Vaccine nationalism of developed countries and China versus the Vaccine Maitri of India

The threatening surge in the COVID cases is gripping the world forcing the countries to opt for the economically inimical lockdown as a panacea to break the infection chain. India which displayed all attributes of bucking this trend till two months ago is witnessing an unprecedented and unabated increase in COVID infections. The second wave, which has become omniscient literally touching doorsteps of every Indian family is engendering new fears about livelihoods and is shattering the prognosis of a viable economic recovery. While the collective complacency of the government agencies and the general public is now believed to be at the root of second COVID wave in India, vaccines are now projected as the magic bullets to battle the Wuhan virus.

Till the entry of vaccines into fray, interestingly both local and state governments have emphasised on the strict enforcement of COVID-specific protocols, mandatory masking and social distancing to avert a lockdown. Testing, tracing, tracking and quarantining of the contacts has remained the focus of the health authorities to contain the infection. But with a major drop in infection rates perhaps, every agency appears to have thrown the caution to the wind. Vaccines are now regarded as be all and end of all of this consuming menace. Curiously, even the vaccine sceptics and anti-vaxxers who debated and doubted the efficacy of Indian vaccines and its approval process having shifting their stance are coming down heavily on the government for slack vaccination program.

Accusing the government of vaccine shortages and the generous vaccine maitri, the ecosystem is now pitching for Universal Vaccination against Wuhan virus. Undeniably while vaccines are widely believed to be best weapons to tackle the pandemic, mass vaccination was never expected to provide 100% protection against COVID-19. In this context, countries by and large aspired to attain herd immunity as a best strategy, relied on vaccinating the vulnerable population first to curb the death rates.

But by and large, owing to the promise of flattening the virus curve substantially, nations have kickstarted vaccination programs. After China shared the genome sequence on Jan 10^th, 2020, researchers started the vaccine designing. By March 2020 first clinical trials in humans were initiated by Moderna in US and China’s Sinovac.  Countries like Russia, UK have launched mass vaccination programs invariably triggering the vaccine wars.

As of April 15^th, 13 vaccines were authorised for use with 60 potential candidates in various stages of clinical trials^1. To accelerate the development, manufacturing and production of vaccines, four vaccine initiatives were instituted-

·        OWS (Operation Warp Seed), a collaboration between various US government agencies;

·        ACTIV- a part of OWS, US’s NHS (National Health Service) partnered with 18 biopharmaceutical companies;

·        COVPN (COVID-19 Prevention Trails Network)-coordinates clinical trial networks;

·        COVAX is part of WHO’s Access to COVID Tools (ACT) Accelerator, spearheaded by Coalition for Epidemic Preparedness Innovation (CEPI), GAVI, the vaccine alliance and WHO, whose goal is to offer low cost COVID vaccines to countries.

Needless to say, while the motive behind four vaccine initiatives has been to ensure universal access to vaccines, this objective is now defeated by burgeoning vaccine nationalism. Instead of cooperating and coordinating the vaccine related research and their manufacture, production and accessibility, developed nations are brazenly indulging in vaccine hoarding and pre-booking denying the precious doses to third world countries. Nearly 190 countries joined the COVAX initiative but of them wealthy countries have directly negotiated deals with vaccine manufacturers.

According to a report, rich countries which account for 16% of World population has already secured more than 50% of World’s vaccine production². Extrapolating these figures, experts project that at this rate, low-income countries might attain a decent vaccination level by 2024. In the meanwhile, several mutant variants will keep pushing back the fight against pandemic. Already Astra Zeneca vaccine is reported to be ineffective against South African mutant strains. An inordinate delay will not only lead to loss of lives but would lead to massive economic downturn. World-wide vaccination is essential to keep the pandemic at bay.

