-Siddhesh Shimpukade

Project Associate for International Affairs at Prastaav & Master’s in Public and International Affairs, University of Pittsburgh (Incoming Student).

The world has been brought to its knees by a monstrous tide of Covid-19 or the novel Coronavirus. The Wuhan originating virus has caused a crash in economies all around the world. Although a vaccine seems imminent now, the road to it doesn’t seem to be an easy one.

The virus struck India in March, with the government imposing an immensely harsh lockdown beginning from March 23rd 2020, creating an economic breakdown that catapulted into a massive diaspora of migrants back to their hometowns and a recession kicking in. During the subsequent months, the lockdown was gradually phased out. But now, India stands with nearly 4.2 million COVID-19 cases, second only to the United States, with almost 6.3 million cases. The GDP of the country has plundered to a negative 23.9%. Aviation, transport, construction, agriculture, and hospitality industries were severely affected. Education in India is also at a halt now, given the rules of social distancing. On the medical front, there is rigorous testing being done. Hydroxychloroquine was being administered to asymptomatic patients, while hydroxychloroquine-azithromycin combination was suggested for the patients who were suffering more. Plasma therapy is in full swing now.

The condition of the world in the coronavirus situation isn’t good. Many countries are being hit by a second wave of the virus, including South Korea, Peru, Israel, Australia and European countries like the UK, Spain, France, Italy, Germany and Belgium as well. Brazil and Russia have crossed the million-case count. Schools and colleges are reopening around the world, whilst following precautions. Many third world countries are facing poverty and food shortage.

The Vaccine Gamut of the World

The pandemic paradigm of vaccine development is being deployed now by countries that are producing COVID-19 vaccines, compared to the traditional paradigm which takes years for the vaccine to be made. This ensures fast processing by conducting steps like data analysis and manufacturing process parallelly but entailing a financial risk along with that. Newer studies in domains of glycomics, proteomics, genomics, and highly advanced technologies are pushing the vaccine production in warp speed.

There are various countries and private organisations in the pursuit of a vaccine. CoronaVac (Sinovach Biotech, China), Sputnik V (Gamaleya Research Institute, Russia) and a vaccine developed by CanSino Biologics, China are the only vaccines that have been approved for limited use by their respective countries, as they are nearing the end of their Phase 3 trials. AstraZeneca and the University of Oxford have developed a vaccine which is the most famous one, as they have supplied it to many countries. India (Serum Institute of India) and England began Phase 2/3 trials and Brazil, South Africa and the United States have started Phase 3 trials. There are many firms and institutes from the US, like Johnson & Johnson, Moderna and University of Pittsburgh, and China, like Wuhan Institute of Biological Products which have started preclinical and clinical trials. There is a “self-ampifying” RNA vaccine under Phase 1/2 trials being developed by Imperial College London and Morningside Ventures. AnGes, a Japanese biotechnology company has developed a vaccine in collaboration with Osaka University and Takara Bio, which is in its Phase 1/2 trials. Countries like South Korea, Australia, Italy have joined in the vaccine race too. India has developed two vaccines indigenously as well. One is designed by the collaborative efforts of Bharat Biotech and ICMR which is undergoing Phase 1/2 trials, called Covaxin, and the other is a DNA-based vaccine developed by Zydus Cadila, which is under Phase 2 trials.[1]

Global Health Diplomacy

Peter Bourne, Special Assistant to President Carter in 1978, rightly stated “The role of health and medicine as a means for bettering international relations has not been fully explored by the United States. Certain humanitarian issues, especially health, can be the basis for establishing a dialogue and bridging diplomatic barriers because they transcend traditional and more volatile and emotional concerns”.[2] Multilateralism in health aid has come a long way, with various institutions and international organisations taking up health security issues. To deal with health issues, the World Health Assembly advocated the International Health Regulations in 2005. A framework initiated by Norway, France, Thailand, Senegal, Brazil, South Africa, and Indonesia in New York in 2006, ‘The Oslo Ministerial Declaration on Foreign Policy and Global Health’ stressed upon the multitudes of advantages health security in the international policy domain can provide.[3] This is what the world can bank upon in the COVID-19 pandemic time.

