India and Vaccine Diplomacy

Following the emergence of the covid-19 pandemic global interaction has focussed on dealing with the impact and consequences of it. Public Health diplomacy has acquired a higher place in international discourse at all levels including the G20¹, regional summits like the East Asia Summit² and in bilateral discussions.

Countries are engaged in finding solutions to the problems that have emerged in terms of economic and social impact. International diplomacy has focussed on ameliorating the socio-economic problems. New emphasis is now on vaccine diplomacy. This relates to the provision of protective equipment, medical devices, medicines, their manufacture and distribution and finally the vaccine itself.

Traditionally, diplomacy is the process by which a country aggregates its national strength in varied fields and uses it to achieve its national interests. India has been using diplomatic efforts to secure access to technology for Covid-19 related solutions. Each country will of course prioritize the availability of vaccines for their own people at two doses per person. At the same time India has utilised its manufacturing capabilities, as the pharmacy of the world and IT services to reach out to countries across the globe to provide essential medicines like hydro chloroquine, paracetamol, masks and the like.

Vaccine diplomacy refers to two types of approach. The first is as a manufacturer and distributor of vaccines. India is the major producer in the world and has provided the vaccines or medicines for HIV, meningitis and malaria. India is among the largest producers of vaccine covering about 60% for many diseases and is hence well placed to scale those production facilities to manufacture the Covid-19 vaccine.³ Another type of vaccine diplomacy relates to science and research and development where a country can be a part of the development process for new vaccines. India is evolving three possible Covid-19 vaccines and will have licensed production of several others currently being developed overseas. Its robust production facilities and skills provided by its unique place in global production and distribution give its vaccine diplomacy a quiet edge.⁴

India is in close contact with all the major producers of the new vaccine accept the Chinese. However, it is this ability that India exhibited to Delhi based diplomats when it took them on the tour of the facilities in Hyderabad on 9 December 2020. The group visited the research and manufacturing facilities of the biotechnology companies, Bharat Biotech and Biological E. That saw India’s own efforts to develop Covid-19 vaccines, including current clinical trials.⁵ India’s R&D facilities, manufacturing capacity, foreign collaborations in pharmaceuticals, including vaccine production, were highlighted. India’s slow and steady approach was appreciated.

Vaccine diplomacy provides a unique opportunity for a revised international cooperation. The demand for the vaccine is global; its development is concentrated in a few countries. Scalable production facilities are available in few countries like India and China. The opportunity for engaging countries in a new diplomatic programme based on vaccines is thus high on the agenda of international cooperation ahead.

India has taken a new initiative along with South Africa to approach the WTO through its TRIPs council and seek a waiver from trade related intellectual property regime for a short duration pertaining to the vaccine⁶. It also covers medical devices and equipment related to the pandemic. The request was introduced on Mahatma Gandhi Jayanti, 2nd October 2020. However, after two meetings, no agreement was reached since the main producing countries and the countries in which major producing companies are located do not wish to provide this window of exception to developing countries.

India has been joined by Mozambique Brazil and South Asian countries in this quest which has been resisted by Australia, Brazil, Canada, the EU, Japan, Norway, Switzerland, the UK, and the USA. Despite greater strategic convergence with many of these countries, India finds that the traditional fault lines at the WTO continue to hamper international cooperation during a global pandemic.

India will be able to scale up production of the vaccine, supportive equipment and devices including delivery mechanisms without the restriction of patents and trademarks for a limited duration if the exception succeeds. Like in the case of the ARV cocktail of medicines this could be a life saving intervention.⁷ The developed countries however believe that the investment by their companies must be rewarded even if there is a global pandemic.

In another initiative India is a part of COVAX a GAVI led group of 189 countries excluding the USA. Their aim is to procure 2 billion doses by the end of 2021 of which half will be for lower-income countries to protect high-risk and vulnerable groups, particularly health care workers, across the world.⁸ Only 20% of the projected requirement is met so far. Advance payments from richer countries are to support the scaled-up production of vaccines which can then be provided to 92 targeted counters as well.