To boost production and access to poorer countries, India and South Africa has called for temporary waiver of intellectual property rights at the WTO Council Meeting in November. Many Low- and Middle-Income Countries (LMIC)s supported the proposal submitted to WTO’s Trade Related Aspects of Intellectual Property Rights (TRIPS). Citing the instances of big pharma companies blockading the development of alternate vaccines in the past, South Africa urged WTO to temporarily waive the patents barriers. TRIPS indeed have a clause that approves exemption for public health needs.

At the WTO Council meeting on November 20^th, India stated, “on one hand, these countries are buying up as much of the limited supply as they can, leaving no vaccines in the pie for developing and least-developed countries. On the other hand, and very strangely, these are the same countries who are arguing against the need for waiver that can help increase the global manufacturing and supply to achieve not just equitable, but also timely and affordable access to such vaccines for all countries”^3. Indeed, unlike other countries, walking the talk, India has generously offered vaccines to over 70 countries at a time when HIC (High Income Countries) has started securing dose several times more than their population.

At the WTO, influential Western Pharmaceutical lobby and HIC intensely opposed the proposal. Arguing that any failure to protect the patent rights might hamper the American innovative and creative industries and more than 45 million jobs, PhRMA (Pharmaceutical and Research Manufacturers of America) in its special report 301 has urged Biden administration to act on countries that posed challenges to their IPR (Intellectual Property Rights). In line with PhRMA reports, previous Obama administrations has imposed tariff sanctions on Thailand and Indonesia, countries referred to in Special Report 301.

Significantly, PhRMA wrote a letter to Biden administration March 5^th calling the India-South Africa proposal as, “significant escalation in anti-global activism and will further polarize legitimate conversations on countries engagement to combat the pandemic”⁴.

On March 10^th for the eight time, the HICs and big pharma blocked the India-South Africa proposal supported by Doctors without Borders (MSF) and WHO chief Tedros. Proposals need consensus of 168 members to pass the resolution. The next meet is slated for June 8^th.

Contending the Big Pharma, public health advocates pointed that vaccine technology is largely financed by public sector not by private capital and hence pharmaceutical companies can’t get monopoly.

Achal Prabhala, coordinator for AccessIBSA project noted that the Pfizer vaccine developed in partnership with European firm BioNTech, received $445 million from German government. While Moderna obtained a research grant of $1billion from US government, Johnson &Johnson received over $1.45 billion from Biomedical Advanced Research and Development Authority, a division of US Department of Health and Human Services^5.

Beside the patent related bottle necks, the big pharma which is already minting profits, is bullying hapless Latin American countries reeling under pandemic. Reportedly, Pfizer aside demanding additional indemnity against civil law suits filed by citizens who suffer adverse vaccine side effects from the governments of Argentina and Brazil asked them to put up sovereign assets like military bases and federal bank reserves as collaterals for potential legal costs. It has even sought immunity against cases brought due to Pfizer’s own fraud, mismanagement or negligence⁶.

While Western pharma agencies are leaving no stone unturned to extract their pound of flesh, China the originator of the virus brought out mandatory Chinese vaccine inoculation for obtaining Chinese visa for 19 countries⁷.The list included-India, Australia, Greece, Indonesia, Israel, Italy, Nigeria, Norway, Pakistan and South Korea.

Notwithstanding the perfidy of complicity in the spread of pandemic, China under ambit of “Health Silk Route” launched the Vaccine Diplomacy along the lines of Mask diplomacy. To bypass the crucial authorisation exercise in recipient countries, Beijing began offering vaccines to countries in its immediate vicinity and slowly extended it to its periphery. Even as its own citizens expressed doubts over its efficacy, China began using these tools to bolster “soft power” and to successfully bully countries that recognised Taiwan. Offering vaccine bait, China forced Paraguay to severe ties with Taiwan.