Source: wired.com

In such a time, where nationalist feelings spark up between countries, it is important to keep the geopolitical aspect in mind regarding vaccines. The US halting funds to WHO definitely is due to the fact that WHO fell short in containing the virus proliferation and they weren’t very transparent from the beginning, but it also has to do with the fact that there is a growing Chinese influence in the United Nations, mostly in the economic aspect. Chinese pharmaceutical companies and institutes, like the Wuhan Institute of Biological Products have started their Phase 3 vaccine trials in the United Arab Emirates, Peru and Morocco. Through the means of the COVID-19 vaccine, People’s Republic of China is cutting their way to the rest of the world for their Belt and Road Initiative. Mexico seems to be onboard with the global COVAX plan initiated by WHO, to provide a well-proportionated access to 2 billion doses of the vaccine, although they aren’t sure of how much their country would receive. So Mexico is going to take part in the clinical trials of GRAd-COV2 (Italy) and Sputnik V (Russia), looking to take part in the trials Sanofi (France), Johnson & Johnson (USA) and CanSino Biologics (China) and is in talks with Cuba and Germany too.[4]

COVID-19 has definitely driven a deeper wedge between USA-Iran relations, as Hossein Salami, commander of the Islamic Revolutionary Guard Corps (IRGC) put the blame on the United States and Israel, calling the pandemic an ‘American biological invasion’.[5] Russia is also being targeted under the accusation of ‘state-backed hacking’ by UK’s National Cyber Security Centre (NCSC), the Canadian Communication Security Establishment (CSE), the United States Department for Homeland Security (DHS) Cyber-security Infrastructure Security Agency (CISA) and the US National Security Agency (NSA). These organisations claim that APT29, or Cozy Bear, a hacking group in Russia has been hacking through American and Canadian servers to access COVID-19 vaccine development and research data. Russia has denied these accusations of theft and espionage.[6]

From all of this, it is being seen that the disease and vaccine has become a major factor in reinforcing and debilitating diplomatic ties among countries and international organisations.

India in the Vaccine Diplomatic Circuit

After the WHO declared the COVID-19 outbreak as a pandemic, India being a tremendous supporter of the South-South Relations (SSR), called for and took part in meetings with member nations of the South Asian Association for Regional Cooperation (SAARC), the Indo-Pacific countries, another one with member nations of the G-20 and later, interactions with foreign ministers of BRICS nations. New Delhi has provided monetary health aid to many countries in South Asia, Southeast Asia and Africa, including its neighbours like China and Nepal too.[7] Beijing, meanwhile, as a part of its ‘Health Silk Road’ campaign under its Belt and Road Initiative, disturbingly has given Bangladesh the highest priority, should they make a COVID-19 vaccine. This can get China to make a more lucrative deal with Dhaka and get closer to acquiring access to the Chittagong port, which in turn will help them claim travel lines in the Andaman Sea, which will prove to be a strategic thorn in the flesh for India.

To counter this, Serum Institute of India (SII), Pune, which is leading the world in volume-based manufacturing of the vaccine, announced a deal with Beximco Pharmaceuticals Limited (Bangladesh) to give Dhaka priority in the potential vaccine which will be developed. SII has partnered with AstraZeneca and Novavax for manufacturing and has collaborated with Bill and Melinda Gates Foundation and Gavi (a global alliance for vaccines), for faster development and proliferation of the vaccines for India and other third world countries.[8] Taiwan, a country showing tactful ability in combatting the pandemic, has expressed its desire to work with New Delhi. There has been information exchange on a small scale between the two countries, especially the dialogues between their respective medical institutions, the National Cheng Kung University Hospital and the All India Institute of Medical Science. These webinars benefitted over 14 thousand Indian healthworkers.[9]

India is deeply embedded in the diplomatic web of the COVID-19 vaccine, which will work in the favour of New Delhi.

The Way Forward

The COVID-19 pandemic has hit the world with full fury. The only thing that can save both lives and the economy is a vaccine. Countries have all pitched in for quick development and trials of vaccines. The world needs to address some nuts and bolts of health issues for the near future.

  • Multilateralism still needs improvement. Organisations like WHO need to be more vigilant and transparent in their approach to health security issues. Moreover, they need to use their autonomy to promote better relations between countries to tackle problems related to health security.
  • The question of equitable access of health supplies and vaccines still remains unresolved. Since a long time in the history of medicine, it has been seen that developed countries tend to create extortionate prices and hoard vaccines at the expense of Low and Middle Income Countries (LMIC). International committees should be developed, which cater only to the health requirements of the LMIC.
  • While the debate on affordability rages on, the issue of ‘patent monopoly’ still exists. A world pandemic can be turned into a petty race amongst private firms to acquire the patent in their name. To counter this, the Doha Declaration on TRIPS and Public Health has advocated for ‘compulsory licensing’ of pharmaceuticals during outbreaks such as pandemics. On the flip side, developed countries oppose the declaration, stating that it would disincentivize medical innovation. To recognise this quagmire, a resolution was passed in 73rd session of the World Health Assembly (WHA) to establish a global patent pool. Other solutions suggested include unlocking the patent for a short interval by patent holders of the vaccine, and granting incentives to innovation while letting other companies produce and distribute the vaccine. This prizing system will hence open the market for more companies and can prevent patent monopolies.[10]
  • Science and policy must work cooperatively to bring out better results for countries and the public. For the science community, it is imperative that they are prompt in making the government and public aware of the challenges and opportunities that may arise. Science diplomacy will help countries develop better ties, put a pause on capitalistic competitions to focus on the needs of the society and will help the world to better tackle issues like climate change and pandemics.

