India’s COVID Vaccination Plan: What is the Ground Reality?

Is India truly conducting the world’s ‘biggest’ COVID vaccine drive? Why the focus on the ‘Make in India’ tag?

Image used for representational purposes.

(Photo: Altered by The Quint)

India’s current national discourse is saturated with propaganda and disinformation — even with regard to critical areas like the COVID-19 pandemic.

This was the trend since the beginning of the pandemic but it has acquired a new tenor with India’s apparent declining numbers (in most parts of the country) and our ‘Vaccine Maitri’ initiative, that is, ‘vaccine diplomacy’.

COVID Management & Vaccination Drive: Is India Really Much Ahead in the ‘Race’?

Consider India’s latest Economic Survey released by the government. It states that India has ‘saved the most number of lives in the world’ by comparing the 30 worst-performing countries in terms of COVID case load, and using a dubious and ‘bizarre’ parameter called ‘actual deaths versus naturally expected deaths’.

It goes on to state that India, through very successful containment strategies, has ‘37 lakh fewer cases than expected’, while the US has 62.5 lakhs more.

Of course, ICMR’s own national sero-surveys — which indicate that 21.5 percent of India has been exposed to COVID-19 already (that is nearly 30 crore of the population, while the official case count is only over 1.1 crore) — or the lead investigators of these surveys themselves who indicate that more than successful containment it is near-herd immunity (which would mean an even higher actual infection load) — that probably explains India’s decline in cases — does not matter. The sheer complexity and unpredictability of the evolving pandemic also does not seem to matter.

This is in keeping with the template — that is, comparing India with the worst COVID situations in the world (US, UK, Spain, Brazil) — to show how we are doing better than prosperous countries. 

In fact, all South Asian countries, some of which are much poorer, have done much better (many by a long shot) than India in terms of fatalities. Bhutan recorded exactly 1 death.

Does India Really Have the World’s ‘Biggest’ COVID Vaccination Drive & Are We the ‘Fastest’?

The Australian think-tank Lowy Institute ranked 98 countries on 6 objective measures on COVID management (confirmed cases, deaths, cases per million, deaths per million, cases as a proportion of tests and tests per thousand). India was ranked 86th.

With the vaccination drive having begun, sustained efforts — to establish not just India’s justifiable contributions to the world but to be seen as the ‘best in the world’ — are also underway. Vaccination is now a competition that needs to be won.

Our PM said: “In merely 15 days, India has vaccinated more than 30 lakh COVID-19 warriors, while a rich country like the US has completed the same target in 18 days and the UK in 36 days… We are not only running the world’s biggest vaccination drive but we are also the fastest in vaccinating our citizens.”

In reality, after 36 days of India’s vaccination drive, it was ranked 57 in the world out of 77 countries.

The other exercise is to portray India as the ‘pharmacy of the world’ — as THE ‘saviour’ when it comes to the COVID-19 pandemic.

This narrative too is flawed. Even while India rightly argues against vaccine nationalism, it reinstates another form of nationalism in which India is the ‘Vishwa Guru’ — a benevolent dispenser of gifts — to those nations who are waiting in queue for the ‘Made in India’ vaccines.

The Made in India vaccines have been touted as not only ‘a symbol of atmanirbhar Bharat’, but also ‘a symbol of self-pride.’ But what the government is yet to tell us is that one of the Indian COVID-19 vaccines — that is being marketed as ‘Made in India’ — has in fact not been developed by India.

Is Covishield an ‘Indian’ Vaccine?

Of the two approved COVID vaccines in India, Covishield is not an ‘Indian vaccine’, but has been developed by an Anglo-Swedish firm, AstraZeneca, in partnership with the Oxford University. AstraZeneca has allowed the Serum Institute of India to manufacture it through technology transfer and a non-exclusive licence.

The other vaccine — Covaxin — which has been developed by an Indian firm (Bharat Biotech), is yet to find international takers.

