through its
B
      order dated 6 May 2021, it also constituted a National Task Force to
      provide a public heath response to the COVID-19 pandemic on the basis
      of a scientific approach. The terms of reference of this National Task
      Force included, inter alia, assessing and making recommendations for
      the need, availability and distribution of medical oxygen; devising a
C     methodology for allocation of medical oxygen and periodical review of
      the allocation based on the stage of the pandemic; providing
      recommendations for augmenting the supplies of oxygen; facilitating audits
      in each State/UT to determine whether oxygen supplies had reached its
      destination; efficacy, transparency and efficiency of the distribution
      networks within the State/UT; providing recommendations for ensuring
D
      availability of essential drugs, augmentation of medical and paramedical
      staff, management of the pandemic and treatment of cases.
            4. During the course of the proceedings on 31 May 2021, we had
      the benefit of perusing the details provided in the affidavit filed by the
      UoI on 9 May 2021. The submissions contained in the affidavit were
E     supplemented and updated in the hearing by Mr Tushar Mehta, learned
      Solicitor General of India, appearing on behalf of the Central
      Government. We have further heard the learned Amici, Mr Jaideep Gupta
      and Ms Meenakshi Arora, learned Senior counsel.
             5. Since the last hearing in this matter, the second wave of the
F     COVID-19 pandemic has started receding across the nation and the
      situation appears to have become more manageable. Hence, some of
      the issues discussed in the previous orders can await further deliberation.
      However, the issue of vaccination is absolutely crucial, since health
      experts globally agree that vaccination of the nation’s entire eligible
G     population is the singular most important task in effectively combating
      the COVID-19 pandemic in the long run. Hence, during the course of
      the proceedings on 31 May 2021, this Court has limited itself to hearing
      submissions on the UoI s vaccination policy and its roadmap for the
      4
        Union of India vs Rakesh Malhotra and another, SLP (Civil) (Diary) No 11622
      of 2021
      5
H       “NCT”
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                              275
              SERVICES DURING PANDEMIC

future. By way of abundant clarification, we note that all of the issues       A
contained in this Court’s previous orders still retain their overall
importance, and this Court shall continue to monitor them alongside the
National Task Force and intervene whenever necessary.
       6. It is also important to note that numerous interlocutory
applications and affidavits by individual State/UT Governments and             B
members of civil society have been filed before us in this matter. We
have perused them to understand the key issues being raised there, along
with the helpful notes provided by the Amici.
      B. Submission by Counsel
       7. Mr Tushar Mehta, learned Solicitor General, relying on the UoI       C
s affidavit dated 9 May 2021, has made the following submissions to
supplement it, in view of the recent updates:
      (i)     The vaccination drive will be complete by the end of
              December 2021, and the Central Government is in active
              talks with foreign vaccine manufacturers at the highest          D
              political and diplomatic levels, to ensure the adequate supply
              of vaccines;
      (ii)    It would be incorrect to state that a consequence of the
              UoI s updated policy on vaccination of those in the 18-44
              age group is that there will be competition amongst the          E
              States/UTs; and
      (iii)   Everyone above the age of 45 years can continue to get
              vaccinated at a facility through on-site registration, without
              previously having to book an appointment through CoWIN.
                                                                               F
       8. Mr Jaideep Gupta and Ms Meenakshi Arora, learned Senior
counsel and Amici, have raised the following issues relating to vaccination
distribution, augmentation of vaccine production and differential pricing
of vaccines and the future preparedness for dealing with the COVID-
19 pandemic:
      (i)     With respect to the procurement of vaccines, reports             G
              suggest that foreign vaccine manufacturers are generally
              not receptive or open to a dialogue with State/UT
              Governments on the basis that, as a matter of corporate
              policy, they only deal with federal governments of different
              nations;                                                         H
276                 SUPREME COURT REPORTS                         [2021] 5 S.C.R.


A            (ii)     Since 1978 till 1 May 2021, the UoI has implemented the
                      Universal Immunization Programme6 under which essential
                      vaccines were procured by the UoI and were distributed to
                      States/UTs free of cost for administering them to the end
                      beneficiary. The said policy has held the test of times. Even
                      during the vaccination drive for COVID-19 in phases 1 and
B
                      2 for vaccination of healthcare workers7, frontline workers8
                      and persons above the age of 45 years, the UoI procured
                      all the vaccines and distributed them to State/UT
                      Governments for administration. The single procurement
                      model has also been followed by other nations for ensuring
C                     fast and effective administration of vaccines against
                      COVID-19;
             (iii)    The UIP has been replaced by the Liberalized Pricing and
                      Accelerated National COVID-19 Vaccination Strategy9
                      from 1 May 2021 in phase 3 of the vaccination drive,
D                     whereby State/UT Governments or private hospitals are
                      required to procure vaccines for persons between the age
                      group of 18-44 years from the private manufacturers on
                      the basis of a pro rata quota set by the UoI;
             (iv)     The Liberalized Vaccination Policy leaves the State/UT
E                     Governments to fend for themselves, rather than the Central
                      Government acting on behalf of the entire nation. As a
                      consequence, the vaccine manufacturers are free to
                      implement a differential procurement price for the UoI for
                      vaccinating persons above 45 years of age, and for the State/
                      UT Governments and private hospitals for vaccinating the
F                     persons between 18-44 years of age;
             (v)      While the Liberalized Vaccination Policy has been introduced
                      to spur competitive prices, there are multiple States/UTs
                      competing to purchase a scarce commodity from a few
                      vaccine manufacturers. Consequently, the manufacturers
G                     have the advantage of creating a monopoly and selling it at
                      any price that they desire to private healthcare institutions.
      6
        “UIP”
      7
        “HCWs”
      8
        “FLWs”
      9
H       “Liberalized Vaccination Policy”
IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                             277
          SERVICES DURING PANDEMIC

         The State/UT Governments do not enjoy the unique position        A
         of the UoI, which has the advantage of being a monopolistic
         buyer and can negotiate an appropriate price for the vaccines
         on behalf of the entire population of India;
 (vi)    The Liberalized Vaccination Policy puts an undue burden
         on persons between the age group of 18-44 years,                 B
         specifically persons belonging to a poor socio- economic
         background, who have to purchase two doses of vaccines
         either from the State/UT Governments or private hospitals;
 (vii)   In the alternative, the UoI has stated that all State/UT
         Governments have agreed to vaccinate their population free       C
         of cost and have undertaken to bear the burden of the
         vaccines which are available at a higher purchase price
         than the one available to the UoI. Thus, the end beneficiary
         is not impacted by the differential pricing in the Liberalized
         Vaccination Policy. With regard to this submission, the Amici
         have raised the following concerns:                              D

         (a)   While some States/UTs have announced that they
               will vaccinate their population for free, this policy
               statement must be confirmed by the State/UT
               Governments on affidavit before this Court. The
               Liberalized Vaccination Policy as it stands today, does    E
               not incorporate a condition whereby the cost of
               vaccination is imposed on the State/UT Governments.
               Instead, the end beneficiary is liable to pay the cost.
               There is a necessity for the State/UT Governments
               to place their decisions on record and for it to be part   F
               of the formal policy, such that persons can enforce
               their right to free vaccination, including before the
               courts;
         (b)   Although the State/UT Governments may have
               announced free vaccination for their population, some      G
               of them are contesting the Liberalized Vaccination
               Policy before this Court and have advanced
               submissions for universal vaccination by the Central
               Government. Thus, it cannot conclusively be stated
               that State/UT Governments have agreed to the policy
                                                                          H
278      SUPREME COURT REPORTS                           [2021] 5 S.C.R.


