While previously attracting global appreciation for its safe, affordable, and accessible alternative to the Pfizer and Moderna candidates, the AstraZeneca COVID-19 vaccine is now at the centre of a major controversy, after Denmark and Norway reported incidents of recipients of the vaccine developing blood clots. This has had a cascading effect across the continent. As of today, 11 European countries, including France, Germany, and Spain, have suspended their roll-out, with new names being added to this list every day. The World Health Organisation (WHO) and the European Medicines Agency (EMA) have reiterated their belief that the vaccine candidate is completely safe and that there is no proven link between the blood clots and the vaccine. Moreover, even if a link is established, it has only affected 37 people out of more than 17 million people worldwide who have received the AstraZeneca shot. Despite these reassurances, however, these countries have chosen to exercise extreme caution and halt its use as a precautionary measure. Regardless of the merits of their decision, it is crucial to explore what the impact of more countries implementing such suspensions could be on India, considering that the AstraZeneca vaccine forms a huge part of India’s vaccine diplomacy and post-pandemic recovery efforts.
The Serum Institute in Pune, which has the capacity to produce 1.5 billion doses of vaccines each year, has acquired a license from AstraZeneca to produce the vaccine to meet the demand of countries like India, Bangladesh, and Nepal. However, with the European Union (EU) continuing to suffer from vaccine shortages, particularly from AstraZeneca, which has been accused of breaching their delivery obligations to the bloc, the EU had also begun looking to acquire the vaccine candidate from facilities outside Europe, including the Serum Institute in India. Due to the expansive production capabilities of the Serum Institute, the AstraZeneca candidate has emerged as central to India’s vaccine program, both domestically and internationally. Accordingly, India has been using the AstraZeneca vaccine to pursue its “Vaccine Maitri” policy, which aims to enhance friendships with countries by helping them meet their vaccine demands.
In pursuance of this policy, India has adopted two methods. The first is the provision of free-of-cost supplies to low- and medium-income countries. The second is through commercial contracts with richer countries. These vaccine diplomacy efforts have helped India expand its regional and international footprint, and advanced its strategic agendas as well.
Primarily, the vaccine deliveries have helped India secure international goodwill; several multilateral organisations, including the World Health Organisation and the International Monetary Fund, have applauded India’s role in bringing an end to the pandemic by using its vaccine production capabilities to meet global demand. In fact, India has already supplied vaccines to 71 countries, with eight million doses being delivered as a gift to low- and middle-income countries, along with 16.5 million doses being provided to the COVAX program.
Apart from cementing India’s image as a solution-provider in a global crisis, this altruistic approach also furthers its strategic goal of emerging as a major international power. For example, India has already provided vaccines to 50% of Least Developed Countries and 34% of Small Island Developing Countries, both of which cumulatively form major and influential groupings in the United Nations (UN). Hence, apart from engendering goodwill, vaccine deliveries to these countries could also advance India’s goals in multilateral fora, particularly the UN.
Moreover, India has also been using its vaccine diplomacy to revive relations with disgruntled allies. For instance, it has provided vaccines free of cost to Nepal and Sri Lanka, both of whom have been growing increasingly closer to China. Furthermore, it has also gifted vaccines to Bangladesh, with whom ties hit a new low following the passage of the Citizenship (Amendment) Act in December 2019. However, since India entered into individual deals for gifting vaccines to these countries, these relationships have taken a positive turn.
For instance, just last week, Indian Prime Minister Narendra Modi held a telephonic conversation with his Bangladeshi counterpart Sheikh Hasina to discuss enhancing the two countries’ relationship by improving bilateral connectivity. In fact, Modi will also visit Bangladesh for a two-day visit starting March 26, where he will meet Hasina and commemorate “50 years of the establishment of diplomatic ties between India and Bangladesh and 50 years of Bangladesh’s war of liberation”. Similarly, earlier this month, Sri Lanka announced its decision to allow India to jointly develop and operate Colombo’s West Container Terminal, shortly after unilaterally withdrawing from a similar agreement for the East Container Terminal. While these developments have not been explicitly linked to India’s vaccine delivery, it is thought that these benevolent gestures had a role to play in the sudden turn in both countries’ tone.
