Biden’s American Exceptionalism and India’s Covid-19 Nightmare
On April 16, Adar Poonawalla, CEO of Serum Institute of India (SII) -- and part-producer of the Oxford-AstraZeneca vaccine called Covishield -- tweeted to the President of the United States Joe Biden, asking to lift the embargo on raw material exports to vaccine makers outside the United States. His tweet and subsequent pleading by many global leaders have sent ripples across the United States, with an increasing number of US lawmakers joining calls for Biden to approve exports of vaccines, raw materials, and waive IP patents on vaccines. Biden finally agreed, approving export of raw materials and agreeing to share 60 million Covid-19 vaccines with the developing world. However, the cost of months of delay to prioritise Biden's "America First" foreign policy, in light of India's Covid-19 woes, provides grim reminders of the costs of American Exceptionalism.
INDIA'S COVID-19 CATASTROPHE
India's second wave of the Covid-19 pandemic reported more than 300,000 infections and 2,000 Covid-19 deaths each day for the past five days. The deluge of deaths is putting pressure on mass crematoriums, with some residents in Delhi reportedly having kept dead bodies at home for two days due to lack of space in the city's crematoriums. Some crematoriums have also started to melt under the pressure of around-the-clock cremations, with experts claiming that the number of deaths are underreported.
In New Delhi, one of the hardest-hit cities in India, hospitals have been begging for oxygen supplies as infections keep soaring without any sign of letting up. Max Healthcare, which runs a network of hospitals in north India, tweeted that it only had two hours of oxygen supply left. Other hospital chains like Fortis healthcare said they were suspending new admissions in Delhi since they were running on backup oxygen supply. Reportedly, on April 24, 6 patients at a private hospital in Amritsar died due to a shortage of medical oxygen in the facility. The Straits Times also reported accusations that states like Haryana had blocked oxygen tankers at the border with Delhi to meet its own needs.
Hospitals in Delhi and Maharashtra have run out of beds, with some hospitals assigning two patients to a single bed. Amid the surge, the state government -- for the first time -- has allocated 14 private hospitals to only treat Covid-19 patients until further notice, outraging many whose relatives need treatment for other conditions. Meanwhile, India's healthcare workers are again succumbing to Covid-19, with many medical staff at a hospital in Madhya Pradesh testing positive for Covid-19. In Chattisgarh, NDTV broadcasts showed a hospital corridor lined with Covid-19 victims awaiting last rites. Some BBC reports have shown Delhi hospitals not responding to a barrage of stretchers and ambulances waiting outside the hospital, hoping to get a single seat inside.
The Indian government has deployed military planes and trains to get medical oxygen to Delhi from the far corners of the country and overseas, including Singapore. During a radio address on Sunday, Indian Prime Minister Narendra Modi urged all citizens to be vaccinated, exercise caution, commenting that the Covid-19 "storm had shaken the country".
GLOBAL VACCINE WOES
Being home to the biggest vaccine producer in the world, India still has been facing increasing difficulties providing vaccine shots for its population. Vaccine shortage was reported across multiple states as of April 8, with Odisha closing 700 centers citing vaccine scarcity. Five other states, including Maharashtra, Andhra Pradesh and Telangana, have also complained of vaccine shortages. Amid the deadly second wave, the country still moved to cover all adults over the age of 18 under its vaccination programme starting May 1, but experts believe India is unlikely to meet its target of covering 250 million people by July. Currently, the country has fully vaccinated 17 million people, with 109 million people receiving at least one dose, covering roughly 2% of the 1.3 billion population.
Global vaccine woes do not end there. The Indian government restricted the export of its domestically produced vaccines to meet demands inside India. This move risks putting a screeching halt on nascent vaccination campaigns in many African countries that purchased Oxford-AstraZeneca vaccines from SII, effectively derailing at least 17% of the entire world's population who were completely dependent on SII's vaccines. The African nations were already experiencing the slowest rollout of any continent. As of April 21, only 15 million doses, out of 36 million acquired for a collective population of 1.3 billion, were administered. Many African governments prioritized administering first doses to secure as many as possible within their populations, in the expectation that more doses would soon arrive. They are struggling to plan their vaccination campaigns since there is high uncertainty regarding enough supplies to administer a full two-dose regimen that offers maximum protection.
