Wasantha Rupasinghe
Although India’s new daily COVID-19 infections dropped this week below 300,000 for the first time in almost a month, the official death toll reached record highs on successive days, with 4,329 fatalities registered on Tuesday and 4,529 on Wednesday.
Making the situation even worse, the pandemic has found new breeding grounds in India’s remote and rural areas, where more than 65 percent of the country’s population—over 800 million mostly oppressed and impoverished people—reside. Health care facilities are virtually nonexistent in rural areas.
As horrific as the official infections and death tallies are, they are widely seen by health experts as gross underestimates of the true extent of India’s COVID-19 catastrophe. Some scientists project that the real number of deaths in India’s “second wave” of the pandemic, which began in mid-February, is between five and 10 times higher than the official figure. This would mean that tens of thousands of people are currently dying from COVID-19 every single day.
Responsibility for this disastrous state of affairs lies squarely with Modi, his far-right Bharatiya Janata Party (BJP) government and India’s venal capitalist elite, which less than two months ago were still boasting about India’s purported exemplary management of the pandemic. Modi systematically ignored warnings from his scientific advisers about the developing second wave, which was driven by new and more infectious variants—including the B.1.617 strain, which was first identified in India and has now spread around the world. Instead, Modi continued to insist, as his government has done for over a year, that nothing can be allowed to get in the way of corporate profits. Even as the official daily death toll reached 3,000 in mid-April and India emerged as the epicentre of the global pandemic, Modi declared that it was necessary to “save India from lockdown,” not from the virus.
The government’s vaccine rollout, which is in complete disarray, is of a piece with Modi’s “profits before lives” strategy. His government is categorically refusing to provide free vaccines to the Indian population, which in practice means that hundreds of millions of impoverished people will go without. The BJP government has also left vaccine production and a significant portion of vaccine distribution to private companies, which are raking in huge profits thanks to the exorbitant costs the government has allowed them to charge. In addition to further enriching India’s fabulously wealthy elite, the Modi government took the decision to rely on private companies so as to showcase the prowess of Indian capitalist enterprise to the world.
The result of this policy is that India has one of the highest prices in the world for COVID-19 vaccines. Covishield, which is based on the vaccine developed by AstraZeneca and manufactured by the Serum Institute of India, costs $12 per dose, while Covaxin, produced by Bharat Biotech, is priced at $17 per dose. Both vaccines require two doses. To put this into perspective, a recent report noted that the pandemic has pushed a further 235 million Indians below the government “poverty line,” which is a set at an income of 375 rupees or about $5 per day. Thus, for a substantial section of the population, the vaccines are effectively out of reach.
In an interview with India Today TV on May 15, Dr. Devi Shetty, a member of the Supreme Court-appointed national task force for devising a scientific mechanism for distributing medical oxygen, remarked, “How many people in the country can afford this kind of money for vaccination? The last few months have been very difficult for the working class and the poor. There has been no source of income for many.”
Compared to the lavish sums of money spent on India’s military and the obscene levels of wealth piled up by the country’s billionaires—who, according to Forbes, saw their wealth nearly double over the past year to $596 billion—the cost of vaccinating everyone over the age of 18 is a pittance. The total cost has been calculated at $6.4 billion, or a mere 0.32 percent of India’s GDP, a small fraction of the 2020 defence budget of more than $71 billion.
The Indian ruling elite’s refusal to spend this minuscule amount to protect the population from the virus is in keeping with its chronic underfunding of health care more generally. For decades, the Indian state, that is all levels of government combined, have spent the equivalent of just 1.5 percent of GDP on health care.
This malign neglect has been compounded by the imperialist powers’ criminal response to the pandemic. Led by the US, they have refused to waive the pharmaceutical giants’ vaccine patents, and blocked the export of vaccines and the materials required to produce them. Hundreds of millions of doses have been stockpiled by the United States in a reactionary move to transform potentially life-saving vaccines into yet another weapon in American imperialism’s extensive military and diplomatic arsenal.
Last month WHO chief Tedros Adhanom Ghebreyesus revealed that as of early April low-income countries had administered just 0.2 percent of the more than 700 million vaccine doses administered globally, while the wealthiest countries had received more than 87 percent. “There remains a shocking imbalance in the global distribution of vaccines,” he remarked. “On average in high-income countries, almost one in four people has received a vaccine. In low income countries, it is one in more than 500. Let me repeat that: one in four versus one in 500.”
When the Indian government launched its vaccine campaign in mid-January, Modi boasted that it would be the “world’s largest vaccination program.” Initially, the program was restricted to those aged over 60 and people aged 45 or over with comorbidities. People aged between 18 and 44, that is, nearly 600 million people, were included in the program as of May 1, even though the government well knew that it did not have the requisite vaccines, and that this would cause further chaos and hardship.
As of May 15, India, the world’s second-most populous country with 1.38 billion people, has administered just 182 million vaccine doses, according to Our World in Data. Merely 40.4 million people, or just 3 percent of the entire population, have been fully vaccinated.
The total population above 18 years old in India is about 966 million. This means approximately 1,93 billion doses of vaccines would be required to vaccinate everyone within 12 months, which translates into 5.4 million doses per day. The production capacity of the main two private vaccine manufacturers in India is limited to 3.8 million doses a day.
The miserable balance sheet of India’s vaccination campaign is the direct result of the Modi government’s focus on using it as a means to advance the economic and geopolitical interests of the ruling elite, not protecting the population from the deadly coronavirus. Its determination to rely solely on private enterprises, even though they lack the necessary production capacity to supply the Indian population, flows from the relentless pursuit of pro-investor policies by the entire political establishment for the past three decades. The BJP government also saw it as imperative to tout “made in India” vaccines under conditions where India is competing with China as a cheap labour platform for global investment, and lining up behind Washington in challenging Beijing militarily and diplomatically in the Indo-Pacific.
The reliance on the private sector for the distribution and administration of the vaccines is throwing up further barriers to substantial sections of the population getting inoculated. After the central government negotiated the purchase of 50 percent of total purchased vaccine doses, which have been designated for those aged 45 and over, it left the states and private hospitals to negotiate their own terms with the private manufacturers for 25 percent each. SII and Bharat Biotech were given a free hand to charge whatever prices they saw fit.
The result of this arrangement is that a disproportionate amount of India’s vaccine production is flowing to large private hospital groups, who are willing to outbid the states. A Times of India report noted that four major health care groups, Apollo, Max, Fortis and Manipal, are securing the lion’s share of vaccines. These vaccines are, in turn, overwhelmingly directed towards better-off layers of the population who can afford the extortionate price of between 1,000 and 1,200 rupees that private hospitals are charging patients on average per dose.
On the other hand, the rural population, which is facing a major surge in infections, is being sidelined, because the major private hospitals have virtually no presence in rural areas. While 30 percent of inhabitants of urban districts had received a first vaccine dose as of May 14, only between 12 and 15 percent of residents in rural and semi-rural districts had gotten a first shot.
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