India will have to spend $1.4 billion to $1.8 billion in the first phase of a coronavirus vaccination programme, even after getting support under the COVAX global vaccine-sharing scheme, according to estimates by the GAVI vaccines alliance.
India, which has the world's second highest caseload of coronavirus behind the United States, plans to inoculate 300 million people over the next six to eight months, likely with vaccines from AstraZeneca, Russia's Sputnik, Zydus Cadila and India's own Bharat Biotech.
Documents reviewed by Reuters underline the scale of the funding challenge India faces to immunise its vast population, with 600 million shots required in the first wave alone for critical workers and people most at risk from COVID-19.
If India got 190-250 million shots of the vaccine under the COVAX facility – a best case scenario – then the government would need to line up about $1.4 billion to make up for the shortfall, according to an unpublished report prepared for GAVI's three-day board meeting that began on Tuesday.
On the other hand, if India received a lower allocation of 95-125 million doses, then the cost to the government of procuring additional shots would go up to $1.8 billion.
India's health and finance ministries did not immediately respond to Reuters e-mail seeking comments.
The COVAX plan, co-led by the World Health Organization and GAVI, aims to provide poor and middle-income countries with diagnostic tests, drugs and vaccines through a fund known as the Access to COVID-19 Tools (ACT) Accelerator, set up last April.
The Indian government has not provided any estimate of the cost of its vaccine programme, though it has said all resources will be provided to protect the population.
GAVI, an alliance of governments, drug companies, charities and international organisations, said it was in discussions with the Indian government over a support package.
"Providing a low range of support would exacerbate the country's ability to allocate enough resources to mitigate the risks of continued transmission of COVID-19," the GAVI report said.
The GAVI report identified India's economic burden due to the pandemic as "disproportionate" and suggested a donor-funded plan of $1.3 billion to secure 190-250 million doses. The plan needs to be approved by the GAVI alliance board.
According to a vaccination plan shared with international donors, India aims to inoculate 10 million frontline health workers by February, 20 million essential workers by the following month and then 270 million people by August, mostly people above the age of 50 and those with other health issues that make them more vulnerable.
India also needed $30 million to $80 million for the insfrastructure to transport and store vaccines that must be kept at very low temperatures, the GAVI report said.