In the modern-day forum of health diplomacy, ‘vaccine diplomacy’ is a term used to describe the branch that is concerned with the use and delivery of vaccines. Numerous aspects included in this framework are:
Core Diplomacy: negotiations between nations that lead to bilateral or multilateral treaties.
Multi-stakeholder Diplomacy: negotiations between nations and international welfare organisations such as the United Nations, World Health Organisation, and other Non-Governmental Organisations.
Informal Diplomacy: this includes peer-to-peer research partnerships and private funders who contribute to the discussion in an independent capacity, due to the unique nature of a crisis.
Given the magnitude of the Covid-19 crisis, the use of vaccine diplomacy has gained the limelight with countries like the US, UK, China, India, and Russia, using it to influence soft power relations, increase goodwill, and build on international relations (Hotez).
Soft power is a political term that connotes a nations’ ability to attract international support and fraternity via means of co-opting and appeals such as acts of altruism and goodwill, instead of using the force of coercion to achieve this end. Over the years, pandemics and global health crises have paved a way for countries to exhibit soft power and competition on the global tapestry has led to cooperation and faster eradication of diseases. For instance, during the smallpox epidemic, the rivalries and competition between the US and Russia led to many successful interventions and a healthy cooperative effort on both ends to resolve the global crisis.
Keeping true to its reputation as the ‘Pharmacy of the World,’ India was one of the first countries to volunteer and participate in this by committing to aid the countries that did not have access to vaccinations or healthcare supplies.
Accounting for 20% of the total global production of generic medications in 2020, India received requests from over 90 countries to provide them with Hydroxychloroquine (initially thought useful for combatting Covid-19), and paracetamols. By May 2020 itself, India had spent over 16 million USD on pharmaceuticals, testing kits, and other medical equipment (Sharun and Dhama).
Vaccine Maitri (Hindi word for Friendship) was used to propagate the ties and links that India formed with its neighbours and other countries in need of vaccination and medical supplies. Treaties and trade supply chains were established by January 2021, and the process of sending out the supplies began in earnest soon after. In the spirit of seva paramo dharma (service is the greatest virtue), so far, India has distributed around 3.3 million doses to Bangladesh, 1.7 million to Myanmar, 1.1 million to Nepal, 0.5 million to Sri Lanka, 0.2 million to the UN peacekeeping forces, and this is apart from the 18.1 million doses that were sent out to the COVID 19 Vaccine Global Access (COVAX) global initiative that is being coordinated by the World Health Organisation, Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi: The Vaccine Alliance (Surie).
Beyond the semantics and altruism, India’s vaccine diplomacy serves as an important and effective tool towards building its soft power and influence over the different countries of the world, serving the purpose of forging, and cementing alliances, particularly with neighbouring countries and within the Indo-Pacific region.
Furthermore, India’s efforts to lobby for a permanent seat at the UN Security Council requires building diplomatic relationships with countries in the Indo-Pacific region. This diplomatic move could translate into crucial votes from supporting countries especially at a time when India has secured a non-permanent seat on the Security Council and is scheduled to host the G20 summit in 2023.
There are also some foreign policy benefits that arise from this diplomatic drive. For instance, the controversial citizenship law enacted by the Indian government in 2019, and the subsequent growth of trade relations between China and Bangladesh led to a strain in the relationship between India and Bangladesh. This supply chain could be indicative of a turning point in these relations and indicate a shift towards the healing of ties (Tharoor).
In lieu of mounting covid cases and new strains that may not respond equally effectively to the vaccines, the Indian government failed to consider a billion doses that it requires for domestic use and in the meanwhile, committed to providing over 200 million doses to the world. Moreover, the vaccine programme for citizens was started out at the same time as the supply chains were rolled out, somewhat under-estimating the need and urgency of vaccinating the domestic population.
This policy has also been criticised for overlooking the extent of the economic and health crisis at home, not focusing, or leveraging the potential for providing aid to the country and shifting attention to neighbours and far off countries when India itself was not fully equipped to deal with the onslaught of the second wave of the pandemic. With a rise in the Covid-19 cases in the deadlier second wave, the healthcare infrastructure of India revealed integral institutional and structural failures. Lack of oxygen supplies, hoarding of medicinal kits, shortage of beds, injections, and facilities for sick and recovering patients put a strain on the healthcare structure, such that it was nearly brought down to its knees. It is a call of reckoning for the Indian state to realise the measures that could have been taken and now should be implemented to prevent and prepare for the oncoming days (Tirkey).