A                  decision taken by the Central Government of deviating
                   from the single procurement model;
             (c)   The Liberalized Vaccination Policy, as a consequence
                   of its differential pricing, treats individuals living
                   across India residing in different States/UTs
B                  unequally, as States/UTs that are financially distressed
                   may not be able to afford to purchase the vaccines
                   at the prices set by the vaccine manufacturers or to
                   lift the quantity allocated to them; and
             (d)   The end result of the Liberalized Vaccination Policy
C                  is that the UoI can purchase vaccines at Rs 150 per
                   dose for Covishield and Covaxin, while the State/UT
                   Governments have to pay Rs 300 and Rs 400 per
                   dose respectively. If the UoI were to be the single
                   procurement agency for all vaccines at a fixed cost,
                   then the cost of vaccination to the public exchequer
D                  would be substantially lower. Thus, it is incorrect to
                   suggest that the end beneficiary, who contributes to
                   the public exchequer, will not be unduly impacted;
      (viii) Although public health is a subject under Entry 6 of List II
             (State List) of the Seventh Schedule to the Constitution,
E            Entry 81 of List I (Union List) deals with inter-State
             migration and inter-State quarantine and Entry 29 of List
             III (Concurrent List) deals with prevention of extension from
             one State to another of infectious or contagious diseases.
             Thus, the management of the pandemic, control of the
F            spread of COVID-19, vaccination policy and pricing, are
             the responsibility of the Central Government, which must
             work in tandem with the State/UT Governments. The
             Liberalized Vaccination Policy, by putting the burden of
             vaccination of persons between 18-44 years of age on the
             State/UT Governments, conflicts with this constitutional
G            balance of responsibilities between the Centre and States/
             UTs;
      (ix)   With regard to the vaccine distribution, the Liberalized
             Vaccination Policy has created a quota of 50:25:25 for the
             18-44 age group. The quota of 25% that is available to State/
H
IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                              279
          SERVICES DURING PANDEMIC

         UT Governments, which is equivalent to the private                A
         hospitals, is extremely disproportionate and not in touch with
         societal realities, as a large number of persons may not be
         able to afford two doses of a vaccine from a private
         hospital. Thus, if State/UT Governments are to bear the
         burden of vaccinating a majority of the persons in their
                                                                           B
         States/UTs, the quota available to the private hospitals must
         be reduced;
 (x)     The Liberalized Vaccination Policy does not provide any
         clarity on the basis of the pro rata allotment of the doses to
         each State/UT (available for purchase by the State/UT
         Government and private hospitals). The Policy does not            C
         indicate whether such apportionment will be on the basis of
         population; state of the pandemic in each State/UT; or the
         number of persons with co- morbidities between 18-44 years
         of age, among others. Further, the Policy does not indicate
         whether the pro rata allotment will be made by the UoI or         D
         the private vaccine manufacturer;
 (xi)    It is reported that UoI on certain occasions has stated that
         it will refrain from interfering in the issue of vaccine
         distribution. Contrarily, UoI has also been stated that it may
         decide to redistribute the vaccines procured by it among          E
         State/UT Governments. The basis on which the re-
         distribution of vaccines will take place among States/UTs
         has not been provided in the policy document;
 (xii)   The Liberalized Vaccination Policy does not provide for
         prioritizing of persons with co-morbidities; persons with         F
         disabilities or suffering from other illnesses; care-givers for
         the elderly and sick; teachers and others in the age group
         of 18-44 years. Further, the CoWIN application is not built
         with functions which prioritize a certain category of persons,
         as it only books appointments on a first-cum-first-served
         basis;                                                            G
 (xiii) News reports indicate that crematorium workers have either
        not been vaccinated, or are unaware that they are eligible
        for vaccination in phases 1 and 2;

                                                                           H
280                 SUPREME COURT REPORTS                          [2021] 5 S.C.R.


A              (xiv) With regard to preparedness, the UoI has claimed that it
                     will be able to vaccinate a substantial number of persons
                     (around 100 crore persons requiring 200 crore doses) by
                     December 2021. However, no projections have been shared
                     with this Court regarding how this target would be achieved.
                     Based on reports, it appears that the UoI has factored a
B
                     number of vaccines that are currently in their development
                     stages to reach its projected number of 200 crore doses.
                     This approach would be misguided as the success and
                     efficacy of vaccines that are currently in the stage of clinical
                     trials is uncertain and cannot be guaranteed;
C              (xv) There is material to suggest that the augmentation of vaccine
                    production will be inadequate to vaccinate the population
                    between 18-44 years of age. The total population of this
                    age group is 59 crores, which would require around 122
                    crore doses. Based on reports, the existing manufacturers
D                   (Serum Institute of India 10 and Bharat Biotech India
                    Limited11) will be able to produce less than 10 crore doses
                    per month. Optimistically, around 15-20 crores doses of
                    Sputnik V will be available per month. At this rate, it would
                    take around 12 months for the population in this age group
                    to be inoculated, by which time the virus may have mutated,
E                   causing further waves of the pandemic;
               (xvi) Meanwhile, there is a necessity to ensure that guidelines
                     regarding standardization of masks are formulated and
                     publicized. Thus, medical guidance is necessary to ensure
                     that masks of appropriate quality are produced and
F                    distributed free of cost to curb the spread of the infection;
                     and
               (xvii) It has been reported that due to dearth of electric
                      crematoria, persons who have succumbed to COVID-19
                      are not dignified with a proper cremation and are cremated
G                     without any rituals. The UoI and State/UT Governments
                      may consider forming appropriate guidelines which augment
                      the creation of infrastructure for electric crematoria and a

      10
           “SII”
      11
H          “BBIL”
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               SERVICES DURING PANDEMIC

               protocol for cremation of the dead.                                    A
       C. National Vaccination Policy
       9. Phase 1 of the National COVID-19 Vaccination Strategy was
launched on 16 January 2021 and 1 February 2021 and was targeted
towards protecting HCWs and FLWs. Phase 2 was initiated on 1 March
2021 and 1 April 2021, and was directed towards protecting the most                   B
vulnerable population in the age group of persons above 45 years of
age. In phase 1 and 2, the UoI was procuring the vaccines and distributing
them to the States/UTs free of cost for disbursal through government
and private COVID-19 vaccination centres. The private facilities were
not allowed to charge a sum above Rs 250 per person per dose (Rs 150                  C
for vaccines and Rs 100 as operational charges) from a beneficiary.
       10. During phase 2, eligible beneficiaries could register and book
appointments for vaccination on the CoWIN 2.0 portal or other IT
applications such as Aarogya Setu. From 1 March 2021 onwards, the
population aged 60 years or which would attain the age of 60 years or                 D
more as on 1 January 2022 was eligible to register on the CoWIN
platform. Further, persons who were aged 45 years or would attain the
age of 45 years to 59 years as on 1 January 2022 and had any of the 20
specified co-morbidities were also eligible to register on the CoWIN
platform. From 1 April 2021 onwards, all persons who were aged 45
years or would attain the age of 45 years to 59 years as on 1 January                 E
2022 were eligible to register on the CoWIN platform. On-site registration
facility was also made available at vaccination centres in this phase.
      11. In phase 3, a Liberalized Vaccination Policy was introduced
by the UoI, which came into effect on 1 May 2021. We have perused
the documents available in the public domain (guidance note12, press                  F
releases13 and policy document14) issued by the Central Government to
understand the written policy of the Central Government with regard to
phase 3. Based on such documents, the main elements of the Liberalized
Vaccination Policy can be identified as:
12
   Guidance Note For COWIN 2.0 dated 28 February 2021, available at <https://         G
www.mohfw.gov.in/pdf/GuidancedocCOWIN2.pdf>
13
   Press releases dated 28 February 2021 and 19 April 2021, available at <https://
pib.gov.in/PressReleseDetail.aspx?PRID=1701549> and <https://pib.gov.in/
PressReleseDetail.aspx?PRID=1712710>
14
   Liberalized Pricing and Accelerated National Covid-19 Vaccination Strategy dated
24 April 2021, available at <https://www.mohfw.gov.in/pdf
LiberalisedPricingandAcceleratedNationalCovid19VaccinationStrategy 2042021.pdf>       H
282                    SUPREME COURT REPORTS                          [2021] 5 S.C.R.


