The big vaccine strategy fiasco in India

Showing the reassuring face of Prime Minister Narendra Modi, the Covid-19 vaccination certificate is like a trophy. This piece of paper with a QR code is in the hands of only 3.4% of the 1.3 billion Indians. In all, 200 million doses were administered: a pace too slow to rapidly immunize a population struck today by a violent wave of coronavirus. With a peak of over 400,000 daily infections in early May, India has been bereaved by 150,000 deaths in two months.

Triumphant beginnings

This winter, India had launched its vaccination campaign with fanfare. The country prided itself on having defeated the virus and the festive, religious or electoral gatherings did not worry the authorities in any way. India then placed its first vaccine orders with the Serum Institute of India (SII), the world’s largest manufacturer, based in Pune.

This family firm is run by the young billionaire Adar Poonawalla, who produces the vaccine for the AstraZeneca laboratory. Very dependent on IBS, India then added to its basket only a homemade vaccine, Covaxin from Bharat Biotech. Between them, the Indian companies produce 85 million doses per month, which the government offers free of charge in public hospitals. Narendra Modi even then promises to “Save humanity” : Nearly 66 million doses are sent to nations in need.

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Everything capsized when a meteoric wave of infections swept through the health system. Damaging the iron image of the Prime Minister, the unpreparedness of the authorities is coupled with a crying need to speed up vaccinations. On April 16, Modi blocked exports from the SII to reserve all production for the Indians. The decision sent shock waves through poor countries awaiting deliveries, such as neighboring Nepal. And, in the midst of a crisis, Adar Poonawalla leaves the ship: he takes refuge in London with his family and admits to being pressured “Overwhelming”.

On May 1, India changed its vaccination strategy and extended it to the entire adult population, including Indians under the age of 45, hitherto excluded. “It’s like inviting 100 people to lunch and you can only cook for twenty”, responded epidemiologist Chandrakant Lahariya. For these new recipients, the government decides to leave it to the federal states and private hospitals to purchase the vaccines.

The poor, left behind by immunization

Bottling is immediate, stocks are running out. This week, Delhi closed 400 public vaccination centers. “We are among the rare great nations not to follow the principle of free and universal vaccination, denounces Harsh Mander, human rights defender. This campaign, launched without having calculated the real vaccine needs, is a huge fiasco. “

Faced with the shortage, the government is trying to order from foreign laboratories, but it is a little late at the negotiating table. To go up the slope, it will be necessary to count on these contributions, on the Russian vaccine Sputnik V approved by the authorities, on the increase of the local production and on the arrival of other vaccines in phase of trials. India is already promising more than two billion doses between September and December. “We still lack clarity on the availability of vaccines and the adequate number of vaccination centers”, nevertheless believes K. Srinath Reddy, head of the Indian Foundation for Public Health.

But in the current chaos, vaccines are slipping away from the poorest. “You need a smartphone to register on the Cowin government application, which is in English, underlines the expert. The poorest are clearly at a disadvantage. “ In Delhi, 20% of residents received a first dose while in the poor state of Bihar, they are only 7.6%. “The working poor cannot afford the vaccinations offered in the private sector, explains Harsh Mander. The system in place legitimizes unequal access to vaccines. In India, the poor are not considered equal citizens. “


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