Don’t Write Off Indian Vaccine Diplomacy Yet

By Krzysztof Iwanek

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India continues to cope with the devastating effects of its second wave of the COVID-19 pandemic, which has taken the lives of thousands of people – the exact numbers remain uncertain. The unfolding tragedy has also shut the gates of New Delhi’s vaccine diplomacy.

In January 2021, India was not only kicking off its vaccination drive, but also sharing millions of doses with other countries. India was heralded in the news as the nation with the biggest vaccine manufacturing capacity. The country’s foreign minister was busy tweeting about each shipment of vaccines to another nation. By March, however, that rosy picture gave way to calamity, overshadowing earlier success. Some believe now that India’s vaccine diplomacy was a mistake, or at least that it did not yield the desired results. But it’s too early for that conclusion.

It is true that by April it became obvious that India was being hit by a massive wave of COVID-19 infections, and that the spike was not confined to specific states, like Maharashtra, but was quickly on its way to being a national crisis. New Delhi then blocked all exports of vaccines, promising it would be a temporary two-month measure to “prioritize” domestic needs. Should we treat the promise literally, that period will end by the beginnings of June, although it is not so clear exports will recommence then. Meanwhile, the current of assistance has started to flow the opposite way: The world is now helping India. As Indian hospitals overflowed with patients, many of them with severe symptoms and with thousands dying due to insufficient equipment, some countries starting to send emergency transports of medical aid to India, such as oxygen concentrators.

Now is a time of reckoning in India. What could have been done differently, who is to blame, and could the governments — both central and the state — have reacted better and faster? It certainly looks that they could have, and in many ways, given that experts and pandemic watchers in the country were sending warning signs early. Another oft-discussed issues is that of vaccine diplomacy – with hindsight, some question if it made sense to share doses with other nations when New Delhi should have focused on vaccinating its own citizens.

The counterpoint to this is the data: India donated over 10 million doses of vaccines to other countries, while it administered 187 million doses to its own citizens (both numbers as of May 21). The number of Indians vaccinated with at least once dose is certainly small, given the country’s population of 1.4 billion, but the gifted doses would not have changed the overall picture.

Besides donations, over 35.7 million doses were sold to other countries and these commercial shipments, presumably, were doses sold by the Serum Institute of India – a private company which has the biggest COVID-19 vaccine producing capacity in the world and which produces AstraZeneca’s vaccine on a license. The doses that New Delhi gifted to other countries were also mostly produced by this company, and then purchased by the Indian government, which decided to donate a part of them to other countries. It is true that the government of India could have halted commercial sales earlier and for longer (it did so briefly in January and in April). Yet, this would have generated legal problems (as the current blocking of exports is doing) and raise moral questions (most of the customers are poorer countries). Moreover, although the number of doses sold was larger than the number of donated doses, and they could have been used to vaccinate millions in India, on a national scale these doses would not have been able to stop the second wave.

Finally, the third type of exports were Indian shipments of nearly 20 million doses of vaccines destined to be used by the COVAX facility for poorer countries. This, however, was not just a moral obligation but a formal one – international donors had in fact earlier supplied the Serum Institute of India with funds so that the company could ramp up manufacturing capacity, provided that a part of the vaccine doses would be later given to COVAX. Indeed, India’s Ministry of External Affairs data show that while the last commercial shipment was on March 29 (and was flown to Palestine), transports for the sake of COVAX continued until mid-April, destined for countries such as Zambia, Mauritania, and Syria.

Ultimately, India’s vaccine diplomacy was not a mistake in the sense that not undertaking it would not have stopped the calamity. This is especially true when we conclude that only the 10 million doses donated by New Delhi to other nations can be really counted as vaccine diplomacy (rather than commercial sales or other commitments). But the question remains – did this policy yield any results?

The list of recipients of New Delhi’s vaccine generosity differs vastly from the list of nations that later helped India with medical equipment. There is hardly any overlap between the two lists. The majority of states that received Indian donations were: (1) India’s smaller neighbors, (2) African countries, and (3) small island nations. By comparison, the nations that later helped India were mostly developed: the U.S., Russia, the EU and individual European countries, and others.

The main reason for this is obvious. India helped those countries that needed assistance and then later received assistance from those that could offer it. If a given country was in such a dire economic condition that it accepted vaccines from India earlier this year, could it afford to send a plane with oxygen concentrators or respirators to India in April? Is it even fair to expect recipient countries, such as Afghanistan, Rwanda, or Albania, to reciprocate that way?