With the mounting internal pressures and focus on handling the situation at home, the Indian government, along with the Serum Institute of India temporarily suspended the supply of vaccines to other nations. Instead, countries are pooling in their resources to aid in oxygen supplies and medications to Indian citizens. In the light of the second wave, India received aid from over 40 countries including the USA, France, Russia, Australia, and the United Kingdom. Addressing the UN Council meeting on multilateralism and maintaining international peace, the Foreign Secretary of India, Harsh Vardhan Shringla said that the Covid pandemic has ‘sharpened our senses,’ and ‘the world is only as resilient as the least resilient country,’ thus extending the country’s heartfelt gratitude towards the nations that stood in solidarity and multilateralism to combat this virus. (Press Trust of India)
A strong case was made in favour of Vaccine Nationalism, wherein the countries would prioritise their own vaccine needs before turning their view to the rest of the world (“Coronavirus: What Is Vaccine Nationalism, How It Affects Us?”). While this policy would be appealing on the domestic front, it puts a strain on the global pandemic situation, especially for poorer countries who are battling socio-economic downfalls along with the loss of life and lack of resources and infrastructure to manufacture their own vaccinations. It poses a diplomatic and public policy dilemma for India owing to the commitment that the centre has made, both, to the countries that it has promised aid to, and to its own citizens who are waiting in anticipation for the availability of first and second doses of the vaccines.
In neglecting the domestic duties and perhaps over-committing to supply vaccines and medical equipment to other nations, India has created a disparity and tug-of-war owing to its inability to meet either of its commitments. This has led to serious impacts on the nation’s health and economy, leading to a massive public cry for help. While at the same time, India’s temporary withdrawal from the global vaccine space has created shortages for poorer countries with no access or resources to produce or disseminate vaccinations. The eyes are on India as it continues to withhold vaccines from other nations, a move that might lead to critical implications on the credibility and integrity of the word of the Indian state, not to mention the legal and economic pitfalls this would entail. Furthermore, the (mis)management of the crisis at home changes the external perceptions about the responsibility and engagement in the eyes of other countries. Taking the example of South Korea; although a small nation with no commitments for dispensation of vaccines, it is still commended on the steps taken by Seoul to control and contain the spread and effect of the virus, thus adding credibility to its status amongst its counterpart nations (Purayil and Gujjeti).
The rapid increase in the COVID 19 cases and the consequent shortage of vaccines and medical apparatus has placed India as the second most affected country in the world. This wave of the pandemic has created an ironic disparity between India’s aspirations and its capacity to play a massive role in international healthcare management. Given that India is one of the most populous countries in the world, taking care of its citizens and curbing the spread of COVID 19 in India would take away a significant amount of strain from the global pandemic worries. Only time will reveal the full force of the strains and repercussions of India’s moves in these last six months, but what is certain is the instrumental role that India has and will be playing in curbing and addressing the impact of the pandemic for the present and future, by both, resuming the export of vaccines, and uplifting the healthcare system and infrastructure at home.
“Coronavirus: What Is Vaccine Nationalism, How It Affects Us?” World Economic Forum, 6 Jan. 2021, www.weforum.org/agenda/2021/01/what-is-vaccine-nationalism-coronavirus-its-affects-covid-19-pandemic.
Hotez, Peter J. ‘“Vaccine Diplomacy”: Historical Perspectives and Future Directions’. PLoS Neglected Tropical Diseases, edited by Sara Lustigman, vol. 8, no. 6, June 2014, p. e2808. DOI.org (Crossref), doi:10.1371/journal.pntd.0002808.
Press Trust of India. “India Extends ‘deep Appreciation’ to Nations Providing Priority Requirements to Battle Covid-19.” India Today, 7 May 2021, www.indiatoday.in/world/story/india-extends-deep-appreciation-to-nations-providing-priority-requirements-to-battle-covid-19-1800098-2021-05-08.
Purayil, Muhsin Puthan, and Anudeep Gujjeti. “What the Second Wave of COVID-19 Means for India’s Public Diplomacy.” The Diplomat, 21 Apr. 2021, thediplomat.com/2021/04/what-the-second-wave-of-covid-19-means-for-indias-public-diplomacy.
Sharun, Khan, and Kuldeep Dhama. ‘India’s Role in COVID-19 Vaccine Diplomacy’. Journal of Travel Medicine, Apr. 2021, p. taab064. DOI.org (Crossref), doi:10.1093/jtm/taab064.
Surie, Mandakini D. India’s Vaccine Diplomacy: Made in India, Shared with the World. 2021, p. 5.
Tharoor, Shashi. “India’s Smart Vaccine Diplomacy.” Project Syndicate, 17 Mar. 2021, www.project-syndicate.org/commentary/india-covid19-vaccine-diplomacy-by-shashi-tharoor-2021-03?barrier=accesspaylog.
Tirkey, Aarshi. “India’s Vaccine Diplomacy.” ORF, 23 Jan. 2021, www.orfonline.org/research/indias-vaccine-diplomacy.