A               (i)      Vaccine manufacturers are required to supply 50% of their
                         monthly Central Drugs Laboratory15 doses to the UoI and
                         would be free to supply the remaining 50% doses to State/
                         UT Governments and in „other than Government of India
                         channel 16;
B               (ii)     Manufacturers were required to make a declaration of the
                         price of the 50% supply that would be available to State/
                         UT Governments and in the „other than GoI channel before
                         1 May 2021. Based on this price, States/UTs, private
                         hospitals and industrial establishments through their hospitals
                         may procure vaccines from the manufacturers. Private
C                        hospitals would be able to procure their supplies only from
                         the 50% supply earmarked for ‘other than GoI channel’ ;
                (iii)    The prices charged for vaccination by private hospitals
                         would be monitored. As a result, the earlier dispensation
                         where private COVID-19 vaccination centres which
D                        received doses from the UoI could charge up to Rs 250 per
                         dose ceased to exist;
                (iv)     The population which is now eligible to obtain vaccines at
                         UoI s vaccination centres is limited to HCWs, FLWs and
                         those above 45 years of age. The population between 18-
E                        44 years is eligible to obtain vaccines from ‘other than GoI
                         channel;’
                (v)      The vaccination would continue to be available for free for
                         eligible population groups in those vaccination centres which
                         receive their vaccine doses from UoI;
F
                (vi)     The vaccination would continue to be a part of the National
                         Vaccination Programme and would follow all existing
                         guidelines. The CoWIN platform would capture the
                         vaccination, stocks and price per vaccination applicable in
                         all vaccination centres. The vaccination drive would comply
G                        with ‘Adverse Event Following Immunization’ management
                         and reporting, digital vaccination certificate and all other
                         prescribed norms;

      15
           “CDL”
      16
H          “other than GoI channel”
       IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                               283
                 SERVICES DURING PANDEMIC

          (vii)   The division of 50% supply to UoI and 50% to ‘other than         A
                  GoI channel’ would be applicable uniformly across all the
                  vaccine manufactures in the country;
          (viii) The fully ready to use imported vaccines are allowed to be
                 utilized entirely in the ‘other than GoI channel’ ; and
          (ix)    The UoI from its share will allocate vaccines to States/         B
                  UTs based on criteria of performance (speed of
                  administration, average consumption) and extent of infection
                  (number of COVID-19 cases). Wastage of vaccines would
                  also be considered in the criteria and would affect the
                  allocation negatively. Based on the above criteria, a State-     C
                  wise quota would be decided and communicated to the
                  States/UTs in advance.
       12. The facility of only online appointment on the CoWIN portal
was initially introduced for the entirety of the population between the
ages of 18-44 years. Later, on 24 May 202117, the UoI announced that               D
on-site registration will be made available for the 18-44 years age group.
However, this is contingent on: (i) the State/UT Government enabling
this policy; and (ii) only in cases of wastage at a particular government
COVID-19 vaccination centre due to a no-show by an online appointee.
Further, this facility has not been expanded to private COVID-19
vaccination centres.                                                               E

          D. Separation of Powers
       13. At the outset, we seek to clarify the nature of this Court s
jurisdiction in the exercise of the power of judicial review over the
management of the COVID-19 pandemic in India. In its affidavit dated               F
9 May 2021, the UoI has highlighted a few concerns which are detailed
below:
          (i)     The executive is battling an unprecedented crisis and the
                  government needs discretion to formulate policy in larger
                  interest and its wisdom should be trusted;
                                                                                   G
          (ii)    The current vaccine policy conforms to Articles 14 and 21
                  of the Constitution, and requires no interference from the
                  courts as the executive has “room for free play in the joints”

17
     Available at <https://www.pib.gov.in/PressReleasePage.aspx?PRID=1721225>      H
284                   SUPREME COURT REPORTS                       [2021] 5 S.C.R.


A                       while dealing with a pandemic of this magnitude;
                (iii)   The current steps are thoughtfully undertaken to tide over
                        an imminent crisis, which may turn out to be imprudent in
                        the long run. However, they need to be appreciated from a
                        short-term and holistic perspective;
B               (iv)    Judicial review over executive policies is permissible only
                        on account of manifest arbitrariness. No interference from
                        judicial proceedings is called for when the executive is
                        operating on expert medical and scientific opinion to tackle
                        a medical crisis; and
C               (v)     Any over-zealous judicial intervention, though well-meaning,
                        in the absence of expert advice or administrative experience
                        may lead to unintended circumstances where the executive
                        is left with little room to explore innovative solutions.
             14. It is trite to state that separation of powers is a part of the
D     basic structure of the Constitution. Policy-making continues to be in the
      sole domain of the executive. The judiciary does not possess the authority
      or competence to assume the role of the executive, which is
      democratically accountable for its actions and has access to the resources
      which are instrumental to policy formulation. However, this separation
E     of powers does not result in courts lacking jurisdiction in conducting a
      judicial review of these policies18. Our Constitution does not envisage
      courts to be silent spectators when constitutional rights of citizens are
      infringed by executive policies. Judicial review and soliciting constitutional
      justification for policies formulated by the executive is an essential
      function, which the courts are entrusted to perform.
F
             15. We had clarified in our order dated 30 April 2021, that in the
      context of the public health emergency with which the country is currently
      grappling, this Court appreciates the dynamic nature of the measures.
      Across the globe, the executive has been given a wider margin in enacting
      measures which ordinarily may have violated the liberty of individuals,
G     but are now incumbent to curb the pandemic. Historically, the judiciary
      has also recognized that constitutional scrutiny is transformed during
      such public health emergencies, where the executive functions in rapid
      consultation with scientists and other experts. In 1905, the Supreme Court
      18
           DDA vs Joint Action Committee, (2008) 2 SCC 672
H
     IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                                 285
               SERVICES DURING PANDEMIC

of the United States in Jacobson vs Massachusetts19 considered a                   A
constitutional liberty challenge to a compulsory vaccination law that was
enacted to combat the smallpox epidemic. Justice Harlan had noted the
complex role of the government in battling public health emergencies in
the following terms:
       “..the State may invest local bodies called into existence for              B
       purposes of local administration with authority in some appropriate
       way to safeguard the public health and the public safety... While
       this court should guard with firmness every right appertaining to
       life, liberty or property as secured to the individual by the Supreme
       Law of the Land, it is of the last importance that it should not
       invade the domain of local authority except when it is plainly              C
       necessary to do so in order to enforce that law. The safety and
       the health of the people of Massachusetts are, in the first instance,
       for that Commonwealth to guard and protect……So far as they
       can be reached by any government, they depend, primarily, upon
       such action as the State in its wisdom may take, and we do not              D
       perceive that this legislation has invaded any right secured by the
       Federal Constitution.”
      The Supreme Court of United States, speaking in the wake of the
present COVID-19 pandemic in various instances, has overruled policies
by observing, inter alia, that “Members of this Court are not public               E
health experts, and we should respect the judgment of those with
special expertise and responsibility in this area. But even in a
pandemic, the Constitution cannot be put away and forgotten” 20
and “a public health emergency does not give Governors and other
public officials carte blanche to disregard the Constitution for as
long as the medical problem persists. As more medical and scientific               F
evidence becomes available, and as States have time to craft policies
in light of that evidence, courts should expect policies that more
carefully account for constitutional rights”21.
      16. Similarly, courts across the globe have responded to
constitutional challenges to executive policies that have directly or              G