It is understandable that every country would want its own people to be covered first but international cooperation to be meaningful must have an element of sharing at times like this. India has placed commercial orders of nearly two billion dozes with half going to US manufacturers then to the UK and a smaller part to Russia. India is the largest country to place an order but it is unlikely that imported vaccine will be used for vaccine diplomacy.

India has already been quick to offer vaccines when available to its South Asian neighbours like Nepal, Bangladesh, Sri Lanka, Maldives and the like and would most certainly share it with Africa. This can be understood from the way that hydro chloroquine and paracetamol were provided in an earlier phase of the pandemic.

Since almost all vaccines are likely to be produced at a large scale in India through the robust efforts of it’s mainly private sector players there would be opportunities for exportable surpluses which would on priority be provided to South Asian neighbours and African countries. While these are likely to be commercially provided at lower costs as available in India there is every possibility that some of these will be as part of grants by the Ministry of External Affairs as part of its vaccine diplomacy. Recently at the India ASEAN Summit the Prime Minister offered $ 1 million support for Covid-19 ASEAN Response Fund⁹. A $ 10 million health fund already exists for Africa for such diplomacy.

The Asian Development Bank has also announced a $9 billion Asia Pacific Vaccine Access Facility. This will enable member economies to procure vaccines using this funding facility. This is in addition to a $20 billion package to Asian developing countries deal with the Covid-19 crisis. That facility is focused on supporting government expenditure programmes and financing for private companies¹⁰

Beside the vaccine itself, there are new opportunities to deal with the delivery, distribution, cold storage and the like.¹¹ Dubai for West Asia and Ethiopia for Africa are emerging as operational regional centers for vaccine storage and cold chains. They provide airline hubs from where you can reach different countries through their well-connected airlines. India can also take advantage of these regional hubs and its pharmaceutical companies present in a large number of neighbouring and African countries to become a part of this distribution chain.

As part of its ‘Vishwa Guru’ positioning India is well-placed to make a steady diplomatic effort to share its capabilities and emerging technology for Covid-19 vaccines, their utilisation distribution especially among developing countries. Indian production facilities are likely to become the main suppliers for vaccine to most international efforts after the initial surge in capturing production is over.

Endnotes

1. The IMF and World Bank’s Covid-19 response financing has come nowhere near the required $2.5 trillion to meet immediate Covid-19 financing needs. https://www.brettonwoodsproject.org/2020/10/g20-communique-analysis-annual-meetings-2020/ [4]
2. https://asean.org/chairmans-statement-15th-east-asia-summit/ [5]
3. https://www.reuters.com/article/health-coronavirus-india-vaccine/not-without-india-worlds-pharmacy-gears-up-for-vaccine-race-idUSL4N2IA1RM [6]
4. https://www.livemint.com/news/india/8-covid-19-vaccine-candidates-scheduled-to-be-manufactured-in-india-vardhan-11607613026942.html [7]
5. https://mea.gov.in/press-releases.htm?dtl/33276/Tour_of_foreign_Heads_of_Mission_and_their_representatives_to_Hyderabad [8]
6. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32581-2/fulltext
7. https://msfaccess.org/wto-covid-19-trips-waiver-proposal-myths-realities-and-opportunity-governments-protect-access [9]
8. https://www.gavi.org/vaccineswork/gavi-covax-amc-explained [10]
9. https://mea.gov.in/press-releases.htm?dtl/33191/Prime_Minister_addresses_17th_ASEAN_India_Summit [11]
10. https://asia.nikkei.com/Spotlight/Coronavirus/ADB-sets-up-9bn-coronavirus-vaccine-fund?utm_campaign=RN%20Free%20newsletter&utm_medium=daily%20newsletter%20free&utm_source=NAR%20Newsletter&utm_content=article%20link&del_type=1&pub_date=20201211190000&seq_num=7&si=00109458 [12]
11. https://asia.nikkei.com/Spotlight/Coronavirus/Japan-to-provide-ultracold-freezers-to-store-COVID-vaccine [13]

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