India’s vaccine shipment to Paraguay has dented Chinese pursuits.  Currently, vaccines are doubling up as China’s political weapons to salvage its reputation and burnish credentials. Like Bangladesh which rejected China’s co-funding clause for vaccine trials, Prime Minister Hun Sen lashed out at China over COVID vaccine trials saying, “Cambodia is not a dustbin”⁸. Sen took Astrazeneca’s vaccine in 2020. But much water has flown from then. After Cambodia registered a record surge in infections in 2021, with no low-cost vaccines on offer, it accepted China’s free sample vaccines initially and later placed orders for more vaccines. Inundated with vaccines, against the wishes of people who are wary of Sinovac vaccines, which has poor reputation and not reviewed by WHO, Cambodia made vaccination mandatory for civil society workers. China’s trick is at play now and its vaccine diplomacy is yielding some results⁹.

Significantly, while the major Superpower and emerging superpower are vying with each other to exploit the pandemic to advance their geopolitical and economic interests, advocating “sarvebhavanthu sukhinah” (may all be happy) India is benevolently gifted vaccines just days after rolling out its own vaccine program.

On April 14^th 46-member group of Least Developed Countries (LDC) backed the India-South Africa proposal calling for IPR abeyance of vaccines till the pandemic is vanquished. But the resolution is unlikely to be passed. As per reports of health group Patients over Pharma, the Big Pharma has spent $50 billion on lobbying since the commencement of vaccine trials¹⁰. While the Western lobby is busy minting profits, India on March 26^th initiated a Joint Political Declaration on Equitable Global Access to COVID-19 vaccines that garnered support of 180 UN members.

Clearly, the health systems across the World and the supply chains are controlled by the big corporates and it is appalling that developed countries are acting at their behest.

Since the outbreak of pandemic, the World has suffered abject lack of a decisive leadership and vision to tide over the devastating trail of devastation and death. Embracing a protectionist approach, America stalled the export of essential medical supplies but threatened India of consequences if it failed to ship Hydroxychloroquine. Repudiating “America First” President Biden subsequently promised vaccine for every American adult and invoked 1950’s Defense Production Act (DPA) to ramp up production of syringes and medical supplies. Americans cheered and welcomed the move not understanding the flip side of this emergency law.

The law ordains America to control supplies and compel companies to prioritise certain orders over others. With an absolute power to sanction loans, US government can facilitate expansion of infrastructure and manufacturing capacities of companies and eventually stock-pile the products. America has set a target of producing 600 million doses by May, double the actual requirement. DPA allows the government to direct suppliers to vaccine companies to make additional doses. To meet the superfluous domestic requirement, America has stalled the raw material supplies to India. Since the pandemic, American Presidents have invoked DPA 18 times¹¹. Besides vaccines, America has accelerated the production lines of COVID test kits, surgical gloves, N95 masks, alcohol swabs and other medical supplies. Needless to say, while this indiscriminate excess production is bound to cause unwanted ramifications, the tremors of this emergency law are more pronounced on India.

India which has earned the reputation of World’s pharmacy is reeling under the raw material crunch and facing difficulties in importing products like cell culture media, single-use tubing assemblies, filters and other chemicals.

In what can be termed as mother of ironies, Americans who lambasted Trump’s protectionism are now hailing Biden’s triumphalism that caters to domestic needs by excluding other countries. Prioritising domestic interests is duty of every leader but America’s behaviour of hoarding all the essential ingredients for vaccine making clearly illustrates its comportment. In terms of numbers America has delivered 24 jabs for every 100 Americans as compared to China’s 3.7, Russia’s 2.7 and India’s 1.1 for every 100 of its residents^12.

While Biden has revoked majority of Trump’s decisions, his order, ban on vaccine exports is still in vogue. America’s global reputation is already on a decline. Hoarding of vaccines, blockading a proposal on waiver of IPR, withholding crucial raw material imports is bound to accelerate the erosion of its remnant good will.

America’s vaccine nationalism is now threatening vaccine production in India. Reliant on raw material supplies from the US, India’s major vaccine manufacturers Serum Institute of India and Bharat Biotech have expressed difficulty to continue or alternatively ramp up production to meet the growing vaccine needs of 16% of World population.

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