19
   197 U.S. 11 (1905)
20
   Roman Catholic Diocese of Brooklyn, New York vs Cuomo, 592 U.S., 141 S. Ct.
63
21
   Calvary Chapel Dayton Valley vs Steve Sisolak, Governor of Nevada, et al, 140
S.Ct. 2603 (Mem) (Justice Alito Dissenting Opinion)                                H
286                   SUPREME COURT REPORTS                      [2021] 5 S.C.R.


A     indirectly violated rights and liberties of citizens. Courts have often
      reiterated the expertise of the executive in managing a public health
      crisis, but have also warned against arbitrary and irrational policies being
      excused in the garb of the “wide latitude” to the executive that is
      necessitated to battle a pandemic. This Court in Gujarat Mazdoor Sabha
B     vs State of Gujarat22, albeit while speaking in the context of labour
      rights, had noted that policies to counteract a pandemic must continue to
      be evaluated from a threshold of proportionality to determine if they,
      inter alia, have a rational connection with the object that is sought to be
      achieved and are necessary to achieve them.
C
             17. In grappling with the second wave of the pandemic, this Court
      does not intend to second-guess the wisdom of the executive when it
      chooses between two competing and efficacious policy measures.
      However, it continues to exercise jurisdiction to determine if the chosen
      policy measure conforms to the standards of reasonableness, militates
D     against manifest arbitrariness and protects the right to life of all persons.
      This Court is presently assuming a dialogic jurisdiction where various
      stakeholders are provided a forum to raise constitutional grievances with
      respect to the management of the pandemic. Hence, this Court would,
      under the auspices of an open court judicial process, conduct deliberations
      with the executive where justifications for existing policies would be
E
      elicited and evaluated to assess whether they survive constitutional
      scrutiny.
                E. Issues with the Liberalized Vaccination Policy
           E.1 Vaccine Procurement and Distribution among Different
F     Categories of the Population
              18. In our order dated 30 April 2021, the UoI was directed to
      clarify its vaccination procurement and distribution policy, especially after
      the introduction of the Liberalized Vaccination Policy. We had also
      directed the UoI to apprise this Court regarding the projected numbers
G     of vaccinations that would be made available in the coming months to
      the public and the efforts being taken to augment vaccine production. In
      its affidavit dated 9 May 2021, UoI has made the following submissions:
                (i)     The vaccination policy for COVID-19 that was adopted
                        prior to 1 May 2021 in phases 1 and 2, was designed as a
H     22
           AIR 2020 SC 4601, para 9
IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                              287
          SERVICES DURING PANDEMIC

         system of prioritization. After vaccinating the HCWs and          A
         FLWs, vaccination was opened up for age groups on
         account of their heightened vulnerability and mortality to
         COVID-19, in consonance with the WHO guidelines and
         international practice;
 (ii)    In phase 1, HCWs (starting from 16 January 2021) and              B
         FLWs (starting from 2 February 2021) were vaccinated. In
         phase 2, persons above 60 years of age and persons over
         45 years of age with certain co-morbidities (starting from 1
         March 2021) and all persons over 45 years of age (starting
         from 1 April 2021) were eligible for vaccination. This priority
         was accorded in view of the fact that COVID-19 deaths             C
         across the world demonstrate that over 85% of all deaths
         occurred in the age group over 45 years;
 (iii)   FLWs such as municipal workers (including crematorium
         workers) and panchayat workers were also vaccinated in
         phase 1 of the vaccination drive;                                 D

 (iv)    With effect from 1 May 2021, the Liberalized Vaccination
         Policy was implemented as a response to repeated requests
         by State/UT Governments, and after detailed deliberations
         with domain experts. The parallel decentralized policy aims
         to achieve higher efficiency and reach;                           E

 (v)     Currently, vaccine manufacturers are obligated to supply
         50% of their monthly CDL released doses to the UoI and
         the remaining 50% doses to the “other than GoI channel”
         which can be procured by State/UT Governments, private
         hospitals and hospitals of industrial establishments to           F
         vaccinate persons in the age group of 18-44 years;
 (vi)    The priority of the UoI remains vaccinating persons aged
         45 years and above for free since they are more vulnerable.
         The simultaneous vaccinations for persons aged between
         18-44 years has been introduced to respect the wishes of          G
         the State/UT Governments. In view of the differential
         vulnerability and mortality rates, the Liberalized Vaccination
         Policy conforms to the mandate of Articles 14 and 21 of
         the Constitution;
                                                                           H
288                 SUPREME COURT REPORTS                          [2021] 5 S.C.R.


A             (vii)   In order to eliminate disparity in bargaining powers, “the
                      Central Government has, in consultation with the
                      vaccine manufacturers determined the pro-rata
                      population of each State in the age group of 18-44 and
                      each State will procure only that quantity”;
B             (viii) The Central Government will notify States/UTs, every
                     fortnight, on the quantity of vaccines that will be distributed
                     for vaccinating persons aged 45 years and above;
              (ix)    With regard to the augmentation of production of vaccines,
                      it is stated that the National Expert Group on Vaccine
C                     Administration for COVID-1923 had procured 6.6 crore
                      doses for the initial phases. Support for other vaccine
                      candidates under clinical development is being provided by
                      the ‘Mission COVID Suraksha the Indian COVID-19
                      Vaccine Development Mission’ ;

D             (x)     The Central Government is in talks with several vaccine
                      developers/manufacturers outside India and is seeking to
                      facilitate imports. The Drugs Controller General of India24
                      has already approved import of 1.5 lakh doses of the Sputnik
                      V vaccine by Dr Reddy s Laboratories ;

E             (xi)    The availability of vaccines for the next 6 months would be
                      difficult to project as it is dynamic and contingent on foreign
                      procurement and successful ramping of production by the
                      two existing manufacturers;
              (xii)   However, it is also stated that manufacturing capacity is
F                     being increased in the following terms:
                      (a)   SII: from 5 crore doses/month to 6.5 crore doses/
                            month by July 2021;
                      (b)    BBIL: from 90 lakh doses/month to 2 crore doses/
                             month, and further increase to 5.5 crore doses/month
G                            by July 2021; and
                      (c)   Sputnik V: from 30 lakh doses to 1.2 crore doses/
                            month by July 2021; and

      23
           “NEGVAC”
      24
H          “DCGI”
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                               289
              SERVICES DURING PANDEMIC