The second and more crucial significance of the AstraZeneca vaccine and India’s ability to produce and deliver it on a large-scale is tied to its influence on India’s post-pandemic economic recovery. While India has distributed roughly 88% of its foreign-bound AstraZeneca doses for free, richer countries, such as Canada and Saudi Arabia, have entered into bilateral commercial contracts with the Serum Institute. In fact, 3.3 million doses of the AstraZeneca vaccine have been supplied as a part of commercial deals. Apart from benefiting the Serum Institute, these commercial deals also support other related industries, including the rubber industry, transportation industry, and storage and refrigeration facilities.
Against this backdrop, the decision of a rising number of European nations to suspend their use of the AstraZeneca vaccines threatens to derail India’s “Vaccine Maitri” strategy, particularly if this abundance of caution spreads beyond Europe. In fact, several African nations have already followed the bloc and halted the use of the vaccine candidate. Hence, with some EU partners now looking elsewhere for vaccine supplies, India faces a risk of endangering both its vaccine diplomacy efforts and its post-pandemic economic recovery.
Worryingly, China’s Sinovac Biotech vaccine met the same fate and resulted in a major setback to China’s vaccine diplomacy. The Chinese candidate’s credibility was brought into question following a research study conducted by the Butantan Institute in Brazil that contradicted the Chinese government’s claim of the vaccine showing efficacy rates of over 78%. Instead, it reported an efficacy rate of a meagre 50.4%. This caused scepticism amongst even its closest allies like Pakistan. Moreover, in Myanmar, several citizens expressed scepticism about being inoculated with the Chinese candidate following reports questioning its safety and efficacy.
Likewise, with many European countries now adopting a precautionary approach to their vaccination programmes, the credibility of the India-produced vaccine has been thrown into doubt, and could potentially make other countries wary of entering into commercial agreements with India or accepting its “gifts” of the AstraZeneca vaccine. In February, South Africa requested that the Serum Institute take back one million doses of its COVID-19 vaccine after South African health authorities determined that it was insufficiently effective against the local variant of the virus. The latest suggestions of a link between the vaccine and blood clots, albeit unproven at this stage, could cause similar cancellations or returns.
Moreover, the doubt surrounding the safety of the vaccine will also impact India’s domestic market, with more and more individuals growing sceptical of being inoculated with what is locally named the Covishield. The International Labour Organisation (ILO) has suggested that the beginning of the vaccine roll-out is the push needed to kickstart India’s economic recovery. Similarly, the International Monetary Fund (IMF) predicts that due in part to the vaccine roll-out, the Indian economy is set to expand by about 11.5% starting April 2021. This is a combined result of the revival of industries such as travel, tourism, and education, all of which have been facing an existential threat due to the COVID-19 pandemic, along with social factors such as an increase in mobility, enhanced work performance, and an improvement in overall public health. Hence, much like commercial contracts with other countries, the success of the domestic vaccine program is also critical for India to begin its path to economic recovery. Against this backdrop, the suspiciously expedited vaccine approval process already fueling anti-vax sentiments in India, reports of several countries suspending the AstraZeneca vaccine’s roll-out could further obstruct the government’s public health response.
Therefore, the success of India’s vaccine programme, both in terms of public health outcomes and diplomatic and economic goals, is inextricably linked to the Serum Institute. In light of this, the decision of several European nations to suspend their use of the AstraZeneca vaccine threatens to severely undercut India’s diplomatic, strategic, and economic goals and weaken its public health response at home. If the AstraZeneca vaccine is indeed safe, as many public health experts around the world have already claimed, India must make significant overtures to prove this point, to allay fears among foreign partners as well as its domestic population. As a nation that is responsible for producing over 60% of the world’s vaccines, India and the Serum Institute must respond to this threat through full transparency and large-scale education and awareness programmes that are undertaken in collaboration with all relevant stakeholders, both at home and abroad. Failure to do so may result in these suspensions, which have thus far only been observed in 11 countries, spreading across the globe, yielding potentially disastrous diplomatic, economic, and public health consequences.
India Should Be Concerned About the Rising Scepticism Surrounding the AstraZeneca Vaccine
The decision by several European countries to halt the roll-out of the AstraZeneca vaccine could impact India’s vaccine diplomacy and its post-pandemic economic recovery.
March 18, 2021
SOURCE: INDIAN EXPRESS