Desperation In India As COVID-19 Rages – Critics Take To Social Media, While Vaccine Manufacturers Hike Prices Emergency Response 26/04/2021 • Disha Shetty Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) India’s Armed Forces Medical Services (AFMS) deploys doctors and paramedics at Sardar Vallabhbhai Patel (SVP) COVID hospital in Delhi to respond to the surge in COVID-19 cases. PUNE – Indian twitter for days has been a desperate space. There are appeals for oxygen cylinders, cries for funding to meet healthcare costs, and panic-stricken relatives scouting for hospital beds for their loved ones. Hospitals are now approaching the courts for help as they run out of oxygen. And even prominent lawyers and influencers are scouting for help online. In the Indian state of Karnataka, deaths are so high that the government has allowed the dead to be buried in land owned by family members, or on farm property, as the crematoriums are flooded with dead bodies. Not only are hospitals discouraging COVID patients from even coming for treatment, but COVID tests have now run out in many parts of the country. While the international community is now proffering offers of assistance – observers fear it will be too little too late. #Karnataka allows cremation/burial of those succumbing to #Covid19 at land/farmhouse owned by family members/relatives, as fatality rate rises due to #COVIDSecondWave. @IndianExpress Here are the guidelines: pic.twitter.com/d36FtldlIF — Express Bengaluru (@IEBengaluru) April 21, 2021 Government Held To Blame The government has been blamed for the mismanagement of the crisis – most recently for allowing the super spreader religious event called the Kumbh Mela, involving mass gatherings of prayer goers in the Ganges River and on land. Indian Prime Minister Narendra Modi’s own election rallies in the election-bound state of West Bengal have also contributed to the rising cases in that state. Modi’s BJP government even offered voters free vaccines if it came to power in the state, whose eight-phase election will continue until 29 April. The Prime Minister, meanwhile, has not only downplayed the crisis – but even gone so far as to argue before the country’s Delhi High Court that there has been no shortage of oxygen – despite the public pleas from patients and hospitals around the country on social media. India’s Health Minister Harsh Vardhan visits the Sardar Patel Covid Center, near Chhatarpur Temple, in New Delhi on April 24, 2021 – an emergency facility set up to cope with the current crisis. Opposition leaders have highlighted instances where tweets criticizing the government’s handling of Covid-19 also have been deleted from social media platforms. They also note that government public health officials utterly failed to restrict the mass Hindu religious gatherings, while Modi has personally boasted about his own the mass election gatherings – despite the clear risks both poised to public health. Amidst all this the country has been reporting close to 350,000 new cases daily, outpacing the highest daily case rates of the worst-affected country in the world, the United States (US) at the peak of its third pandemic wave. In terms of cumulative cases, as well, India now ranks second after the US. Opening Up Domestic Vaccine Market On May 1 the government will open up vaccines to those above the age of 18 – but it’s clear that in light of the severe vaccine shortages, many people will still not be able to access vaccines for several months. And at the same time, the country is opening up its vaccine market to private players as Health Policy Watch reported earlier. Some 50% of the total available vaccine supplies will be offered by the vaccine manufacturers directly to the States and private hospitals. But this means that they will now have to negotiate directly with the manufacturers, as well as competing with each other to procure limited supplies at significantly higher prices than the national government is paying. Meanwhile, only those people over age 45 eligible for free national government supplied jabs – with individual states having to decide on whether or not to subsidize the costs of vaccinating other population groups. Most states so far have said they would provide the vaccines free of cost – at a huge financial toll. Critics said that the privatization move, effectively, means that the national government has shifted its vaccine costs to the state budgets. India’s former health secretary took to Twitter to criticize the move and called it an abdication of fundamental duty by the government and one that will lead to chaos and confusion from May 1 onwards as state governments and private hospitals jostle to procure vaccines. The vaccine policy announced yesterday is completely biased towards pharma companies. It has neatly shifted the confusion &chaos that will emerge from May 1st away from itself and towards the state governments to answer. Never seen such abdication of a fundamental duty. — healthiswealth (@sujakrao) April 20, 2021 Leena Menghaney, a public health lawyer specializing in vaccine pricing in India, said the new policy would create inequities in access to the vaccine within the country. “In no other country you would see the price one for the central government and one for the state.” Vaccine prices shoot up amidst case surge While vaccines sold to the central government will continue to be priced at Rs 150-400 ($2-$5), the new prices set by India’s two vaccine manufacturers, Bharat Biotech and the Serum Institute will range from Rs 400 – 1200 ($5-20). SII’s CEO Adar Poonawalla recently declared that the company lacks capital for investing in vaccine manufacturing scale-up, particularly in light of the fact that it has to pay AstraZeneca some 50% in royalties to locally-manufacture the AstraZeneca vaccine. Earlier he also told an Indian news channel that the price of $2 was profitable but meant that SII was forgoing “super-profits” that would allow them to invest in vaccine research and development. COVAX Also Affected – While International Community Proffers Help India’s crisis also affects the 91 low-income countries depending on vaccine supply through the Covax agreement. Currently the exports of vaccines are frozen given the magnitude of the humanitarian crisis in the country. “It (India’s crisis) comes at a great cost where other most vulnerable populations in developing countries are still waiting for vaccines,” said Menghaney. Poonawalla has said that he expects the export situation to ease in two to three months. Following the global outcry over India’s situation the United States, the United Kingdom, European Union, as well as other countries from around the world have stepped in to offer help – including emergency oxygen supplies and PPE. And Pakistan’s Prime Minister Imran Khan expressed concern for India’s explosive infection situation – putting aside decades of geopolitical friction over Kashmir and other disputed areas to do so. Significantly, the United States also has agreed to lift an export ban on the raw materials required by the Serum Institute of India to manufacture the local version of the AstraZeneca vaccine (Covishield) after initially refusing to do so. The country has also offered to help India with rapid diagnostic test kits, ventilators, and Personal Protective Equipment (PPE). Ashish K Jha, dean of the Brown Institute of Public Health has called these excellent steps. Also on Monday, the United States was reported to be poised to donate excess vaccine doses to the WHO co-sponsored COVAX initiative – and if so, Indian observers were hopeful, some of those could be directed to the subcontinent. WASHINGTON (AP) — AP Exclusive: US to begin sharing up to 60M AstraZeneca COVID-19 vaccine doses with world after federal safety review. — Jonathan Lemire (@JonLemire) April 26, 2021 The World Health Organization (WHO) also announced additional help to India, with WHO Director General Dr Tedros Adhanom Ghebreyesus calling the situation “beyond heartbreaking” in a press briefing on Monday. Around 2,600 WHO staff members will be deployed to India he said to support the response effort along with dispatches of PPE and other equipment. -Disha Shetty is an independent journalist based in Pune, India who writes on public health, environment and gender. Image Credits: Press Information Bureau (PIB), Credit: Press Information Bureau (PIB). 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