      (xiii) The regulatory and testing process for foreign vaccines has        A
             been simplified by the NEGVAC which now allows bridging
             trials (a nearly 4-month long process) of foreign vaccines
             to occur simultaneously with market development.
       19. Based on the response of the UoI and the submissions made
by the Amici, we understand that there are three broad issues that are of       B
concern: (i) vaccine distribution between different age groups; (ii) vaccine
procurement process; and (iii) the augmentation of the vaccine availability
in India.
       20. The affidavit of the UoI sufficiently clarifies the prioritization
of the groups in phases 1 and 2 for obtaining the COVID-19 vaccines.            C
These include HCWs, FLWs and persons above the age of 45 years.
The prioritization of these groups was based on the experience of India
and other countries during the first wave of the pandemic in 2020. It
was largely observed that these groups faced a higher risk of infection
and thus, it was necessary to inoculate them free of cost and on a priority
basis by the Central Government. During the vaccination for these groups,       D
the Central Government had allowed on-site registration and there was
no prior requirement for booking an appointment on CoWIN. Having
said that, the vaccination policy has been substantially changed for persons
between 18-44 years of age. The Liberalized Vaccination Policy requires
some of these persons to pay for the vaccines; limited vaccines are             E
made available for this category with the State/UT Governments/private
hospitals and an additional requirement of mandatory digital registration
and booking an appointment through CoWIN has been imposed, among
others. Unlike the prior policy, the Liberalized Vaccination Policy does
not prioritize persons with co- morbidities and other diseases, persons
with disabilities, or any other vulnerable groups. This is especially at        F
issue because the experience of the second wave of the pandemic has
provided an experiential learning that the COVID-19 virus is capable of
mutation and now poses a threat to persons in this age group as well.
Reports indicate that persons between 18-44 years of age have not only
been infected by COVID-19, but have also suffered from severe effects           G
of the infection, including prolonged hospitalization and, in unfortunate
cases, death. Due to the changing nature of the pandemic, we are now
faced with a situation where the 18-44 age group also needs to be
vaccinated, although priority may be retained between different age groups
on a scientific basis. Hence, due to the importance of vaccinating
                                                                                H
290             SUPREME COURT REPORTS                            [2021] 5 S.C.R.


A     individuals in the 18-44 age group, the policy of the Central Government
      for conducting free vaccination themselves for groups under the first 2
      phases, and replacing it with paid vaccination by the State/UT
      Governments and private hospitals for the persons between 18-44 years
      is, prima facie, arbitrary and irrational.
B             21. With regard to the procurement process for vaccinations which
      is to be followed in view of the Liberalized Vaccination Policy, there are
      a number of issues that need to be addressed. The Amici have indicated
      that many State/UT Governments and local municipal bodies have issued
      tenders and attempted to negotiate with foreign manufacturers but they
      have largely been unsuccessful, as foreign manufacturers are not inclined
C     to negotiate with individual State/UT Governments and prefer negotiating
      with federal governments of countries. Additionally, it has been urged
      that Central Government is also better placed to use its monopoly as a
      buyer (India being the second most populous country) to bargain for
      higher quantities of vaccines at reasonable prices. We find that the
D     submissions urged by the Amici are extremely pertinent and have
      indicated that in practice, the Liberalized Vaccination Policy may not be
      able to yield the desired results of spurring competitive prices and higher
      quantities of vaccines.
              22. Additionally, the Liberalized Vaccination Policy seeks to remove
E     the issue of bargaining disparities by stating that each State/UT would
      have a prefixed pro rata quota based on their population in the 18-44
      age group, 50% of which will be available to the State/UT Governments
      and 50% to the private hospitals. The Amici have raised concerns that
      there is a lack of clarity regarding whether the UoI will intervene in the
      distribution process. Given that inter-State barriers in India are porous
F     and persons are free to migrate and work in different parts of the country,
      it is essential to understand if the pro rata allotment will take into account
      such migration to more densely populated industrial and urban States/
      UTs. Other concerns, such as the stage of the pandemic, the healthcare
      infrastructure and existing capacities of a State/UT, the literacy rate,
G     age and overall health condition of its population, may also be relevant
      factors in making such a pro rata determination. The UoI should thus
      specify whether it seeks to address these concerns within the vaccination
      policy such that the State/UT Governments have a realistic assessment
      of the assistance they can anticipate from the UoI.

H
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                               291
              SERVICES DURING PANDEMIC

        23. We shall now address the issue related to augmentation of           A
vaccine production/availability. We have noted the submissions of the
UoI in its affidavit dated 9 May 2021, that it is difficult to predict the
projections for vaccines given that it depends on variable factors such
as introduction of new foreign vaccines, capability of increased production
by existing manufacturers, among others. Mr Tushar Mehta has during
                                                                                B
the course of his oral submissions stated that he is in a position to address
these concerns of this Court and that the UoI aims to vaccinate
approximately 100 crore persons by the end of December 2021. Mr
Mehta has agreed to provide a detailed roadmap regarding projected
availability of vaccines from the various vaccine manufacturers. It has
also been highlighted that the Central Government is in active negotiations     C
with various private foreign manufacturers to augment the availability of
vaccines in the near future.
      24. In view of the above, we direct the UoI to undertake a fresh
review of its vaccination policy addressing the concerns raised. Further,
we direct the UoI to provide the following clarifications:                      D
      •      As noted above, the UoI is directed to place on record a
             roadmap of projected availability of vaccines till 31
             December 2021;
      •      The preparedness with respect to specific needs of children
             in the event of a third wave of the pandemic in terms of           E
             medical infrastructure, vaccination trials and regulatory
             approval, and compatible drugs;
      •      Whether under the policy of the UoI, it is permissible for
             State/UT Governments or individual local bodies to access
             vaccine supplies of foreign manufacturers;                         F
      •      The number of crematorium workers vaccinated in phase
             1. A targeted drive can be conducted for vaccination of the
             remaining crematorium workers;
      •      The State/UT Governments are diverting the vaccines
                                                                                G
             (procured by them at a higher price than Central
             Government) for the persons in the age group of 18- 44
             years to vaccinate persons above 45 years of age, due to a
             shortage of vaccines being supplied by the Central
             Government. The manner in which the Central Government
                                                                                H
292                SUPREME COURT REPORTS                        [2021] 5 S.C.R.


A                    will factor this quantity and price differential into their
                     subsequent allocation and disbursal of vaccines to States/
                     UTs for the persons above 45 years of age; and
            •        The mechanism for redistribution, if the 25:25 quota in a
                     particular State/UT is not picked up by the State/UT
B                    Government or the private hospitals.
           E.2 Effects of Vaccination by Private Hospitals under the
      Liberalized Vaccination Policy
             25. Under the Liberalized Vaccination Policy covering persons in
      the age group of 18-44 years, the total vaccines produced will be divided
C     in a ratio of 50:25:25 between the Central Government, State/UT
      Governments and private hospitals. In its affidavit dated 9 May 2021,
      the UoI notes the following salient features of this Liberalized Vaccination
      Policy, in relation to vaccination by private hospitals:
            (i)      Out of the 50% quota allocated for the ‘other than GoI
D                    channel’, 50% will go to the State/UT Governments,
                     calculated on a pro rata basis as per the population. The
                     balance 50% would be open for private hospitals
                     procurement, based on contracts with the manufacturers.
                     As such, the State/UT Governments and private hospitals
E                    would each end up with 25% of the total CDL doses;
            (ii)     Vaccination through the private sector of 25% of the total
                     CDL quantity would reduce the operational stress on
                     government facilities and help with issues of crowding at
                     vaccination centres; and
F           (iii)    Paid vaccination through private hospitals has been
                     introduced for persons who can afford to pay, thereby
                     reducing the operational stress on the Government.
                     However, it has also been submitted that this policy may
                     undergo a change based on performance and future
                     availability of vaccines.
G
             26. As a consequence of this Liberalized Vaccination Policy, 50%
      of the population of any State/UT in the 18-44 age group is expected to
      pay for its vaccination. From the UoI’s affidavit, we understand that this
      has been done while taking into account the ability of a certain section of
      the population to pay for their vaccination. However, the present system
H
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                                293
              SERVICES DURING PANDEMIC

