In January 2021, India launched its Vaccine Diplomacy “Vaccine Maitri” initiative, just four days after it began its own domestic vaccination program following the government’s approval of the indigenous Covaxin and the Oxford Astra Zeneca. However, India’s much publicised “Vaccine Maitri” seems to have taken a hit in the face of a much larger second wave of the COVID-19 pandemic as it is currently undergoing a massive surge in Covid-19 cases, a second wave which was, according to most experts, unavoidable but manageable. Prime Minister Narendra Modi even went as far to say: “India was the pharmacy of the world”. In Jan 2021, according to Akanksha Singh, WHO, Director General Tedros Adhanom Ghebreyesus tweeted to thank India and Modi for continued support to the Global Covid-19 response.
It is true that India became the largest producer of generic medicines, contributing about 20% of the total global production and the 62% of the global demand for vaccines. However, the second wave caught the country unaware, exposing India’s ill-equipped health system. In early March 2021, it was reported that, India’s health minister Harsh Vardhan declared the country was “in the endgame” of the Covid-19 pandemic. Mr Vardhan also lauded Prime Minister Narendra Modi’s leadership as an “example to the world in international co-operation”. From January onwards, India had begun shipping doses to foreign countries as part of its much-vaunted “Vaccine Maitri”
According to Shashi Tharoor, Mr Vardhan’s unbridled optimism was based on a sharp drop in reported infections. Since a peak of more than 93,000 cases per day on average in mid-September 2020, infections had steadily declined. By mid-February 2021, India was counting an average of 11,000 cases a day. The seven-day rolling average of daily deaths from the disease had slid to below 100.
According to Tharoor, the euphoria at beating the virus had been building since late 2020, as politicians, policy makers and parts of the media believed that India was truly out of the woods. In December 2020, central bank officials announced that India was “bending the Covid-19 infection curve”. There was evidence, they said, in poetic terms, that the economy was “breaking out amidst winter’s lengthening shadows towards a place in sunlight”. Mr Modi was called a “vaccine guru” stated Shashi Tharoor, April 2021.
At the end of February 2021, India’s election authorities announced key elections in five states where 186 million people were eligible to vote for 824 seats it has been reported. Beginning 27 March 21, the polls would stretch over a month, campaigning had begun in full swing, with no safety protocols and social distancing. In mid-March 2021, it has been reported that, the cricket board allowed more than 130,000 fans, mostly unmasked, to watch two international cricket games between India and England at the Narendra Modi stadium in Gujarat. In less than a month, things began to unravel. India was in the grips of a devastating second wave of the virus and cities were facing fresh lockdowns.
India is in now in the grips of a public health emergency, with social media feeds full of videos of Covid-19 funerals at crowded cemeteries, wailing relatives of the dead outside hospitals, long queues of ambulances carrying gasping patients, mortuaries overflowing with the dead, and patients, sometimes two to a bed, in corridors and lobbies of hospitals, according to various media reports and The Lancet Covid-19 Commission.
The volcanic eruption of Covid-19 India’s second wave led to vaccine shortages. It has been reported that the Serum Institute of India, the country’s and the world’s biggest vaccine maker said it would not be able to ramp up supplies before June because it didn’t have enough money to expand capacity. As a result of that India placed a temporary hold on its “Vaccine Maitri” and all exports of the Oxford-AstraZeneca coronavirus vaccine, because the doses were needed urgently at home, and allowed imports of foreign vaccines.
It is important to note that India’s devastating second wave comes a year after the country imposed one of the most rigid lock down restrictions in the world. India’s vaccine diplomacy had received praises after it rushed millions of doses of COVID-19 vaccines to over 60 countries, thus giving a quest to be recognised as a global power a real boost, stated Shashi Tharoor from project syndicate. Now, with more than 300 000 new cases a day and the death toll evidently much higher than reported, India is no one idea of a global leader, argued Shashi Tharoor.
