Recommendations for the Covid Vaccine Intelligence Network (Co-Win) platform
The first confirmed case of Covid-19 was recorded in India on January 30, 2020, and India’s vaccination drive started 12 months later on January 16, 2021; with the anxiety and hope that this signals the end of the pandemic. The first phase of the vaccination drive identified healthcare professionals and other frontline workers as beneficiaries. The second phase, which has been rolled out from March 1, covers specified sections of the general population; those above 60 years and those between 45 years and 60 with specific comorbid conditions. The first phase also saw the deployment of the Covid Vaccine Intelligence Network (Co-Win) platform to roll out and streamline the Covid 19 vaccination process. For the purpose of this blog post, the term CoWIn platform has been used to refer to the CoWin App and the CoWin webportal.
During the first phase, it was mandatory for the identified beneficiaries to be registered on the Co-Win App prior to receiving the vaccine. The Central Government had earlier indicated that it would be mandatory for all the future beneficiaries to register on the Co-Win app; however, the Health Ministry hours before the roll out of the second phase tweeted that beneficiaries should use the Co-Win web portal (not the Co-Win app) to register themselves for the vaccine. The App which is currently available on the play store is only for administrators; it will not be available for the general public. Beneficiaries can now access the vaccination by; (i) registering on the CoWin website; or (ii) Certain vaccination (sites) have a walk-in-facility: On-site registration, appointment, verification, and vaccination will all be on-site the same day; or (iii) register and get an appointment for the vaccination through the Aarogya Setu app.
The scale and extent of the global pandemic and the Covid-19 vaccination programme differs significantly from the vaccination/immunisation programmes conducted by India previously, and therefore, the means adopted for conducting the vaccination programme will have to be modified accordingly. However, as several newspaper reports have indicated the roll out of the CoWin platform has not been smooth. There are several glitches; from the user data being incorrectly registered, to beneficiaries not receiving the one time password required to schedule the appointment.
An entirely offline or online method (internet penetration is at 40% ) to register for the vaccine is not feasible and a hybrid model (offline registration and online registration) should be considered. However, the specified platform should take into account the concerns which are currently emanating from the use of Co-Win and make the required modifications.
Privacy Concerns
When the beneficiary uses the Co-Win website to register, she is required to provide certain demographic details such as name, gender, date of birth, photo identity and mobile number. Though Aadhar has been identified as one of the documents that can be uploaded as a photo identity, the Health Ministry in a response to a RTI filed by the Internet Freedom Foundation (IFF) clarified that Aadhaar is nor mandatory for registration either through the Co-Win website or through Aarogya Setu. While, the Government has clarified that the App cannot be used by the general public to register for the vaccination, it still leaves open the question of the status of the personal data of the beneficiaries identified in the first phase of the process, who were registered on the App, and whose personal details were pre-populated on the App. In fact in certain instances, Aadhar details were uploaded on the app as the identity proof, without the knowledge of the beneficiary.
These concerns are exacerbated in the absence of a robust data protection law and with the knowledge that the Co-Win platform (App and the website) does not have a dedicated independent privacy policy. While the Co-Win web portal does not provide any privacy policy, the privacy policy hyperlinked on the App directs the user to the Health Data Policy of the National Health Data Management Policy, 2020. The Central Government approved the Health Data Management Policy on December 14, 2020. It is an umbrella document for all entities operating under the digital health ecosystem.
An analysis of the Health Policy against the key internationally recognised privacy principles which are represented in most data protection frameworks in the world, including the Personal Data Protection Bill, 2019, highlights that the Health Policy does not provide any information on data retention, data sharing and the grievance redressal mechanism. It is important to note that the Health policy has also been framed in the absence of a robust data protection law; the Personal Data Protection Bill is still pending before Parliament.
The Co-WIn website does not provide any separate information on how long the data will be retained, whether the data will be shared and how many ministries/departments have access to the data.
A National Health Policy cannot and should not be used as a substitute for specific independent privacy policies of different apps that may be designed by the Government to collect and process the health data of users. Health Data is recognised as sensitive personal data under the proposed personal data protection bill and should be accorded the highest level of protection. This was also reiterated by the Karnataka High Court in its recent interim order on Aarogya Setu. It held that medical information or data is a category of data to which there is a reasonable expectation of privacy, and “the sharing of health data of a citizen without his/her consent will necessarily infringe his/her fundamental right of privacy under Article 21 of the Constitution of India.”
Link with Aarogya Setu
A beneficiary registered on the Co-Win platform can use the Aarogya Setu App to download their vaccination certificate. Beneficiaries have now also been provided an option to register for vaccination through Aarogya Setu. However, the rationale for linking the two separate platforms is not clear, especially as Aaroya Setu has primarily been deployed as a contact tracing application.
There is no information on whether the data (and to what extent) that is stored in the Co-Win platform will be shared with Aarogya Setu. It is also not clear whether the consent of the beneficiary registered on the Co-Win platform will be obtained again prior to sharing the data or whether registration on the Co-Win platform will be regarded as general consent for sharing the data with Aarogya Setu. This is contrary to the principle of informed consent (i.e the consent has to be unambiguous, specific, informed and voluntary), which a data fiduciary has to comply with prior to obtaining personal data from the data principal. The privacy policy of Aarogya Setu has also not been amended to reflect this change in the purpose of the App.
Co-Win registration as an entry to develop health IDs?
One of the objectives of the Health Data Management Policy is to develop a digital unique health ID for all the citizens. The National Health Data Management Policy states that participation in the National Health Data Ecosystem is voluntary; and the participants will, at any time, have the right to exit from the ecosystem. Currently, the policy has been rolled out on a pilot basis in 6 union territories, namely; Chandigarh, Dadra & Nagar Haveli, Daman & Diu, Puducherry, Ladakh and Lakshadweep. As Health is a state subject under the Indian Constitution, Chhattisgarh has raised concerns about the viability and necessity of the policy, especially in the absence of a robust data protection legislation.
Mr. R.S. Sharma, the Chairperson of the ‘Empowered Group on Technology and Data Management to combat Covid-19’ had in an interview to India Today stated “ “Not just for vaccinations, but the platform will be instrumental in becoming a digital health database for India”. This indicates that this is an initial step towards generating health ID for all the beneficiaries. It would also violate the principle of purpose limitation, that data collected for one purpose (for the vaccine) cannot be reused for another (for the creation of the Digital Health ID system) without an individual’s explicit consent and the option to opt-out.
Conclusion
Given India’s experience and reasonable success with childhood immunisation, there is reasonable confidence that the country has the ability to scale up vaccination. However, the vaccination drive should not be used as a means to set aside the legitimate concerns of the citizens with regard to the mechanism deployed to get pet people to register for the vaccination drive. As a first step it is essential that Co-Win has a separate dedicated privacy policy which conforms to the internationally accepted privacy principles and enumerated in the Personal Data Protection Bill. It is also essential that Co-Win or any other app/digital platform should not be used as a backdoor entry for the government to create unique digital health IDs for the citizens, especially without their consent and in the absence of a robust data protection law.