Rwanda and Ghana, who were among the first to receive doses from COVAX, are dangerously close to exhausting their initial vaccine supplies. Botswana temporarily halted its vaccination campaigns in some areas after the allotted doses ran out. Kenya, which is close to running out of their initial one million doses, said that it would seek to acquire J&J and Pfizer vaccines to continue their inoculation campaigns. Bangladesh finished administering 8.1 million doses in the country using SII produced vaccine and announced that it will be halting first doses from April 26 until further notice. According to contracts, Bangladesh was to procure 30 million doses of Oxford-AstraZeneca vaccine from SII but received only 7 million doses until now.
On April 24, the Indian High Commission in Dhaka issued a release, addressing Bangladesh's foreign ministry, stating that the country will not export Oxford-AstraZeneca vaccines anytime soon. The supply of the vaccine is delayed due to a crisis of raw materials. The note understandably indicated the United States saying that "key countries" of the world have been withholding raw materials critical for the manufacturing of these vaccines. At such a point, all vaccine producers in India, including SII, are working to meet the country's internal demand. Adar Poonawalla, during an interview, told NDTV on April 21 that "there is no clarity" on vaccine exports at least before June-July, pushing more than 17% of the world's populations to scramble for other vaccines and defend themselves against rising virus variants with minimum strength.
'AMERICA FIRST'
In the United States, however, demands for vaccinations are falling. The New York Times reported that once sites overflowing with vaccine recipients are now closing their shutters due to a lack of recipients, with some counties declining their vaccine shipments. Millions are skipping their second doses. As many as 5 million, or nearly 8 percent of those receiving a Pfizer or Moderna jab have missed their second doses. The United States is currently sitting on 20 million AstraZeneca stocks, without any plans of using it.
Top US infectious disease official Dr Anthony Fauci had stated previously that the AstraZeneca vaccines have good efficacy but the United States will likely not require them. John Kerry, in his recent visit to Dhaka, announced that the US is committed to making vaccines available to other countries as soon as 100 million Americans are inoculated. The United States has already administered more than 200 million Covid-19 vaccine doses, yet US vaccine help remained elusive until April 26.
When asked in White House press briefings in mid-April about the administration's response to India's repeated pleading -- requesting to relax the vaccine and raw materials embargo -- both Dr Anthony Fauci and the White House Covid-19 response senior advisor Dr Andy Slacitt had no response. "I'm sorry. We could get back to you on that, I'm sure. But I don't have anything for you right now," Dr Fauci said.
Later, when White House Press Secretary Jen Psaki was asked the same question, she said that "the United States offers our deepest sympathy to the people of India, who are suffering during this global pandemic, and we are working closely with Indian officials at both political and experts' level to identify ways to help address the crisis."
Separately, a White House spokeswoman wrote in an email to Reuters that, "We (the United States) are in active conversations at high levels and plan to quickly deploy additional support to the Government of India and Indian health care workers as they battle this latest severe outbreak. We will have more to share very soon."
On April 22, State Department spokesman Ned Price, in a response to questions about the export ban, said that the United States first and foremost is engaged in an ambitious and effective and, so far, successful effort to vaccinate the American people. He went so far as to claim that "it's in the interests of the rest of the world to see Americans vaccinated." Milind Deora, a Mumbai politician, responded on Twitter saying stockpiling and blocking exports of crucial raw materials is only undermining the Indo-US partnership. Among a plethora of US politicians urging Biden to waive export bands and patent laws, US Congressman Raja Krishnamoorthi urged the Biden administration to release unused vaccines stating that the US government needs to get the vaccines where they will save lives.
While announcing on April 26 that the United States will share its Oxford-AstraZeneca vaccines, Jen Psaki stated that it still may take another few weeks to ship the first batch of 10 million. It is also important to note, that the United States still did not pledge to provide India with vaccines from its' stockpiles.
The National Security Council spokesperson said that the United States has been under mounting pressure to support the ongoing efforts in Delhi, and will release raw materials upon consultation, bringing a dismal end to the back-and-forth exchanges between the two countries that have been going on for months. If the 'America First' outlook costs millions of lives abroad, and a new Covid-19 variant is poised to outrace the vaccines, then we must begin to assess the viability, and comprehensiveness of Biden's American Exceptionalism.
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