The Indian government’s COVID-19 vaccine rollout could have been world-leading. Instead, vaccination clinics are running out of supplies, and just 3 percent of the population is fully immunised. India’s rich are responsible for this disaster.
India is one of the world’s pharmaceutical giants. The Serum Institute is the world’s largest vaccine manufacturer, producing 1.5 billion vaccine doses per year. Half the world’s children are vaccinated with its products, and India’s vaccine exports account for 60 percent of the global total. In mid-2020, the Serum Institute secured a deal to manufacture one billion doses of the Oxford-AstraZeneca vaccine, half of which were to be exported as part of the COVAX dose-sharing program.
In December, Prime Minister Narendra Modi declared that 300 million Indians would be vaccinated by August this year. K. Srinath Reddy, president of the Public Health Foundation of India, said the country had “the advantage of having run a very large universal immunisation program”. Indeed, 110 million children were immunised for polio over three days in January, while the pandemic raged.
Yet as thousands die from the coronavirus each day, the vaccine rollout is a shambles. The government can’t claim a lack of manufacturing capacity. It has that. It can’t claim inexperience or a lack of infrastructure for mass vaccination drives. It has that. It can’t claim a lack of money to buy vaccines. There is an abundance of that.
India is home to more than 100 billionaires, the fourth greatest proportion on earth. The country also has the world’s third largest military budget—$73 billion per year—amounting to more than double all public expenditure on health care. The central government even has money to burn on pure vanity. Construction continues on a US$1.7 billion government palace in Delhi. Most Indians are monstrously poor, but those who run the country are far from poverty.
The middle and upper classes are faring okay when it comes to getting vaccinated. It is India’s working class, and the ultra-poor, who are missing out. A vaccine centre administrator, speaking to the Times of India, said, “We are only seeing elite people coming into our centres”.
Of course, the wealthy have a leg up—the government organised the vaccine rollout over the internet, but half the population don’t have access to it. To get vaccinated, residents need to create an account on the government’s “CoWin” website, and then register to book an appointment. Predictably, the website is prone to crashing, glitches—such as falsely distributing vaccination certificates—and the appointments fill up in seconds.
This is not the action of a government doing its utmost to immunise the maximum number of people, fast. The government has ditched the tried-and-true methods of India’s previous vaccination drives, which involved medical teams, sponsored by state and federal governments, setting up vaccination centres in the tens of thousands, and often going directly to the doors of hard-to-reach communities. Instead, Modi has created a vaccine lottery for the wealthy.
And of course it wouldn’t be capitalism if the elite weren’t provided an opportunity to make profits. Legislation directs vaccine manufacturers to supply 50 percent of vaccines to the central government at the set price of 150 rupees (A$2.60) per dose, and to distribute the remainder to states and private hospitals at whatever cost they wish.
Modi justified this as supposedly incentivising vaccine production; it has only incentivised price gouging. The vaccine is free in public hospitals, but in private facilities—where two thirds of Indians receive their health care—residents are asked to pay. No wonder Adar Poonawalla, CEO of the Serum Institute, increased his personal wealth by 85 percent in the first months of the pandemic; for him, no dollar is too dirty.
For India’s enormous population to be vaccinated, particularly in highly populated rural areas where health care is scarce, the vaccine rollout would have to be centrally coordinated, free of cost, and logistically tactful, targeting the most vulnerable populations first. Instead, on 20 April, Modi announced with hubris that everyone over the age of 18 could now receive the vaccine—widening the net while the vaccine rollout was behind target and under supplied.
As Shahid Jameel, a virologist at Ashoka University in New Delhi, explained in the Lancet, the journal of the British Medical Association, “It was all bad planning”. The Modi government simply had priorities other than ensuring a smooth vaccine rollout.
One was ambitions of regional dominance. India’s central government refused to allow emergency use of vaccines from a foreign source, such as the Russian vaccine Sputnik V, as late as February. This was informed by the desire to inoculate the domestic population and become a major exporter of vaccines that were made in India.
Petty politicking also came into play. Election mega-campaigns were conducted in five Indian states in the first months of this year. In Bihar, campaigners from Modi’s ruling party, the Indian People’s Party, dangled the carrot of free COVID vaccinations if they were voted in—the implicit threat being that if the opposition were elected, residents would have to pay. The central government was also accused of slowing the distribution of vaccines to states not governed by the People’s Party, in a ploy to “prove” that its opponents were less capable of organising mass vaccinations.
To say that India was too poor to have managed mass vaccinations, that instead Western governments should have intervened to organise the rollout, lets the Indian rich and powerful off the hook for their crimes. Things did not have to be this way.
The inability of India’s rulers to immunise the nation’s workers and the poor, alongside chronic shortages of hospital beds and oxygen and refusal by the central government to organise a lockdown, are all catastrophes caused by Indian capitalism.
It is impossible to imagine that the Indian government would have bungled a major military operation in the way it has botched the vaccine rollout. The state can organise upwards of 900 million people to vote in federal elections every five years. Yet when it came to stopping working-class people from dying of COVID-19, it threw forward planning, rationality and urgency out the window in place of chaos, negligence and profiteering.
It is possible that India’s vaccine production will be boosted in coming months. The Modi government has announced a US$400 million grant to vaccine manufacturers, which should expand manufacturing. And it has allowed the emergency use of a variety of foreign vaccines. But such measures, while necessary, have come too late to address the current crisis. As Celine Gounder, professor at the New York University Grossman School of Medicine, told the New York Times, “You can’t vaccinate your way out of a surge”.
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