NEW DELHI - Prime Minister Narendra Modi's party's promise of free Covid-19 vaccines for poll-bound Bihar state has not only been called out for being an election ploy, but has also triggered a demand for free vaccines for the entire country of 1.35 billion people.
The states of Tamil Nadu and Madhya Pradesh have also said they will provide vaccines free of charge to residents.
While the federal government has not announced any official plans, at least one federal minister, Mr Pratap Sarangi, has said everyone will get a vaccine for free, when one is available.
Mr Adar Poonawalla, head of the Serum Institute of India, which has been chosen by Oxford University and AstraZeneca to manufacture their vaccine, estimates it will cost 800 billion rupees (S$14.7 billion) to vaccinate the whole country.
Questions have popped up over the economics of promising free vaccines, with vaccine costs unknown and already overburdened exchequers hit by the pandemic. Many believe those who can pay should be made to pay.
The Indian economy contracted 23.9 per cent in the first quarter of this year after all economic activity was shut down in March in response to the pandemic.
According to a recent Reserve Bank of India study, states are expected to see their fiscal deficit hit 4.6 per cent of gross domestic product (GDP) - double what they had budgeted for the year pre-pandemic.
"It's going to be a huge burden (on the exchequer) unless there is some attempt to force companies to lower prices," said trade economist Biswajit Dhar, a professor at Jawaharlal Nehru University.
There is also concern over whether there will be an equitable distribution of any vaccine.
Mr Dhar said: "The government has been talking about a phased introduction of this vaccine. But when the vaccine comes to the market, influential people will pay whatever and get access. There is a big gap between the announcement and implementation."
Mr A.K. Shiva Kumar, an international development economist and policy adviser, said the Indian government and the global community would need "to engage with vaccine manufacturers to ensure that patent laws are not used to create monopoly power, prices are regulated to offer the right incentives to manufacturers, and vaccines are mass produced and made available free of cost to the population".
India, with over eight million cases, has the second-highest number of cases in the world after the United States, which has nearly nine million.
India has seen a downward trend in daily new cases but that is tempered by concern over the ongoing festival season, where large gatherings are the norm.
Still, many have welcomed the idea of free vaccines for all.
Mr Nitin Pai, co-founder and director of the Takshashila Institution, an independent centre for research and education in public policy, argued that protecting the health of the population would bring adequate economic returns.
"Despite the fiscal constraints, the Indian government can adequately finance the 0.4 per cent of GDP required for a national vaccination programme," said Mr Pai.
"Besides, if the programme boosts economic growth by a couple of points, the higher tax revenues alone will justify the public expense."
Mr Kumar, too, noted: "All governments have a moral obligation to ensure that life-saving vaccines are provided free to the entire population. So does India."
But the Bharatiya Janata Party's (BJP) pledge of free vaccines as Bihar headed to the polls last Wednesday has got the opposition seeing red about public health being tied to politics.
The BJP has countered the criticism, saying all state governments were free to make similar announcements and that the promise showed the importance given to healthcare.
Congress leader Rahul Gandhi tweeted on Oct 22: "GOI (Government of India) just announced India's Covid access strategy.
"Kindly refer to the state-wise election schedule to know when will you get it, along with a hoard of false promises."