Of the 65 lakh doses gifted by India as a grant, only 2 lakh doses have been that of Covaxin. Even locally in India, health workers have shown great hesitancy in taking Covaxin. The reason is that India went shockingly against scientific norms (and at great peril to the established reputation of Bharat Biotech) to approve Covaxin even before Phase 3 trials had been completed. This is the same nationalism that pushed India’s medical research body to announce that Bharat Biotech’s vaccine would be available by available by Independence Day — 15 August 2020.

Did Serum Institute ‘Up the Ante’ During the Current Regime’s Tenure?

The ruling dispensation would like to have us believe that India’s manufacturing prowess in the pharmaceutical arena is something that has been achieved during its tenure. In reality, the Serum Institute was established in 1966 and has been one of the largest vaccine manufacturers in the world, playing a role in global vaccination efforts for decades.

Of the vaccines sent to other countries by India, only 37 percent (worth Rs 125 crores) has been given gratis to friendly countries while the rest are paid exports.

Ironically, Maldives, Bangladesh and Sri Lanka, who have received such vaccine ‘gifts’, have vaccinated a higher percentage of their population than India thus far.

Why the Constant Emphasis on ‘Make in India’ Tag for COVID Vaccines?

But the biggest obfuscation has been caused by the excessive focus on the ‘Made in India’ tag for Indian vaccines. In fact, the present vaccines have also been the product of a global pooling of resources to create a COVAX Facility and COVAX Advance Market Commitment (AMC), a financing mechanism to ensure that vulnerable sections and 92 low- and middle-income countries (including India) will have fair access to vaccines irrespective of the ability to pay. It was created by the initiative of the WHO, GAVI, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and working in partnership with philanthropic organisations like the Bill and Melinda Gates Foundation. 94 self-financed, high-income countries also joined the facility.

The Facility initially spent USD 2 billion for the development and procurement of vaccines with contributions from various high-income countries and philanthropies; additional donations are further needed to reserve vaccines for COVAX AMC.

The pooling of resources and the “extraordinary and unique global collaboration,” even among rival pharmaceutical companies, was necessitated by the global nature and the severity of the pandemic.

Since there was no guarantee of success, the variety of vaccine candidates were supported by the facility with an upfront commitment of funds, so that vaccines are manufactured even before they clear the regulatory process. That is how the usual time of 10 years to develop a vaccine was reduced to a less than a year.

Global Pooling of Resources to Fight COVID

Contrary to what the government is claiming, if the Serum Institute is manufacturing a billion doses for low-income countries through the COVAX Facility, it is because of the AstraZeneca deal (which apparently disallows it from selling them for a profit) and also that it has received funding from CEPI, and the Gates Foundation (which has, for example, provided it with around Rs 1100 crores) to expand manufacturing capacity and also to mitigate the risks of manufacturing a vaccine before approvals. And India itself is slated to receive 97 million vaccine doses from COVAX AMC.

But this global pooling of resources by advanced economies itself has not been motivated by a moral cause but an economic one — no economy will recover until the virus is eliminated globally.

Neither Propaganda Nor Nationalism Can Resolve COVID Crisis

Rather than the bombastic narrative of India ‘saving’ the world and ‘helping’ other poor countries through solely local ‘Made in India’ vaccines, what is urgently needed is for India and the rest of the Global South to vehemently challenge the pharmaceutical industries’ and developed countries’ refusal to waive the patent regime for COVID-19 vaccines — and for a wider and equitable vaccine development and production plan instead of low-income countries having to depend on technology transfer and only high-income country donor-led efforts like COVAX AMC.

Even COVAX AMC is going to give the lower-income countries only a fraction of the full requirement of vaccines (and with great uncertainty about the timeline of delivery) while many high-income countries have colonised vaccines five to ten times of their population numbers through bilateral deals.

What is necessary is to cut through the noise to recognise our realities for what they are. Neither propaganda nor nationalism can be the answer to a global pandemic.

(Nissim Mannathukkaren is with Dalhousie University and tweets @nmannathukkaren. This is an opinion piece. The views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)