Even where overlap between the two lists did occur, it may perhaps be explained by longer and deeper relations. The countries that both received donations from India and later reciprocated with assistance include South Asian neighbors, such as Bangladesh (which shared its stocks of Remdesivir) or Bhutan (which offered to share medical oxygen through a plant located close to a border with India). In such cases, it may be argued that India and these countries have long established relationships, and that they would have helped India regardless of the earlier donations of vaccines.

Despite all of this, I would still argue that it is too early to write off India’s vaccine diplomacy. After all, diplomatic efforts are a complicated process, often undertaken with long-term objectives. We should not expect that 200,000 vaccine doses sent to Paraguay in March would translate into an iron partnership between India and Paraguay by April. If India’s vaccine diplomacy does not start up again, then it surely will not bring New Delhi any larger political gains.

But what if it does recommence? Our judgement may be clouded by the current circumstances. This is probably the worst moment to expect India to start donating to other nations again. Given the recent horrible experiences, the Indian government will probably continue prioritizing its own vaccination program much longer than the initially stated two months, and even rising domestic manufacturing capabilities will probably be utilized by New Delhi making larger orders for itself (whether the public health system will be able to keep with the pace of vaccination is another question, and in huge doubt). Restarting foreign donations now would likely be heavily criticized by Indian citizens, many of whom are very angry with how the central government mishandled the crisis.

But while India’s pace of vaccination remains slow and patchy, the situation is even worse in many other developing countries. As of now, the number of fully vaccinated Indians (those who have been administered two doses) is a paltry 3 percent of the population, but in many African countries it is even less than 1 percent, and many times smaller in absolute numbers. Indian governments at every level have undoubtedly failed, but at least Indian companies (especially the Serum Institute of India) have the capacity to manufacture vaccines on a massive scale, while most of Africa and parts of Asia are at the mercy of foreign donors for lack of that capacity.

The truth is that outside the bubble of advanced and rich countries like the U.K., the U.S., Israel, and others, the global COVID-19 vaccination program is barely beginning. Should New Delhi learn from its current mistakes and cope with its dire domestic challenges better, it may restart its vaccine diplomacy and that will be widely welcomed. The needs around the world remain high.

And, at any rate, only prolonged efforts will lead to diplomatic success. Such policies are like shouts in a canyon: Some of their echoes may appear later than we expect. New Delhi cannot expect to become a major global player in the domain of health assistance by just giving out a few million vials of vaccines for free. But in the past India has proved that it is capable of boosting its image and achieving political gains through prolonged and multifaceted assistance to another country. Afghanistan is a clear example of this. In the case of Afghanistan, there were strong strategic reasons to provide assistance, and New Delhi does not have the means to invest in every relationship in such a way. But it has experience in long-term efforts that include assistance, and the image-building that must accompany it in order to truly yield diplomatic results.

While we can best assess the ultimate results of India’s vaccine diplomacy with a cool head a few years from now, it cannot be ruled out that the efforts to far — even frozen and cloudy as they are at present — may still have yielded modest results.

First, the current has put India firmly on the map of global health politics. Two years ago, if people were asked which countries would be crucial in dealing with a hypothetical pandemic, I assume many would not have mentioned India. Of course, the Serum Institute of India was a known entity already because of the other vaccines it produced by it, such as for measles, but that was not well known outside certain circles.

Second, New Delhi has taken diplomatic first steps on new ground. In its vaccine diplomacy, India confirmed that it remains focused on its region – with neighbors receiving the largest donations – and does not have the resources to deeply engage in distant regions. And yet, shipments to Africa, South America, and various island nations can certainly be considered first steps on new ground.

Third, should such steps continue, we may yet see India benefit politically. For instance, small island nations may seem to have little to offer New Delhi, but India has long attempted to engage them diplomatically, for example seeking support for United Nations reform. It is similarly too early to tell how much the China-India rivalry has seeped into global vaccine diplomacy, and whether New Delhi has scored any points in that contest.

India’s assistance to Paraguay is illustrative as a case that ticked many political boxes at the same time. Paraguay is one of the few nations left that recognize Taiwan as a sovereign country; Beijing reportedly pressed the South American country to derecognize Taiwan, while offering its vaccines. Paraguay refused and then India sent its vaccines to the country. Even though the number of doses was small, hardly enough to make a huge difference, the story made waves in global media.

Fourth, and on a most general level, while the current crisis has showed New Delhi’s many mistakes on the domestic front, the earlier circumstances which led to it donating doses highlighted the country’s strengths. For example, the Serum Institute of India is able to produce cheap vaccines on a massive scale, and to do so with the use of foreign technology. This can be grounds for a fruitful international health alliance in the future, with Western countries sharing the know-how (including licenses) with India, a country with a massive workforce and cheap manufacturing conditions, in order to supply the world with affordable vaccines.