India’s crisis is our crisis

May 5, 2021

India has been added to the UK ‘red list’. With the country setting a global record for case numbers reported in a single day and reports of oxygen shortages and hospitals becoming overwhelmed, a year into this pandemic we may well be facing its most serious crisis yet.

The UK government ‘red list’ travel restrictions amount to a ban on most arrivals (UK and Irish nationals are permitted but only subject to mandatory hotel quarantine). They have been supported by many activists and scientists but they pose troubling questions for the future.

These restrictions are no doubt a grim necessity as a temporary, emergency measure. But there is a clear risk that they are gradually turning into the opposite: a semi-permanent drift into a world of ever more egregious restrictions on the movements of people across borders. In the case of the UK and India – like many other examples – this will have a damaging human impact due to the diasporic and family ties that bind communities in these two countries closely together. With the costs of mandatory hotel quarantine in the UK also incredibly high, this further introduces a form of border apartheid based on economic class: wealthy nationals can return, albeit with the inconvenience of mandatory quarantine, while the great majority of people are locked out.

These arrangements cannot be allowed to become semi-permanent. They demonstrate how we increasingly face a stark choice between a flawed pandemic nationalism and the only effective way out of the crisis for the whole of humanity: international cooperation.

India’s crisis has underlined how, in our highly interconnected world, ‘no one is safe until we are all safe’. Indeed, the country is an example of the fragility of all societies in the face of this pandemic. In early March, the government declared it was in the ‘endgame’ of Covid-19. But a too swift reopening – including regional elections involving 186 million people and mass sports events without social distancing – has led to a rapid resurgence of the virus. In some parts of the country, cases numbers are doubling every five days. A Lancet report has warned that daily deaths could hit 2,320 by June unless swift, strict measures are taken.

Orientalism and vaccine inequality

When the western media reports on crises gripping non-western states they often find it hard to resist sliding into the default setting of orientalism. This refers to narratives and frameworks that assume some level of western superiority, exaggerate the difference between the ‘east’ and ‘west’, and sensationalise life in the ‘exotic’ countries and regions of Asia and the global south. The Guardian, for example, chose to run an entire piece from the perspective of a healthy, white Australian family self-isolating in Bangalore’s ‘war zone’.

In truth, the mistakes that have been made in India are very similar to those seen at different phases in this crisis in other states – notably Britain and the US but also, more recently, France, which took far too long to move to lockdown in the latest wave.

Fortunately, the vaccine breakthrough means that there is now a clear pharmaceutical route out of the crisis. The latest data shows that they drive down infection rates. Oxford University found that one shot of the AstraZeneca and Pfizer vaccines reduced infection by 65 per cent. However, when production is failing to meet global demand this success brings moral risks.

States with access to vaccines could soon achieve ‘herd immunity’, close their borders and shield their now protected populations. They could then stand back and watch while the virus rips through the rest of the world. Not only would this be morally wrong, but it is also clearly against the long-term interests of these societies. It would aggravate the damage to the global economy (thereby hurting those states that took this nationalistic path) and increase the likelihood of viral mutations that may develop some degree of resistance to the vaccines.

While no one openly supports this beggar-thy-neighbour approach, there is a danger that some states are drifting by a mix of accident and design into this view. In the UK, domestic vaccination plus border control now seem to be the main priorities of the government.

The alternative is the only practical way out of the crisis: sharing technology and investing in global manufacturing capacity, in order to deliver the largest and most rapid vaccination programme the world has ever known. This is within our power if we choose to cooperate.

Share the vaccines

Orientalism also assumes countries in the ‘east’ and ‘eest’ do not have shared experiences and challenges. Among other things this is particularly hard to square with the rise of authoritarianism and racism that has poisoned Chinese, India, American and European politics alike. Even among progressive politicians and movements, there is a strong temptation to pursue ‘our people first’ policies. In the US, Biden initially maintained Trump’s ban on all vaccine exports and raw materials. Facing its domestic crisis, India followed suit with its own ban and a spiral of such behaviour will unfold unless states agree to cooperate.

India needs to be at the centre of a coordinated, global industrial strategy. Its Serum Institute is the largest vaccine manufacturing centre in the world, and the country accounts for 60 per cent of global vaccine production in a normal year. Prior to its ban it had exported 60 million vaccines – and its 138 million domestic doses is in absolute terms second only to the United States. However, the Institute has said it is not running at full capacity and appealed directly to the Biden administration to lift the ban on vaccine raw materials. Only now facing the latest crisis has the Biden administration agreed to send vital supplies to the Indian manufacturer.

To change the current production model means mapping and capitalising on all available production capacity globally. It would then require suspending Covid-19 vaccine patents and providing toolkits to global manufacturers to join the race to protect the world.

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Backed by the World Health Organisation (WHO), this should not be seen as a radical proposal. South Africa and India have also taken it to the World Trade Organisation (WTO), leading a coalition of states calling on intellectual property rules for Covid-19 vaccines to be suspended. The damaging opposition of the world’s wealthiest states is becoming increasingly unsustainable in light of the failure of the current system to meet global demand.

Outdated intellectual property laws, which prioritise private monopoly over the sharing of technology, must now be pushed aside in the interests of global public health. The American pharmaceutical sector, in particular, has assumed a dominant position in Covid-19 vaccines with a whole stream of company products: Moderna, Johnson & Johnson, Novavax, CureVac, and Pfizer (produced in collaboration with the German company, BioNTech). Yet, these companies have not signed up to the WHO’s Technology Access Pool, which aims to share scientific and manufacturing knowledge to exit the global crisis as quickly as possible.

This makes the position of the Biden administration key to the global situation. The US Government actually has a patent licence claim over all the American vaccines – with only Pfizer so far paying a royalty. Given this fact private sector monopoly control is completely unjustifiable. Last week a remarkable list of 170 former world leaders urged the US to suspend the patents. Crucially, this is not a question of charity but enlightened self-interest. It pursues the only practical route out of the crisis based on cooperation and global governance.

By liberalising patent rules and sharing technology, production can be expanded across the world to meet the extraordinary level of demand for these medicines. The significant vaccine manufacturing capacity in India can play a vital role in these efforts. The alternative a world of closed borders and vaccine apartheid would be tremendously damaging to all states.



Teaser photo credit: Covid-19 testing centre in Warora, Maharashtra. Photo: Ganesh Dhamodkar/Wikimedia Commons

Luke Cooper

Luke Cooper is an associate researcher and consultant at LSE IDEAS. His book Authoritarian Contagion (Bristol University Press) in June 2021

Tags: coronavirus strategies, vaccines