of allowing only digital registration and booking of appointment on              A
CoWIN, coupled with the current scarcity of vaccines, will ultimately
ensure that initially all vaccines, whether free or paid, are first availed by
the economically privileged sections of the society. As such, even those
who may have been able to afford a vaccine, may opt for a free vaccine
simply because of issues of availability, even if it would entail travelling
                                                                                 B
to far-flung rural areas. Hence, any calculations of the economic ability
of a given individual may not directly correspond to the vaccination route
(paid/unpaid) they opt for. Consequently, it is plausible that private
hospitals may have vaccine doses left over with them because everyone
who could afford them has either already bought it or availed of a free
vaccine, while those who need it may not have the ability to pay for it.         C
       27. Further consequences of the vaccination by private hospitals
under the Liberalized Vaccination Policy relate to a simple issue at the
core of their existence: that while they provide a public health service,
they still remain private, for-profit entities. Consequently, they may sell
the vaccine doses procured at a higher price, unless regulated stringently.      D
Private hospitals also may not sell all their vaccine doses publicly through
appointments on CoWIN, but rather sell them for lucrative deals directly
to private corporations who wish to vaccinate their employees. Finally,
private hospitals are not equally spread out across a State/UT and are
often limited to bigger cities with large populations. As such, a larger
quantity will be available in such cities, as opposed to the rural areas.        E

        28. It is pertinent to clarify here that we are not opposed to the
involvement of private hospitals in the vaccination drive. Private health
care institutions have an important role as well. The UoI has correctly
noted in its affidavit that these hospitals will reduce the burden on
government facilities. This was also happening earlier for the vaccination       F
of those above 45 years of age, where the Central Government was
providing these hospitals with vaccines and they were allowed to charge
patients a nominal fee (Rs 250). However, the issue is about the effect
of privatizing 50% of all vaccines available for the 18-44 age group. In
view of the above concerns, we direct the UoI to provide the following           G
clarifications:
       •      The manner in which Central Government will monitor the
              disbursal of vaccines to private hospitals, specifically those
              who have hospital chains pan India. Further, whether (i)
              private hospitals are liable to disburse vaccines pro rata         H
294                SUPREME COURT REPORTS                         [2021] 5 S.C.R.


A                    the population of States/UTs; and (ii) the mechanism to
                     determine if private players are genuinely administering the
                     lifted quota in that State/UT alone. The UoI shall place on
                     record any written policy in relation to this.
            •        Whether the Central Government conducted a “means-test”
B                    of the demographic of a State/UT to assert that 50% of the
                     population in the 18-44 age group would be able to afford
                     the vaccine. If not, the rationale for private hospitals being
                     provided an equal quota for procurement as the State/UT
                     Governments.
C           •        The manner in which the Centre and States/UTs shall ensure
                     an equitable distribution of vaccines across sections of the
                     society, and how this factors into the rationale of equal
                     apportionment between State/UT Governments and private
                     hospitals.

D           •        The nature of the intervention with respect to the final, end-
                     user price that is being charged by private hospitals,
                     especially when a cap on procurement by the private
                     hospitals has been set.
            E.3 Basis and Impact of Differential Pricing
E           Impact of differential pricing
             29. In our order dated 30 April 2021, we had elicited the UoI’s
      justification for enabling decentralized procurement where a pre-fixed
      and differential price was set for the Central Government, States/UTs
      and private hospitals. The UoI through its affidavit dated 9 May 2021,
F     has submitted the following:
            (i)      The Liberalized Vaccination Policy was introduced to
                     incentivize existing manufacturers and invite more
                     manufacturers, which will ensure fastest vaccination of the
                     majority of the population. Differential pricing has been
G                    introduced in order to instill a competitive market which
                     would drive the market towards affordability and attract
                     offshore vaccine manufacturers;
            (ii)     Vaccine manufacturers are mandated to transparently
                     declare the price in advance for procurement by State/UT
H
        IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                              295
                  SERVICES DURING PANDEMIC

                  Governments and private hospitals. The price for the Central     A
                  Government is pre-fixed and declared;
          (iii)   Extensive consultations with the manufacturers were held
                  to ensure that pricing is uniform and reasonable. The UoI
                  stated that these were “due to consultations and persuasion”
                  by the Central Government;                                       B
          (iv)    On the differential pricing of the vaccines, it is stated that
                  “the Central Government by nature of its large
                  vaccination programme, places large purchase orders
                  for vaccines as opposed to the State Governments and/
                  or Private Hospitals and therefore, this reality has some        C
                  reflection in the prices negotiated”; and
          (v)     In any event, all persons of all age groups will get free
                  vaccination throughout the country since all State/UT
                  Governments have announced free vaccination for persons
                  aged 18-44 years, in addition to the Central Government          D
                  vaccinating persons over 45 years for free.
       30. The current Liberalized Vaccination Policy enables State/UT
Governments and private hospitals to procure 50% of the monthly CDL
approved doses in the country at a pre-fixed price. The justification for
this Policy has been adduced in a bid to spur competition which would              E
attract more private manufacturers that could eventually drive down
prices. Prima facie, the only room for negotiation with the two vaccine
manufacturers was on price and quantity, both of which have been pre-
fixed by the Central Government. This casts serious doubts on UoI s
justification for enabling higher prices as a competitive measure.
Furthermore, the Central Government justifying its lower prices on                 F
account of its ability to place large purchase orders for vaccines, raises
the issue as to why this rationale is not being employed for acquiring
100% of the monthly CDL doses. The Union Budget for Financial Year
2021-2022 had earmarked Rs 35000 crores for procuring vaccines 25. In
light of the Liberalized Vaccination Policy, the Central Government is             G
directed to clarify how these funds have been spent so far and why they
cannot be utilized for vaccinating persons aged 18-44 years.
       31. In response to our questions on the poor and marginalized
suffering on account of the vaccine prices, the Central Government in
25
     Available at <https://www.indiabudget.gov.in/doc/Budget_Speech.pdf>, page 7   H
296               SUPREME COURT REPORTS                        [2021] 5 S.C.R.