India was no exception to the mighty wrath that the COVID-19 pandemic wrought into the world. Having cases in the thousands on a daily basis, the Indian government will need to take swifter action.

  • India needs to draft out long-term policies that encompass every aspect like economy, trade, information, diplomacy, and health to deal with pandemics and other such medical emergencies. Such cross-disciplinary policies will need to be in coherence with multilateral institutions, for the benefit of India to weave stronger supply chains in the world.
  • One glance at the health diplomacy insinuated by the pandemic, and it is easy to say that Indian diplomats need to be given more autonomy on their decisions. This will induce better international ties with countries in times of need.
  • While it is important for India to be addressing the ‘wolf-warrior diplomacy’ of China given the recent border clashes, antagonizing China completely may not work in the favour of India. Taiwan can prove to be a highly resourceful ally to New Delhi in such a time, but it should be wary of Beijing. A trilateral health venture between India-Taiwan-US can prove to be a better option.[11]

Current Updates:

On 13th Sept, 2020 the health minister of India, Dr. Harshvardhan briefed the nation through press conference that the vaccine shall be ready by first quarter of 2021 and India will play a key role being the 60% manufacturer of worldwide vaccine produced. Though the Oxford vaccine trails have was re-started after minor pause due to complications in subject, hopefully the India collaborator will also soon restart its on-going human trails. Further the latest updates includes that animal trials for vaccine developed by Hydrabad based Bharat BioTech showed positive response in building up immunity when exposed to the virus.[12]

In a time of crisis like this, Health Diplomacy seems the only way out. Creating nationalist economic competitions will not work for any country. Multilateral institutions have to be strengthened now to tackle this and any other forthcoming outbreak of disease.

[1] Coronavirus Vaccine Tracker, The New York Times, available at: https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html

[2] K. Sachdeva & S. Alag, “Understanding Health Diplomacy”, The Parley Project, 2 (2020)

[3] COVID-19: Health Diplomacy is the way out, Modern Diplomacy available at: https://moderndiplomacy.eu/2020/07/14/covid-19-health-diplomacy-is-the-way-out/

[4] COVID-19 Vaccine Diplomacy: Mexico courts allies across ideological spectrum, Reuters, available at: https://in.reuters.com/article/health-coronavirus-mexico-vaccine/covid-19-vaccine-diplomacy-mexico-courts-allies-across-ideological-spectrum-idINKBN25Q0K3

[5] Iran Knows Who to Blame for the Virus: America and Israel, Foreign Policy, available at: https://foreignpolicy.com/2020/03/19/iran-irgc-coronavirus-propaganda-blames-america-israel/

[6] Coronavirus: Russian spies target Covid-19 vaccine research, BBC News, available at: https://www.bbc.com/news/technology-53429506

[7] India’s public health diplomacy in the time of COVID19, Observer Research Foundation, available at: https://www.orfonline.org/expert-speak/indias-public-health-diplomacy-in-the-time-of-covid19-67783/#:~:text=One%20particular%20area%20of%20India’s,global%20battle%20against%20the%20pandemic.

[8] India initiates Covid-19 vaccine diplomacy, The Straits Times, available at: https://www.straitstimes.com/asia/south-asia/india-initiates-covid-19-vaccine-diplomacy

[9] Taiwan is eager to work with India to fight the COVID-19 pandemic, says Foreign Minister Joseph Wu, The Hindu, available at: https://www.thehindu.com/news/international/coronavirus-taiwan-is-eager-to-work-with-india-to-fight-the-covid-19-pandemic-says-foreign-minister-joseph-wu/article31577577.ece

[10] Global Vaccine Divide: Covid-19 Pandemic and Opportunity for India, Modern Diplomacy, available at: https://moderndiplomacy.eu/2020/05/30/global-vaccine-divide-covid-19-pandemic-and-opportunity-for-india/

[11] More than a Bargaining Chip: Health Diplomacy and India-Taiwan Relations, Institute of Peace and Conflict Studies, available at: http://www.ipcs.org/comm_select.php?articleNo=5717

[12] Covaxin demonstrates protective efficiency in animal studies: Bharat Biotech, reported by express pharma, available at: https://www.expresspharma.in/covid19-updates/covaxin-demonstrates-protective-efficacy-in-animal-studies-bharat-biotech/

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1 Comment

Raunak Chaturvedi · September 14, 2020 at 11:31 am

A very well written article. Congratulations to Siddhesh.

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