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India’s Vaccine Diplomacy Draws Global Attention

It’s no wonder that today, vaccine diplomacy has become a major foreign-policy talking point everywhere from China to the United States.  As the global demand for medicines, medical supplies, and personal protection equipment increased, countries imposed export restrictions to stabilize domestic supplies.
|| Bhoomika Mohan

Since the coronavirus pandemic began, the country has been at the forefront of supplying medicines and generic drugs to others. India received requests from more than 100 countries for hydroxychloroquine (once thought to help treat COVID-19) and paracetamol (a painkiller), and sent supplies to Brazil and Israel. By May 2020, India was spending 16 Million Dollars on pharmaceuticals, test kits, and other medical equipment for about 90 countries.

Vaccine nationalism soon followed with the possibility that rich countries would attempt to hoard vaccines by striking pre-purchase deals with pharmaceutical companies. Throughout it all, though, it was always clear that a global challenge of this magnitude would eventually require a global solution, based on international health cooperation between public and private-sector stakeholders. And Indian Prime Minister Narendra Modi recognized early on that his country could play a unique role in that process.

Between mid-January and the second week of February, India exported more than 1.6 crore doses of Covid-19 vaccines to 20 countries, helping save lives. The exports went to countries in the immediate neighbourhood to West Asia Africa and the Americas. About 62.7 lakh doses (or 37%) of these exports are gifts to friendly countries.

Data made public by the Union ministry of health shows India will earn revenue from shipments of about 63% of the vaccines sent to UAE, Kuwait, South Africa, Algeria, Egypt, Morocco, Brazil and Bangladesh. Together, these countries received more than 1 crore doses, all supplied between January 25 and February 2.

The corona virus vaccine — one of the world’s most in-demand commodities — has become a new currency for international diplomacy.

Countries with the means or the know-how are using the shots to curry favor or thaw frosty relations. India sent them to Nepal, a country that has fallen increasingly under China’s influence. Sri Lanka, in the midst of a diplomatic tug of war between New Delhi and Beijing, is getting doses from both.

India’s vaccine diplomacy puts it in direct competition with China—which has made no secret that vaccine distribution is wrapped up in its broader geopolitical ambitions. In fact, it has even explicitly included vaccine distribution in its broader Health Silk Road initiative, which aims to bolster China’s international soft power.

India will need more than a billion doses to protect its own population. But it also aims to offer 20 Million Doses to neighboring countries Nepal, Bangladesh, Sri Lanka, Afghanistan, the Seychelles, and Mauritius by this spring. It will then distribute vaccines to Latin America, Africa, and the former Soviet Republics. Many of the recipient countries have signed so-called vaccine pacts with India on a government-to-government basis to finalize the number of doses and determine whether they will be provided under commercial terms. While commercial overseas shipments are likely to start around March, India has already sent 3 Million doses of the vaccine Bangladesh, Nepal, Bhutan, and the Maldives.

If the government can ensure that its domestic vaccine requirements are being adequately met, as seems to be the plan, there is little possibility of political blowback for Modi of sending vaccine elsewhere. Meanwhile, the foreign-policy benefits in strategic areas could be great.

For instance, India is keen on mending ties with Bangladesh.

New Delhi’s controversial citizenship law enacted last year and the news of $40 billion in investments from China to Bangladesh had strained ties between the two nations. The COVID-19 vaccine can let a little slack back in.

Similarly, vaccine diplomacy provides an opportunity for India to resolve outstanding issues with Nepal. Relations between the two countries recently hit a new low when they entered into a heated exchange over the Kalapani dispute, an area situated at the strategic China-Nepal-India trijunction.

In Indian Ocean countries like the Maldives and Mauritius, India’s vaccine diplomacy can help foster stronger ties in the region, and offset China’s growing influence attributable to its financial investments and social-development projects.

The quality and efficacy of Chinese vaccines have been questioned due to concealment of test data and lack of transparency in information. Recent reports have revealed that Brazil—which was initially planning to deploy China’s Sinovac—raised concerns about the efficacy and safety of the vaccine and ultimately decided to opt for India’s Bharat Biotech. Such outcomes will help India position itself as the more responsible global power. Simply put, India has longer track record of supplying medicines and vaccines to the rest of the world, especially to low- and middle-income countries.

Nevertheless, China has one big advantage over nearly every other country: It has largely been able to control the pandemic within its borders, and its economy is mostly back on track. That means China can potentially devote more diplomatic attention and resources to its global vaccine outreach. However, unlike India, there is little transparency about the safety of efficacy of Chinese vaccines.

The “vaccine maitri” (Hindi for vaccine friendship) initiative was announced by Prime Minister Narendra Modi days after India began its nationwide vaccination campaign in January.

“India is deeply honored to be a long-trusted partner in meeting the healthcare needs of the global community,” Modi said last month. “Supplies of COVID vaccines to several countries will commence [on January 20], and more will follow in the days ahead.”

The initiative started with countries in India’s immediate neighborhood and key partner nations in the Indian Ocean. The doses were distributed as “gifts” — in line with New Delhi’s “Neighborhood First” policy.  Countries in Latin America and the Caribbean were among those further afield.

Several countries, including Nepal and Bangladesh, purchased additional doses on top.

According to the Foreign Ministry, India dispatched more than 15.6 million doses to 17 countries in the first two weeks.

The Indian government’s global vaccine initiative has received a mixed response at home.

India has approved two coronavirus shots so far: one developed by Oxford University and AstraZeneca, and another produced by Indian firm Bharat Biotech.

India has been shipping out the Oxford-AstraZeneca vaccine, domestically produced by SII in the western city of Pune, and known in India as “Covishield.”

Critics have questioned whether exporting precious vaccine doses is the right move, instead of speeding up the vaccination drive in India.

India, which has the world’s second-highest caseload of coronavirus, plans to immunize 300 million people by August. It vaccinated about 3 million healthcare workers in the first two weeks of the campaign that began on January 16 and will need to step up the pace to meet the summer target.

Some argued for involving the private sector in the vaccination campaign.

Pakistan, unsurprisingly, is not among the countries receiving COVID vaccine shipments from India. In a press briefing, the Indian Foreign Ministry said that they had not received any requests from Pakistan seeking vaccine supplies.

Pakistan’s Foreign Office and Health Ministry did not respond to DW’s requests for comment.

Vaccine diplomacy is not new. It has been a part of science and health diplomacy since the discovery of the smallpox vaccine in 1798. Britain’s Edward Jeener discovered the smallpox vaccine and offered advice on its administration to countries like Russia, Turkey, Spain, Canada, and Mexico. The creation of a network of laboratories in Francophone countries, Indochina and North Africa to prepare and administer the rabies vaccine by the French Pasteur Institute in the late 1800s is another example of vaccine diplomacy. The eradication of poliovirus from the world was largely made possible due to the scientific collaboration between the American-Polish developer of the oral polio vaccine Albert Sabin and Soviet virologists during the Cold War.

Building clinical trial capacity in neighbouring countries and low- and middle-income countries (LMICs) is also a priority for India, according to Department of Biotechnology secretary Renu Swarup. Her department is working with India’s external affairs ministry to facilitate phase III clinical trials of Covaxin in Bangladesh and Myanmar. India is training several neighbouring countries to strengthen their clinical capabilities under the Partnerships for Accelerating Clinical Trials (PACT) and Indian Technical and Economic Cooperation (ITEC) programmes.

The World Health Organsation recently recognised India’s vaccine altruism as a facilitator of equitable access to COVID-19 vaccines. Though, how long India can shoulder the financial burden of providing free vaccine doses to neighbouring countries is still a question.

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