The meticulous planning behind India’s vaccine diplomacy


On June 21, Pakistani Foreign Minister Shah Mehmood Qureshi sent an overjoyed note to his countrymen. “China has promised to immediately provide 500,000 doses of vaccine (as a gift) to Pakistan by January 31,” Qureshi was quoted saying by ‘Dawn’.

China offered Sinopharm to Pakistan. Priced at $145 for double dose, Sinopharm is the world’s costliest vaccine, 10 times costlier than India’s Covishield and Covaxin. On the brighter side, it faced less controversy compared to Sinovac, the other big Chinese brand, which failed efficiency tests in Brazil (January 13, BBC).

The costly gift may bolster Pakistan’s ego. But 500,000 doses are too little to inoculate the frontline staff of a country of 210 million. With 160 million people, Bangladesh received a gift of two million doses of Covishield vaccine from India.

‘Vaccine Maitri’

Dhaka is not alone to receive Indian gifts. Under the “Vaccine Maitri (friendship)” programme, India is giving millions of doses of vaccine to smaller neighbours and friends. The initiative was launched parallel to the roll out of vaccination drive in India on January 16.

So far Nepal (population 28 mil) got 1,000,000 doses of vaccine; Myanmar (54 mil) 1,500,000; Bhutan (760 thousand) 150,000; Maldives (530 thousand) 100,000; Mauritius (1.2 mil) 100,000 and Seychelles (97 thousand) 50,000. Deliveries are yet to begin for Sri Lanka and Afghanistan. Most likely, many more countries will be added to the list.

And, there lies the heartburn, not only for the Imran Khan government in Pakistan– which is facing tremendous criticism at home for failing to start vaccination – but, more for China. Already blamed for the pandemic; China’s image is under a second attack in the face of India’s vaccine diplomacy.

On January 20, a day prior to China’s decision to extend help to Pakistan, Dawn reported that India started sending millions of doses of Covid vaccine as “grant assistance” to smaller neighbours and friends, “except Pakistan”.

Dawn was not alone to appreciate India’s vaccine donation drive. The entire world watched in awe as India went out to help neighbours when the rich North was cornering production to save their own people.

China had resources, but they were keen to do business. Bangladesh cancelled the trial of Sinovac in October 2020, as the company wanted Dhaka to share the cost.

“India is giving away millions of coronavirus vaccine doses as a tool of diplomacy,” reported Washington Post on January 22.

Wider Plan

What India is doing is far from a frivolous attempt. Nothing frivolous works in global politics and, less in the Indian neighbourhood.

Jawaharlal Nehru’s “Hindi-Chini Bhai Bhai” (India-China Brotherhood) was a disaster. Atal Bihari Vajpayee’s Bus ride or Prime Minister Narendra Modi’s unscheduled visit to Lahore – nothing improved India-Pak relations.

The vaccine diplomacy is part of a wider plan by the Modi government to seize the opportunity created by the Covid-19 pandemic to turn the global spotlight on India. With China facing a trust deficit, India threw its hat to take the leadership position.

The initiative is multi-pronged and has both long-term and short-term goals.

On the economic front a series of reforms is unleashed to improve the core competence of the economy; step up domestic manufacturing to improve value addition and job creation; encourage greater play of technology and private capital and; last but ensure relocation of a share of the global value chain from China.

The domestic economic agendas are spearheaded by the Atmanirbhar Bharat programme, that includes $ 20 billion production-linked incentive in 10 select sectors, so as to reduce imports and create global scale capacities to optimize export potential.

On the diplomatic front there are issues with the WTO trade architecture, which failed to take note of the non-transparent practices pursued by China. More importantly, India is pursuing a change in global power balance, which is now heavily tilted in favour of the top five, including China, holding permanent seats in the UN security council.

Perception management is a key element in achieving these goals. Despite the initial setbacks, India is successful in limiting the damage from pandemic. The infection curve is downhill and the economic recovery is gaining momentum.

The next bit of support will come from vaccine diplomacy, which again has much wider implications than merely donating a few million doses.

Saviour of the world

That India’s $40 billion pharmaceutical industry has roughly 60 percent of the global vaccine manufacturing capacity was known. However, the developed North barely took note of it before the COVID struck, as the vaccines were mostly consumed in the South.

