First there was the biometrically linked Aadhar number to give Indians a sense of identity. Then there was Aarogya Setu, the detective app that would tell Indians whether the virus was lurking anywhere near them. Now, the CoWIN app has been introduced as the sole mechanism by which Indians can obtain vaccines against Covid-19.
Though there is ample evidence that this kind of digital solutionism results in large numbers of Indians being denied the benefits they are entitled to receive because they do not have access to technology, India’s policy makers seem to believe that apps can solve all problems.
The triumphalism of this narrative was expressed in a tweet by Harsh Vardhan, the minister for health and family welfare, on April 28, a few hours after the opening of registrations for Phase 3 of the vaccination drive on the CoWIN portal. He said he was “pleased to note our world-class CoWIN platform ensured smooth rollout of beneficiary registration for Phase 3 of the world’s #LargestVaccineDrive”.
Phase 3 of the vaccination drive opened it to people in the 18-44 age group; the two previous phases were restricted to people older than 60 (and those above 45, with comorbidities) and then those between 45 and 60 unconditionally.
An equally proud tweet came from the CEO of the National Health Authority.
This excitement about the “world-class” standards of the system and the seemingly high rate of user engagement obscures the fact that the CoWIN platform has been released in an environment of acute vaccine shortages. Every day, states have been complaining that they have had to suspend their vaccine campaigns because they have not received adequate stocks.
Fewer vaccine shots mean fewer appointment slots and so the enormous rush on CoWIN to find them. This has led to system crashes, delays in users receiving passwords that allow them to proceed to the next stage in the booking process, frozen screens and slots being exhausted in a few seconds. Many users vented their feelings of rage and sarcasm.
The process of booking an appointment to be vaccinated has become like a “fastest fingers first” competition, users complain. As a consequence many states, notably Maharashtra and Karnataka, have demanded that they be allowed to operate their own portals/apps.
A technology designed to exclude
This cheerleading masks the basic truth about the stupendous extent to which the CoWIN platform actually ensures that millions of Indians will not have access to vaccine appointments.
Around 33% to 45% people in the 18-44 age group – approximately 200 million to 280 million people – have no or poor access to the internet or any online platforms. There are other barriers too. Though the CoWIN app is multilingual, many Indian languages are missing from it. Besides, the portal is only in English. Further exclusion may arise from factors such as location ( from areas with poor connectivity), gender (internet usage is skewed in favour of males), and education levels.
This vaccine inequity is playing out right in front of our eyes. Many instances have been reported of city dwellers driving to rural areas for a vaccine appointment (read these reports from Bengaluru, Mumbai and Noida). Residents of those areas were unable to register for the vaccine slots because of a combination of the factors mentioned above.
The Common Service Centres run by the Ministry of Electronics & Information Technology to provide digital services to rural areas have not been of much use because many are closed due to Covid-19 restrictions. As a consequence, only about 0.1% of the total registrations on CoWIN have been effected by these centres.
Attack of the nerds
This situation of vaccine scarcity is further muddied by what can be called the “attack of the nerds”. People who know how to write computer code have created bots and scripts that automatically check for vacant vaccination slots and send out alerts to members of groups on social media (Facebook, Twitter, Instagram) and messaging platforms (WhatsApp, Telegram, even e-mail).
Familiarity with technology is being used as a weapon to grab opportunities that should have been equitably distributed. This should be resolved as fast as possible.
Finally there are privacy concerns about the CoWIN platform. It has no stated privacy policy, which means that the entity running the platform could theoretically share user data or even sell it to third parties.
There are good reasons for those fears: data from the government’s Vahan vehicle registration database has been “shared” extensively and was even sold to a private firm. CoWIN data could be held for an indefinite period and there is no provision for demanding that it be deleted after it has served its purpose.
Since India has no laws safeguarding privacy, any new provision for sharing or sale of this data could be created by the stroke of the executive pen.
Why is it so hard for governments to recognise that access to any service that hinges on the use of digital technology is often reduced for large segments of the population that do not have access to the internet?
Such digital initiatives seem to be driven by a host of factors. Firstly, political parties care more about the social classes that use the internet, especially social media and messaging apps, because these are important vehicles for perception management about governance.
Secondly, these digital techniques signify technological advancement. That feeds well into the optics of the projection of technological leadership. Thirdly, all of this techno solutionism stems from the general tendency to gather more personal data about every citizen, especially those who are more affluent.
The talk is about “monetisation of data”, “data empowerment” and “health stacks”, which removes focus from the much harder problem of building public health infrastructure (healthcare centres, hospitals). The money, resources and enthusiasm showered on digital efforts could well have been spent on creating this infrastructure.
What can be done
To overcome the challenges, India needs large-scale offline mechanisms that provide access to vaccinations. No country in the world – not even affluent ones – uses only online methods. Even the United States and the United Kingdom offer vaccine bookings through phone-based helplines and manual registrations.
The announcement on Tuesday that on-site CoWIN registration will now be opened to the 18-44 year age group is welcome. Even more, while India waits for door-to-door vaccinations to be allowed, door-to-door registrations may be an extremely effective strategy in overcoming the digital divide.
As the infection in India moves into smaller towns and rural areas, offline schemes are of prime importance. There is a dire need to counter vaccine hesitancy and allay the apprehensions Indians have about vaccinations.
Popular forms of engagement, such as door-to-door awareness visits, public-service announcements, and folk songs should be employed to persuade Indians to get vaccinated.
It is also time to harness the learning and experience acquired through India’s long-running National Immunisation programe. India’s success in eliminating polio was due to a sustained campaign across the country. Universal, free and rapid vaccinations, enabled by all forms of access, notably manual walk-in registrations, is the key.
The official notion that problems of online access can be solved by getting citizens to seek the help of friends or family for online registration is utterly naive. CoWIN will become a “deletive reality” app that deletes non-digital citizens from social view.
Anurag Mehra teaches engineering and policy at IIT Bombay. His policy focus is on exploring the interface between technology, culture and politics.
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