Could India have avoided the mess it finds itself in?
All this past week, the news was dominated by societies that seem to be living on separate planets.
In the US, the CDC issued new guidelines allowing 100 million citizens (roughly 30% of the population that is fully vaccinated against Covid-19) to go without masks in various settings.
Meanwhile, on that very day, India reported over 360,000 new cases, and its cumulative death toll crested past 200,000 for the first time (it is the only the fourth country to get there, after the US, Brazil, and Mexico). But that is only the tip of the iceberg, because public health experts warn of massive undercounting. The actual number of infections and casualties is 20 or 30 times higher.
All across the country, the public record is an agonizing litany of desperation and loss. There’s an acute oxygen shortage, desperate shortfalls of medicine and hospital beds, and nigh-universal breakdown in governance.
Some cities and states are functioning better: Mumbai and Maharashtra, Kerala’s vaunted primary care systems, some North East states with their vigilant community models. But in most of India, and for the vast majority of its populace, both patients and medical care professionals have been simply abandoned. The human toll is incalculably immense.
Writing on Twitter account, Virginia Tech political science professor Dr Bikrum Singh Gill commented: “Disconcerting seeing people in the heart of empire -- US, UK, Israel -- celebrate coming [into the] post-vaccination world at [the] very time in which people in Delhi and Gaza are begging for oxygen. All the more so since the two realities are not separate but are fundamentally intertwined.”
Dr. Gill added: “Even critical observers in the West restrict their commentary to this being a failure of the Indian state. Yes, [India] has much to be accountable for, but the real responsibility for this unfolding tragedy lies with [the] US capitalist state and its vaccine imperialism. In its subservience to profit-taking interests of Pharma capital, [the US] first actively worked to destroy the WHO’s global public vaccine initiative. Then, along with other Western states, it rejected efforts by India and South Africa to have patents on vaccines waived at WTO.”
All this is true. When Oxford University announced it was working on Covid-related intellectual property last year, it made the public pledge “to offer non-exclusive, royalty-free licences to support free of charge, at-cost or cost + limited margin supply.” But then the Bill & Melinda Gates Foundation engineered an exclusive deal with AstraZeneca, with no price controls. That course change has unfolded a historic global disaster, and with devastating consequences for billions of lives.
It is India’s burgeoning Covid-19 crisis that has most fully exposed the inherent moral and tactical bankruptcies of the Gates Foundation’s fatally botched global plan.
As accurately summarized by Achal Prabhala and Leena Menghaney in The Guardian, they rely -- entirely absurdly -- on the Pune-based Serum Institute of India (SII) to provide every single Covid-19 vaccine dose for all of the 92 poorest countries in the world, as well as huge numbers of people in the West. At least one-third of all of humanity’s fate was leveraged to rest on this one single fulcrum of production.
Every single one of those poor souls is left hanging in limbo, as SII now “faces the impossible choice of either letting down the other 91 countries depending on it, or offending its own government.” This choice is actually no choice. Every vaccine made in India will stay in India, now and for a long time to come.
Prabhala and Menganey conclude: “This colossal mess was entirely predictable, and could have been avoided at every turn. Oxford should have stuck to its plans of allowing anyone, anywhere, to make its vaccine. AstraZeneca and Covax should have licensed as many manufacturers in as many countries as they could to make enough vaccines for the world [and the] Indian government should have never been effectively put in charge of the wellbeing of every poor country in the world.”
Forty-six-year-old Prabhala is one of the most persuasive voices for international intellectual property reform and access to medicines. From his home in Bangalore, he told me: “I woke up to a headline in the New York Times two days ago which declared that the EU was all set to welcome vaccinated Americans for the summer season. This was at exactly the same time that new infections in India had climbed to 350,000 a day, and deaths had topped 3,000 a day. I felt sick, and outraged. As it is, I can’t watch Indian news -- the news of merely my friends and family getting infected, falling ill, having to be hospitalized -- and worse -- is too much to take.”
Prabhala pointed out that “India is an anomaly. Yes, we’re suffering beyond belief, but we also produce vaccines, and we have a lot of vaccines potentially on hand, which is a situation that absolutely places it apart, [but we have] bungled this exceptional advantage. First, by vastly under-counting our need for vaccines and doing absolutely nothing to invest in a sufficient supply, and then by waiting until we were in the eye of the storm (April, 2021) to finally provide financial commitments for a large quantity of vaccines to the two manufacturers who have vaccines on the market so far.”
What is more, “there’s a global problem we are precipitating by this incompetence,
and as hard as it is to say in the horrible crisis unfolding around us, the Indian government has usurped vaccines that do not belong to the country, and that had been contracted out long before [and] by banning all exports, the Indian government has left about a third of the world’s population out to dry -- with just enough vaccines to cover 1% of their population, if they’re lucky. This is a compounded tragedy.”
I asked Prabhala how to characterize the stark divides we are experiencing, and he told me: “If vaccines are denied to people in the world on the basis of class and nationality, and therefore, effectively by race and ethnicity -- as they are being denied in this moment -- it’s apartheid. It’s hard to describe what’s unfolding now as anything but vaccine apartheid. I guess you could choose your metaphor: At the beginning of this pandemic, we were all supposed to be in the same boat, but that boat turned out to be the Titanic, and we can all see now who’s in first class, and who’s trapped in steerage as the boat sinks.”
Vivek Menezes is a writer based in Goa, India.