Former UIDAI head urges Aadhaar biometrics use and registration model for rapid COVID-19 vaccine distribution
The use of biometrics in the Aadhaar program may help India vaccinate its 1.3 billion people against COVID-19 quickly, and the approach it took to Aadhaar biometric enrollment may provide a model for vaccine delivery, according to a two-part editorial in the Hindustan Times.
Nandan Nilekani, former head of the Unique Identification Authority of India (UIDAI), writes that with 35,000 stations serving up to 1.5 million people per day at its peak, the speed and scale Aadhaar registration achieved bodes well for the country’s ability to deliver a vaccine to all its citizens.
India has enormous vaccine manufacturing capacity, and Nilekani writes that the system for distributing any vaccine should prioritize speed and reach, and not be based on scarcity. Even if there is a scarcity issue when India begins rolling out a COVID-19 vaccine, domestic manufacturing capability will ensure adequate supply by the end of 2021, even assuming some of the domestic capacity is used for exports.
The country’s existing vaccination infrastructure, however, will not suffice, as it is geared towards vaccinating pregnant women and 25 million newborns each year, not a billion or even two billion within two years. Following that system, the government would procure large volumes of vaccines and distribute them, but with uncertainty about how effective the first vaccine on the market will be, and other, possibly more effective vaccines likely to be developed after it, the usual model could result in the government’s vaccine stock becoming worthless, and the vaccination project becoming heavily politicized, according to Nilekani.
In the second part, Nilekani argues for a vaccine distribution infrastructure utilizing private and public resources in a similar way to how Aadhaar registration and biometric capture was completed for over a billion people.
The government would maintain a list of approved vaccines, set a fee rate per vaccination, and create a list of “Authorised [sic] Vaccinators” from among government and private hospitals, labs and pharmacies. An ecosystem to train hundreds of thousands of people to administer vaccines, and “specifications and templates” for vaccination stations, permanent, temporary, or mobile would be established. Software for laptops and smartphones and a privacy and security-preserving back-end would be stood up.
Nilekani suggests that people could be authenticated through Aadhaar biometrics, a phone number, or “any other digitally authenticable ID.”
When the individual is vaccinated, the certified vaccinator uploads the vaccination data to a central database to receive automatic payment, and a certificate can be downloaded to the person’s smartphone, printed out, or stored in a digital locker. Nilekani believes this process could be completed in about ten minutes, with 50 vaccinations at each station every day adding up to 5 million daily vaccinations.
The certificate of immunization would allow travel, like a yellow fever vaccination document.
Nilekani writes that digital ID, digitized records and self-reporting could improve India’s vaccine safety surveillance, with anonymized aggregate data indicating vaccine effectiveness or side effects.
The combination of Jan Dhan financial inclusion accounts, Aadhaar identification, and Mobile technologies collectively referred to as JAM positions the country to set up pre-paid vouchers, while electronic health records can be stored in the government’s MEITY digital locker. Government digital platforms for online learning and approved supplies procurement can also play a role in this new public health delivery system, which could improve India’s health care overall, according to Nilekani.
Even the experience and professional capacity that was built up for Aadhaar can be harnessed to help India meet the challenge of the world’s largest national vaccination project. If successful, Nilekani suggests, India could show the world how to defeat COVID-19 with self-reliance.