Tharoor had previously warned that India had exported three times as many vaccines as it had administered domestically. According to Tharoor, India was lagging behind its own target of immunizing 400 million people domestically, after vaccinating some three million health care workers in a campaign that began in Jan 2021, The Lancet Covid-19 community.
India’s Covid-19 Tsunami prompted many to ask “What is causing India’s second wave and why is so much worse than the first? One of the leading epidemiologists in India, who helped write India’s national Covid-19 vaccine policy, Chandrakant Lahariya, said:
“after the first wave people dropped their guard. “In some of the most badly hit States, like Delhi and Maharashtra, community transmission was so rampant that there have been several localised waves”.
On the other hand, different media reports blamed lax social distancing and mask wearing, alongside mass political rallies for recent elections and religious events such as the Kumbh Mela, in which hundreds of thousands of Hindus gather at the Ganges river. V Raman Kutty another epidemiologist and honorary chairman of the non-profit organisation Health Action by People, Kerala, said:
“Malls and theatres opened, there were sporting events, elections, and religious events. Politicians even made the unsupported claim that India had beaten the pandemic”.
Gupta M et al, 2020 had however, issued a warning in the report published in the International Journal of Infectious Diseases in December 2020 that the transmission rate fell significantly during the first lockdown but warned that lockdown was only a temporary measure to quell outbreaks. The authors of the said journal recommended ramping up testing and self-isolation to prevent secondary infections. India’s health infrastructure was also troubled before the pandemic and with the Covid-19 Tsunami is now overwhelmed.
In the latest crisis, it has been reported that medical supplies and oxygen are being shipped in from 15 countries and international aid organisations such as UNICEF. It has also been reported that, India would need about 500 000 ICU beds and 350 000 medical staff going forward, at present India has only 90 000 ICU beds, almost fully occupied as argued by, Business Standard, 29th April 2021. Furthermore, India is also struggling to vaccinate its population of 1.36 billion, despite boasting one of the largest pharmaceutical manufacturing capacities in the world and despite having been in the lead with regard to vaccine diplomacy according to Thiagarajan K, 2021.
As to why India’s Covid-19 infections dropped at the start of 2021, remains unknown. Experts now say that crowing about India’s exceptionalism in “beating the epidemic and declaring victory on the virus turned out to be cruelly premature. Mihir Sharma, a columnist with Bloomberg said: “As is typical in India, official arrogance, hyper nationalism, populism and ample dose of bureaucratic incompetence have combined to create a crisis.
India’s second wave was fuelled by letting the guard down, attending weddings and social gatherings, and by mixed messaging from the government and allowing political rallies and religious gatherings. All these led to a feeling of Triumphalism, said K Srinath Reddy, the President of the Public Health Foundation of India. According Reddy some in India felt they had reached herd immunity and with everyone wanting to get back to work. According to Reddy, this narrative fell on many receptive ears, and the few voices of caution were not heeded to, he said.
However, according to Lahariya and other epidemiologists, stated that it was likely to have been the true tapering off of the first wave. They also noted that the “test positivity rate was falling by January-February 2021 and such assumptions were made that there was a drop in infections. Different media houses have also reported that, “Official statistics in India are often doctored to suit the political bosses, and that there was tremendous pressure to report less, there is also lack of transparency in the figures for infections and mortality too. The second wave is a totally different story., Lahariya noted.
While the International media has blamed what is seen as the Modi government’s missteps and complacency for the unprecedented health crisis, New Delhi has hit back saying, these are complementary baseless, malicious and slanderous allegations according to Eurasia, April 2021. Going forward, India should learn not to declare victory over the virus prematurely, and it should put a lid on triumphalism. People should also learn to adapt to short local lockdowns in the event of the inevitable future spikes of the infection.
In the case of Botswana, the emergence of Triumphalism, infodemics fuelled by naivety at times idiocy and political fanaticism seems to be taking centre stage with little understanding on Vaccine Diplomacy, Vaccine Nationalism and Cosmopolitanism.
*Thabo Lucas Seleke is a Researcher & Scholar, Global Health Policy (LSHTM)
