Jaishankar's mission impossible

VACCINATING INDIA (II)

Udayan Hazarika

(The writer can be reached at udayanhazarika@hotmail.com)

India's helpless position in vaccinating the country once again has come to the fore when it decided to add an item namely 'discussion of Covid-19 vaccine supply to India' in the agenda of the External Affairs Minister (EAM) Dr S Jaishankar's US Mission. The media is presenting this US visit of EAM as the basic objective for exploring the scope for getting more vaccines from the US for the "country and its neighbours". Media research about the word 'neighbours' reveals that it includes requirements communicated by Bangladesh, Nepal, Sri Lanka and the Maldives. However, no questions have so far been raised as to how far the EAM can make progress in the discussion on a subject like the supply of vaccines, etc which is alien to him? Has the Government attached a contingent of officers from the Health Department to back him up? The Government press release issued by the External Affairs Ministry simply puts the vaccine matter as the last task in one sentence i.e., "External Affairs Minister will have two interactions with business forums on economic & COVID-related cooperation between India and the US. This is the last part of the press release and conveys that it was a mere interaction and nothing important can be expected to come out of such interaction. The first part of the May 21 press release reads: "External Affairs Minister will be visiting the United States from 24-28 May 2021. In New York, he is expected to meet UN Secretary-General Antonio Guterres. In Washington DC, External Affairs Minister will hold discussions with his counterpart Secretary of State Antony Blinken. He will also be meeting Cabinet members and Senior Officials of the Administration dealing with the bilateral relationship"." From the press release it is very clear that the three major agenda of his visit are directly related to foreign and economic affairs.

By the time, Dr Jaishankar starts his maiden Journey to Washington DC as EAM, two more important happenings have marked India's vaccination history i.e. i) the truth that Covaxin has not yet been recognised either by the World Health Organisation or, and European Vaccines… has come out and it was inevitable. Covaxin was adopted by granting emergency use authorisation (EUA) by the Central Drugs Standard Control Organization (CDSCO) in India while it was yet to complete the 3rd of the three clinical trials conventionally required. As per the latest information (WHO May 18 2021) Bharat Biotech although has submitted its expression of Interest for certification yet the proposal is held back for want of more information. Once the proposal is cleared WHO will decide about its inclusion in the Emergency Use List (EUL). Thereafter, the company may go for obtaining approval from various regulatory authorities such as European Medicines Agency. The Russian vaccines which are produced in Dr Reddy's Laboratory at Hyderabad under the certificate are also yet to be cleared by WHO for which those who have taken covaxin shall not be allowed to fly to European countries. Secondly, the allegation by the Serum Institute of India that the Government decision to kick start the vaccinating programme for 45+ and 18+ were taken horridly knowing very well that there were no vaccines in store.

This allegation from the SII is a grave one and it proves how the Government is trying to play with the lives of millions of Indians. All Indians are not well educated- they believe in what they hear from educated people – they have meagre means which they cannot spare for experimental purposes. They need to take the hard decision whether to go for treatment if at all necessary or wait for the vaccines as they think it will cure the disease. They are at the crossroads- whether to wait for the vaccines or to take the patient to the hospital. Undecided in this dilemma, many have died waiting for the vaccines and many will die too. The Health Ministry till the other day busy in clarifying how many doses have been sent to States till dates knowing very well that this information will not come to help of the masses. The information about how many vaccines have been arranged for the States after 45+ and 18+ declarations would have been useful. For further transparency, the Government could have come out with a list showing how much has been sent to each state date wise and the criteria of such allocation. The Executive Director of SII Sri Suresh Jadav reportedly alleged that the government began inoculating people from multiple age groups without taking into account the available stock of vaccines and the WHO guidelines. The country should have followed the WHO guidelines and prioritised vaccination accordingly." The fact that vaccine was not available with the SII was categorically reported by the Institute to the States who had approached them for vaccines. The Minister of Health Rajasthan stated in a meeting that "the Serum Institute told us that till May 15, they may not even be able to complete the prior of the Central Government." Another Health Minister from non-BJP State Chhattisgarh stated Modi Government is playing an elaborate joke on everybody. "Currently we are producing close to seven crore vaccines both including covishield and covaxin. If half of this goes to the Centre, then only 3.5 crore doses are available for the States to vaccinate those above 18 years. The 18-45 years category is at least 35-40 per cent of our population. Just 3.5 crore doses are for them. .. this is a joke."

As per the Government of India's estimates (technical Group of Population Projections), there are roughly 595 million people in the age group 18-44. Thus in all 120 crore doses will be required to cover the whole population or at least 60 crore doses will be required for the first doses which is an impossible task. It was hardly a week ago that the Government of India attempted to open discussions with Pfizer, Moderna, Jhonson & Johnsons for the supply of vaccines to India which however have conveyed that the possible time for talking about vaccine supply to India shall be September 2021 only. Given that, the EAM will attempt to impress the political giants in the US handling the issue of exporting vaccines. There is hardly any chance that it will work and some exceptional or wonders will happen. The above three vaccine producers are the major players in the COVEX programme of WHO and are bound to fulfil their commitment to the COVEX. Moreover, it has recently been proved that their vaccines are effective against the B 617 variant of Covid-19 which is predominant in India. Thus, in absence of a regular team from the Health Department, Mr Jayashankar shall not be in a position to take part in the dialogues with the vaccine producers who have already conveyed their current inability. The Government is expecting that if nothing could happen, Mr Jaishankar shall at least be able to impress the US to supply as many vaccines as possible from the quota earmarked for export. President Joe Biden had recently announced about this quota saying that the US will begin shipping 20 million doses of Pfizer-BioNTech, Moderna and Johnson & Johnson's Covid-19 vaccines to needy countries by June end, in addition to 60 million shots of Astra Zeneca. If Dr Jaishankar could manage at least half of the above-mentioned quota, which comes to about 40 million doses comprising about only 6 per cent of the required doses, the outcome of his effort will be almost like 'mission accomplished.

This would be an arduous task indeed! If the US has India in its mind for the earmarked vaccines, it would have disclosed its agenda much earlier especially when it sent its first batch of US AID to India in the last part of April. India was expecting vaccines from the US in place of stationery supplies that it received from the US. Engaging EAM in this task of procuring vaccines exposes Government's desperateness to correct its earlier mistakes and realisation of the gravity of the situation. However, the global market is almost empty and everybody is buying time except China. China is presently ruling the global vaccine market. India's bilateral trade relation with China is still at its peak. To correct the early faults on this count, India may turn to China and make a bilateral agreement. India needs to correct its vaccine policy and the Centre must rely on the States and act on behalf of the States in the global market as a single entity.