A     its affidavit stated that the eventual beneficiary of the vaccine would not
      be affected by the Liberalized Vaccination Policy since every State/UT
      has promised to vaccinate its residents free of cost. Nevertheless, it is
      reiterated that the UoI should consider utilizing its position as the
      monopolistic buyer in the market and pass down the benefit to all persons.
      Even if the States/UTs were to fund the higher-priced vaccines, a burden
B
      they were not discharging before the Liberalized Vaccination Policy was
      introduced and potentially may not have planned in advance for, these
      funds are expended at the behest of the public exchequer. The Centre
      and States/UTs, both operate in the service of the Indian population, and
      raise and disburse funds in their name. The additional funds expended
C     on procuring vaccines against a deadly pandemic are necessary
      expenditure for any State/UT Government which has battled the public
      health emergency for over 15 months now. However, an avoidable
      expense would eventually hurt the welfare of individuals residing within
      those States/UTs, who may potentially be benefitted by the differential
      funds being utilized for ramping up the health infrastructure in the State/
D
      UT, which is equally important to combat the pandemic. If the Central
      Government s unique monopolistic buyer position is the only reason for it
      receiving vaccines at a much lower rate from manufacturers, it is
      important for us to examine the rationality of the existing Liberalized
      Vaccination Policy against Article 14 of the Constitution, since it could
E     place severe burdens, particularly on States/UTs suffering from financial
      distress.
            Basis of pricing
            32. In our order dated 30 April 2021, we had requested for data
      on government funding and support, direct or indirect, into the two
F     vaccines that are currently authorized for public use – SII’s Covishield
      and BBIL s Covaxin. Additionally, in order to evaluate the bottlenecks in
      vaccine scarcity, we had sought the UoI’s stance on invoking its powers
      of compulsory licensing under the Patents Act, 1970 in order to ramp up
      manufacturing and other statutory provisions to drive down costs. The
G     UoI has adduced the following justifications in its affidavit dated 9 May
      2021:
            (i)     SII and BBIL have taken a financial risk in developing and
                    manufacturing these vaccines and prudence dictates pricing
                    through a transparent and consultative negotiation, and
H                   statutory provisions must be invoked in the last resort;
      IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                              297
                SERVICES DURING PANDEMIC

        (ii)    Covaxin is developed under a public-private partnership          A
                through a formal MoU between Indian Council of Medical
                Research26 and BBIL. ICMR would receive a 5% royalty
                on net sales, the intellectual property is shared between
                ICMR and BBIL and clauses such as prioritization of in-
                country supplies have been included. Phase 3 trials of
                                                                                 B
                Covaxin have been funded by the ICMR to the tune of Rs
                35 crores;
        (iii)   Covishield is manufactured by SII. The Central Government
                has directly transferred Rs 11 crores to 14 clinical trials
                sites for conducting phase 3 trials of over 1600 participants;
                and                                                              C

        (iv)    Covaxin production is being augmented with government
                support to the tune of Rs 200 crores to one private
                manufacturer and 3 public sector manufacturing facilities
                – Bharat Biotech, Hyderabad; Indian Immunologicals,
                Hyderabad; Haffkine Biopharmaceuticals, Mumbai; and              D
                Bharat Immunologicals and Biologicals, Bulandshar. This
                is projected to enhance Covaxin s current manufacturing
                of 1 crore doses/month to nearly 10 crore doses/month in
                the next 8-10 months. Grant-in-aids have been
                recommended, but the disbursements are yet to be made.           E
        33. We commend the co-operative efforts of the UoI and the
private manufacturers in developing and distributing vaccines which are
critical to mitigate the pandemic. The import of our further line of
questioning is to facilitate a better understanding of the process of
development and augmentation of vaccine production and its pricing for           F
States/UTs and private hospitals. Hence, we direct that the UoI to provide
the following clarifications:
        •       Since the Central Government has financed (officially, Rs
                35 crores to BBIL and Rs 11 crore to SII for phase 3 clinical
                trials) and facilitated the production (or augmentation of       G
                production) of these vaccines through concessions or
                otherwise, it may not be accurate to state that the private
                entities have alone borne the risk and cost of manufacture.
                Additionally, the Central Government would have minimized
26
     “ICMR”                                                                      H
298             SUPREME COURT REPORTS                          [2021] 5 S.C.R.


A                  the risks of the manufacturers by granting Emergency Use
                   Authorization to the vaccines, which should factor into its
                   pricing.
            •      The manner in which public financing is reflected in the
                   procurement price for the Central Government, which is
B                  significantly lower than price for the State/UT Governments
                   and private hospitals. Given that the R&D cost and IP have
                   either been shared between the Central Government and
                   the private manufacturer (in case of Covaxin) or the
                   manufacturer has not invested in R&D of the vaccine (in
                   case of Covishield), the manner in which the pricing of
C                  vaccines has been arrived at, with the Central Government
                   refusing to intervene statutorily. The justification for
                   intervening in pre-fixing procurement prices and quantities
                   for States/UTs and private hospitals, but not imposing
                   statutory price ceilings.
D           •      Comparison between the prices of vaccines being made
                   available in India, to their prices internationally.
            •      Whether ICMR/BBIL formally invited contracts for
                   voluntary licensing and if so, whether they have they received
                   viable offers. The manner in which the UoI is independently
E                  trying to assist manufacturers for developing BSL3 labs
                   which are essential for Covaxin production.
            E.4 Vaccine Logistics
             34. We have already noted that as a consequence of the Liberalized
F     Vaccination Policy, the responsibility for the vaccination in phase 3 is
      being divided between the Central Government (for those above 45 years
      of age, HCWs and FLWs) and the State/UT Government along with the
      private hospitals (for the age group of 18-44 years). This would mean
      that the limited vaccine logistics available in a State/UT would have to
      be shared between the State/UT Government and the Central
G     Government. This is different from the situation under the UIP, where
      the Central Government buys and allocates vaccines to States/UTs, in
      order to ensure that their cold storage facilities are not overwhelmed.
      Hence, we direct the UoI to provide the following clarifications:

H
    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                              299
              SERVICES DURING PANDEMIC

      •       The manner in which cold storage equipment capacity is           A
              being balanced between the Central and State/UT
              Governments. The manner in which the States/UTs are
              managing the logistical burden for vaccinating persons aged
              between 18-44 years, along with persons aged over 45
              years.
                                                                               B
      •       Whether cold storage facilities in India have increased for
              the COVID-19 vaccination drive; the present numbers, and
              comparison with the numbers prior to March 2020;
      •       Whether the cold storage equipment is indigenously
              manufactured or is imported. If it is imported, the steps        C
              which have been taken to start indigenous manufacturing.
      •       The steps being taken to improve the cold storage
              management for vaccines which may require lower
              temperature to be stored, compared to the ones which
              currently have approval in India.                                D
      E.5 Digital Divide
       35. In our order dated 30 April 2021, we had highlighted the
concerns relating to the ability of the marginalized members of society
to avail of vaccination, exclusively through a digital portal in the face of
a digital divide. The UoI’s affidavit made the following submissions in        E
relation to the accessibility of the CoWIN portal:
      (i)     The CoWIN portal enables one person to register 4 persons
              using the same mobile number;
      (ii)    All gram panchayats in the country have Common Service
                                                                               F
              Centres27 which can effectively enable people residing in
              rural areas to register online for the vaccination;
      (iii)   Citizens who do not have access to digital resources could
              take help from family, friends, NGOs and CSCs;
      (iv)    Walk-ins cannot be permitted due to the scarcity of vaccines     G
              and fears of over-crowding at centres. The online
              registration requirement counters this fear and also
              effectively monitors the administration of the second dose.
              The policy may be re-considered subsequently when more
              vaccines are available;
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300                  SUPREME COURT REPORTS                                [2021] 5 S.C.R.


