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The Big Story: Tardy grade

The support was late, but effusive. Over a couple of hours on Sunday, a whole slew of top US officials issued statements of support for India as it struggled to handle an enormous surge in Covid-19 cases, recording the worst daily numbers globally.

The messages of solidarity started with President Joe Biden and included Vice President Kamala Harris, the secretary of state, the defence secretary, the national security adviser and the surgeon general, among others.

Crucially, the Biden administration statement went beyond words:

“The United States has identified sources of specific raw material urgently required for Indian manufacture of the Covishield vaccine that will immediately be made available for India. To help treat COVID-19 patients and protect front-line health workers in India, the United States has identified supplies of therapeutics, rapid diagnostic test kits, ventilators, and Personal Protective Equipment (PPE) that will immediately be made available for India. The United States also is pursuing options to provide oxygen generation and related supplies on an urgent basis.”

The US effort comes after countries around the world mobilised to provide aid to India, as its Covid-19 crisis reached horrific proportions. In many parts of the country, patients are struggling to get access to medicines and ventilators, and hospitals are taking to Twitter and going to court to desperately plead for more oxygen supplies.

On Friday, Indian External Affairs Minister S Jaishankar held an online meeting with the country’s ambassadors to the European Union, the US, Germany and executives from a number of multinational pharmaceutical and vaccine companies.

Over the weekend, support poured in from many sources:

The Hindu has a round-up of some of the other commitments, including from the European Union, the United Arab Emirates and even offers of help from Pakistan. The Financial Times provides some more details, including support from Germany’s Angela Merkel who last week complained about India halting pharmaceutical exports.

Belated Biden

The US support in particular was much discussed in part because of how late it seemed to come.

India and the US have grown closer than ever before over the last few years, in part because of the rise of China, as the Quad alliance between these two countries along with Australia and Japan to counter Beijing has made evident. The India-US connection today includes a very vocal public sphere, including researchers and think tanks that have studied and encouraged the partnership as well as an Indian-American population that is more visible than ever before.

With a large vaccine rollout in the US seeming to stabilise the pandemic, many American public voices had begun talking about how the country should now help the rest of the world. With India’s case count turning into an absolute tsunami, the obvious partner to begin helping was New Delhi.

“Only the United States has the capacity, resources and technical know-how to bend the curve of India’s catastrophic second wave of disease,” wrote Ashish K Jha, dean of the Brown University School of Public Health. “One democracy coming to the aid of another in this time of crisis is exactly what the world needs now. It will be good for India. It will be good for the United States. And it will make the world a safer place.”

Many also made the point that the rise and spread of variants in India – which is sparking global concern but has barely been studied in the country – posed a threat to the whole world. Jha, moreover, pointed out that the US reportedly has 30 million AstraZeneca vaccines that have not been authorised and are unlikely to be used on the American population.

Yet, when questions were raised about supporting India last week, the Biden administration said, “It is not only in the US interest to see Americans vaccinated, but it is in the interests of the rest of the world to see Americans vaccinated.”

This did not go down well.

At one end, there was a joint request from a number of Indian think tanks to the Biden administration to “seriously, urgently, and actively consider exceptions” to pandemic-era protections it put in place that were coming in the way of vaccine production in India.

At another, there was anger (and some mobilisation from the Bharatiya Janata Party’s infamous IT Cell), which finally had a convenient villain to blame, to deflect criticism aimed at Prime Minister Narendra Modi for his failure in curbing the virus and preparing India’s healthcare system for a second wave.

Other elements of the Hindutva nationalist ecosystem (and evidently some pro-Russian voices), ignoring the Biden administration’s willingness to work with India within the Quad, attempted to make this about a perceived anti-Modi sentiment within the White House.

The eventual turnaround from the US should put some of these questions to rest. But the delay in responding – and the vociferious reaction from the public sphere – speaks volumes about the weight of expectations from the current India-US relationship, and the challenges it may pose for Biden.

Belated Modi?

Despite Jha’s claims of the US being the only country with the know-how to bend the curve of India’s second Covid-19 wave, however, the fact is that supplies and support from abroad can only go so far.

India is facing an enormous calamity, of its own making. While the support on oxygen – which still presents complex logistical challenges – and key drugs ought to help with the current shortages, it cannot prevent the explosion in cases that will undoubtedly continue to grow.

The Indian government’s NITI Aayog think tank – which has the ignominious track record of predicting that the epidemic would end in India on May 16 2020 – told Prime Minister Narendra Modi and state chief ministers last week that this current wave is expected to peak in mid-May 2021. It will potentially hit 500,000 new cases a day, up from the global record 350,000 per day right now, Niti Aayog said.

The University of Michigan’s Bhramar Mukherjee predicted as much as 800,000-1 million cases a day at the peak, while saying this could be mitigated through restrictions and other measures.

Worryingly, this current surge is spreading far beyond Delhi – which always receives oversize coverage because of the significant presence of the media – where it is less likely to receive attention.

Even more disturbingly, governments are attempting to prevent information on the pandemic from being transparently presented. Underreporting of deaths appears to be rampant, as made clear from many reports.

Moreover, in the last few days, the Centre has ordered Twitter to take down posts criticising its handling of the pandemic, including from Opposition politicians and the media. And in Uttar Pradesh, where Chief Minister Adityanath is always prepared to engage the police state, authorities have been told to seize the property of individuals who “spread rumours” and “spoil the atmosphere”.

And it is impossible to ignore the Trump-ian series of statements that were made by the ruling party as cases climbed over the last few months, as well as its delay in taking the crisis seriously.

Support on the vaccination campaign, whether raw materials or actual vaccines, will indeed help India in the medium term. The country is currently facing shortages, has just unveiled a baffling new approach to vaccinations and cannot expect a big jump in supplies until the second half of the year.

But even there, no vaccination effort can prevent the spread of the current second wave, in part because of the country’s massive population and limited capacity to actually carry out inoculations much faster than the current pace.

On vaccine raw material supplies though, it does seem as if the tardiness was not only from the American end:

This has not been helped by confusing and conflicting statements from the Serum Institute of India, whose head Adar Poonawalla said most recently that the raw material hold-up was only affecting Covovax and not Covishield, India’s version of the Oxford-AstraZeneca vaccine that is currently India’s most widely administered vaccine. Covovax in an unauthorised vaccine that will only come into play later in the year.

The US statements, however, say they will be making available raw material for Covishield.

Regardless, the fact that Poonawalla even needed to tweet asking to Biden asking for help – rather than relying on India-US diplomatic channels – suggested something awry in Delhi’s handling of the Serum Institute and the vaccine effort.

Even more confusingly has been the limited communication from the Indian government on the effort to have intellectual property rights on vaccines temporarily waied. Biden and other Western leaders have rightly been criticised for failing to support this measure, sponsored by India and South Africa at the World Trade Organisation and supported by 100 countries.

Not everyone believes this would necessarily make a huge difference to the global vaccine effort. But though India is a co-sponsor of the demand, Modi has not put his weight behind the issue on the global front. And India has not followed in Israel’s lead on even issuing compulsory licences for a vaccine co-developed by the government at home.

Global support can help with immediate shortages and even medium-term issues like vaccine supplies. But India’s confused approach to the second wave and its baffling vaccine policy suggests that international help will not be enough to solve what is evidently a home-grown crisis.

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