The perception has now undergone a sea change.

“There are many vaccines being produced in countries around the world but there’s only one nation that has the manufacturing capacity to produce sufficient quantities to satisfy the demands of citizens in every country, and that’s India,” Australia’s ambassador to India, Barry O’Farrell was quoted saying by a Reuters report on December 10.

The whiff of opportunity was felt when the former US President Donald Trump threw his weight, in April 2020, to force India resume export of hydroxychloroquine. India is the largest producer of the cheap anti-malarial drug that is consumed mostly in Asia and Africa.

Based on a sketchy study, indicating possible use of the drug against coronavirus infection, Delhi stopped exports of hydroxychloroquine in March. Though the abilities of the drug were not proven, Trump helped India attract the global spotlight.

Since then, India focused its energy in ensuring fast production of a slew of cheaper Covid vaccines.

Serum Institute took commercial risk of stockpiling 50 million doses of Oxford University and AstraZeneca developed ‘Covishield’, even before the entire procedure of clinical trials were over and UK or India approved its ‘emergency’ use.

The vector vaccine is now a hit in the world market due to its low cost, high efficiency and less complex handling procedures.

Meanwhile, Bharat Biotech of Hyderabad, developed inactivated Covaxin, with the support of government controlled, Indian Council of Medical Research (ICMR). DNA-based, ‘ZyCoV-D’ manufactured by Cadila Healthcare and India’s Department of Biotechnology, is on trial mode.

All-round planning

Overall, a total of nine vaccines are lined up by India. Two are approved for emergency use. Four more are on clinical trial and three are in pre-clinical trial stage. This is over and above the vaccines manufactured by Indian makers like Serum for use in other countries.

A critical review may tell that the Modi government had an all-round plan on vaccines.

On the one hand, manufacturers were encouraged to maximise global opportunities riding on the trust deficit suffered by China. At the same time, Delhi ensured that sufficient capacities are reserved for vaccination of India’s large population.

To ensure targeted inoculation and prevent undue profiteering, companies are barred from open market sales in India. Apart from ensuring low cost of vaccines in the domestic market; the bulk deals struck by the government are also acting as international benchmarks.

In short, India didn’t allow a laissez-faire in the vaccine market. Attention was focused on affordability. Priced at Rs 265 a dose, Covaxin is the costliest variety available in India at this juncture. When compared to the global scenario, this is distinctly cheap.

According to India’s health ministry (PIB, January 12), the per dose price of foreign vaccines are: Moderna Rs 2300-2700, Pfizer Rs 1431, Sinovac Rs 1027, Sinopharm Rs 5500, Novavax Rs 1100, Johnson and Johnson Rs 734, Sputnik-V Rs 730.

Price is an important factor not only to poorer countries. South Korea, one of the developed economies, denied to strike a deal with Moderna or Pfizer in a huff. It waited for the right price.

Last but not the least, the Modi government took this opportunity to give its “Make-in-India” campaign a boost by lining up two India-made vaccines.

In January, Bharat Biotech entered its first overseas deal with Brazil’s Precisa Medicamentos for supplying Covaxin. As is the international practice, the deal will be effected after human trial and due regulatory approval in Bzazil.

Will Pakistan learn?

Smaller countries suffered the most during SARS. As richer nations booked capacities, the most affected region in South East Asia got the vaccine three months behind the USA.

By donating vaccines as soon as it was available in the domestic market, India is creating a new precedence. It may also be a way to use soft power to convince South Asian economies about India’s capabilities and why it pays to be a good neighbour.

The episode also came handy in sending a strong message to Pakistan. Historically, the biggest stumbling block before regional cooperation, Islamabad continued with its belligerent stance even in the face of Prime Minister Modi’s call to South Asia to fight Covid together.

However, it is unlikely that Pakistan will learn anything from it. They avoided entering commercial deals with Indian vaccine makers and are finding costlier solutions in China. Last heard Cansino, another Chinese make, which is yet to hit the market, offered Pakistan 20 million doses. Price of the vaccine is unknown.

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(The author is a well-known public policy expert, with interest in economics, connectivity and infrastructure. He writes extensively on these issues. The views expressed are his own.)

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