A             (v)      Identity proofs are required for the purpose of determining
                       age and keeping a track of persons who are due for the
                       second dose. However, in recognizing the issues arising with
                       the insistence of one of the seven prescribed photo-ID
                       proofs, the Central Government issued an SoP dated 23
                       April 2021 which enables bulk registration of certain
B
                       identifiable groups, such as homeless persons, who would
                       be identified and registered by the District Immunization
                       Task Force; and
              (vi)     It is clarified that walk-in vaccination facilities will continue
                       for persons over the age of 45 years in separate, designated
C                      vaccination centres. This is because vaccinations have been
                       underway for this age group for a while and over- crowding
                       has not been experienced so far.
            36. A survey on ‘Household Social Consumption : Education’ was
      conducted by National Statistics Office (July 2017-June 2018)28 which
D     revealed the following:
              (i)      Around 4% of the rural households and 23% of the urban
                       households possessed a computer. In the age group of 15-
                       29 years, around 24% in rural households and 56% in urban
                       areas were able to operate a computer; and
E             (ii)     Nearly 24% of the households in the country had internet
                       access during the survey year 2017-18. The proportion was
                       15% in rural households and 42% in urban households.
                       Around 35% of persons in the age group of 15-29 years
                       reported use of internet during the 30 days prior to the date
F                      of survey. The proportions were 25% in rural areas and
                       58% in urban areas.
              37. The Telecom Regulatory Authority of India in its report
      titled ‘Wireless Data Services in India’ 29 noted that:
              (i)      Out of the total population of 1.3 billion, only 578 million
G                      people in India (less than 50%) have subscription to wireless
                       data services. The wireless tele density in rural areas is
      27
         “CSC”
      28
         Available at <http://mospi.nic.in/sites/default/files/publication_reports/
      Report_585_75th_round_Education_final_15 07_0.pdf>
      29
         Available at <https://www.trai.gov.in/sites/default/files
H     Wireless_Data_Service_Report_21082019_0.pdf>
     IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                                     301
               SERVICES DURING PANDEMIC

               57.13% as compared to 155.49% in urban areas as on 31                   A
               March 2019. The report stated that:
                   “[this] reflects the rural-urban divide in terms of telecom
                   services penetration. Since, the number of wireless data
                   subscribers are less than 50% of the total wireless
                   access subscribers, the number of wireless data                     B
                   subscribers in rural areas would be much lower”.
       (ii)    The report also noted that in a few Indian States like Bihar,
               Uttar Pradesh and Assam the tele density is less than 75%;
               and
       (iii)   The monthly income of persons living below the poverty                  C
               line in urban areas and rural areas is Rs 1316 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. As                   D
               such, the report notes that this would bear a considerable
               cost for persons living below the poverty line.
       38. According to the Annual Report of CSC for 2019-20, published
by the Ministry of Electronics and Information Technology, while there
are 2,53,134 Gram Panchayats in India, as on 31 March 2020 only 2,40,792               E
Gram Panchayats are covered with at least one registered CSC30. Hence,
approximately 13,000 Gram Panchayats in India do not have a CSC.
       39. 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                  F
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. A vaccination policy exclusively
relying on a digital portal for vaccinating a significant population of this
country between the ages of 18-44 years would be unable to meet its
target of universal immunization owing to such a digital divide. It is the             G
marginalized sections of the society who would bear the brunt of this
accessibility barrier. This could have serious implications on the

30
   Available at <https://csc.gov.in/assets/events-report/Annual-Report-2019-20.pdf>,
at page 8                                                                              H
302             SUPREME COURT REPORTS                          [2021] 5 S.C.R.


A     fundamental right to equality and the right to health of persons within the
      above age group. In this regard, we direct that the UoI to provide the
      following clarifications:
            •      It may not be feasible to require the majority of our
                   population to rely on friends/NGOs for digital registrations
B                  over CoWIN, when even the digitally literate are finding it
                   hard to procure vaccination slots.
            •      The issue of over-crowding may also arise at CSCs in rural
                   areas where people would have to visit constantly in hope
                   of a vaccine slot opening up.
C           •      Certain vaccination centres may be earmarked for on-site
                   registrations for the population aged between 18-44 years
                   without the existing conditions prescribed in the circular
                   dated 24 May 2021, potentially with a view to prioritize those
                   with co-morbidities/disabilities/other socio-economic
D                  vulnerabilities. Alternatively, whether specific daily quotas
                   may be introduced for on-site registration at each centre or
                   specific centres.
            •      This policy may not allay the issue of hesitancy which may
                   arise from approaching a State authority (such as the District
E                  Immunization Task Force) to obtain registration for the
                   vaccination. Whether on-site registration with self-
                   attestation of age to ensure widespread vaccination can be
                   provided.
            •      The CoWIN platform and other IT applications like Aarogya
F                  Setu should be made available in regional languages. The
                   timeline for ensuring the availability of the platform in
                   multiple regional languages.
            •      Conducting a disability audit for the CoWIN website and
                   other IT application like Aarogya Setu to ensure that they
                   are accessible to persons with disabilities.
G
             40. It has been brought to our notice that the CoWIN platform is
      not accessible to persons with visual disabilities. The website suffers
      from certain accessibility barriers which should be addressed. These
      include:
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    IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND                              303
              SERVICES DURING PANDEMIC

      (i)     Audio or text captcha is not available;                          A
      (ii)    The seven filters, which inter alia, include age group, name
              of vaccine and whether the vaccine is paid or free, are not
              designed accessibly. This issue can be addressed by creation
              of a drop-down list;
      (iii)   While visually challenged persons can determine the number       B
              of available vaccine slots, one cannot find out the day those
              slots correspond to. This can be resolved by ensuring that
              table headers correspond to associated cells;
      (iv)    Keyboard support for navigating the website is absent;
                                                                               C
      (v)     Adequate time should be given to disabled users to schedule
              their appointment without the possibility of being
              automatically logged off; and
      (vi)    Accessibility protocols, such as use of appropriate colour
              contrasts, should be adhered to.                                 D
      F. Conclusion
       41. We direct the UoI to file an affidavit, which shall address the
issues and questions raised in Section E, wherein it shall ensure that
each issue is responded to individually and no issue is missed out. We
also direct that the affidavit should provide the following information:       E
      •       The data on the percentage of population that has been
              vaccinated (with one dose and both doses), as against eligible
              persons in the first three phases of the vaccination drive.
              This shall include data pertaining to the percentage of rural
              population as well as the percentage of urban population so      F
              vaccinated;
      •       The complete data on the Central Government s purchase
              history of all the COVID-19 vaccines till date (Covaxin,
              Covishield and Sputnik V). The data should clarify: (a) the
              dates of all procurement orders placed by the Central            G
              Government for all 3 vaccines; (b) the quantity of vaccines
              ordered as on each date; and (c) the projected date of supply;
              and
      •       An outline for how and when the Central Government seeks
              to vaccinate the remaining population in phases 1, 2 and 3.      H
304                SUPREME COURT REPORTS                           [2021] 5 S.C.R.


A             •      The steps being taken by the Central Government to ensure
                     drug availability for mucormycosis.
             42. While filing its affidavit, UoI shall also ensure that copies of
      all the relevant documents and file notings reflecting its thinking and
      culminating in the vaccination policy are also annexed on the vaccination
B     policy. Hence, we direct the UoI to file its affidavit within 2 weeks.
             43. We also note that UoI’s stated position in its affidavit dated 9
      May 2021 is that every State/UT Government shall provide vaccination
      free of cost to its population. It is important that individual State/UT
      Governments confirm/deny this position before this Court. Further, if
C     they have decided to vaccinate their population for free then, as a matter
      of principle, it is important that this policy is annexed to their affidavit, so
      that the population within their territories can be assured of their right to
      be vaccinated for free at a State vaccination centre. Hence, we direct
      each of the State/UT Governments to also file an affidavit within 2 weeks,
      where they shall clarify their position and put on record their individual
D     policies.


      Nidhi Jain                                                      Directions issued.



E




F




G




H


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