Time for India To Reinvigorate Vaccine Diplomacy in South Asia

India's role in providing vaccines to South Asia was pronounced even before the COVID-19 pandemic.

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The COVID-19 pandemic has inflicted high costs on the health and socio-economic well-being of people globally. International organisations such as World Health Organisation and World Trade Organisation have unanimously emphasized the importance of international cooperation in ensuring the smooth flow of vaccines and other vital medical supplies across countries. Like many other countries committed to global vaccine cooperation, India was among the forerunners in its ‘vaccine diplomacy’.

Being the world’s third-largest producer of pharmaceuticals, India has supported the global community on several fronts, most notably by launching the “Vaccine Maitri” initiative in January 2021. As per data released by the Ministry of External Affairs, around 6.64 crore doses of the COVID-19 vaccine have been exported to 95 countries, of which 3.58 crore doses were supplied to 26 countries under commercial contracts, 1.07 crore to 47 countries as grants and 1.98 crore to 47 countries under the COVAX facility.

After initially garnering global applause, India recently received severe criticism when the deadly second COVID-19 wave engulfed the country – internally for sending vaccines abroad and from international organisations for reneging on its promises. Because of an internal shortage, the government had to halt the exports of vaccines provisionally, till the time its production is deemed adequate to cater to both the national as well as international communities.

Even though the situation in India remains critical and halting of exports seems to be the only option for now, it is also important to reaffirm the importance of trade in vaccines.

Trade in vaccines

There is a considerable amount of vaccine trade that takes place at the global level. In the last five years, the world trade of vaccines for human medicine has increased by 50% times from $42.91 billion in 2016 to $65.14 billion in 2020. This trend has been mainly driven by advanced economies, such as Belgium, Ireland, France, the US and Italy.

To gain insights into the supply and demand conditions driving the trade in vaccines, let us analyse trade data for the last two years. If we look at 2019, before the COVID-19 pandemic, we find that vaccines were exported by 92 countries but imported by 214 countries. In 2020, vaccines were exported by just 88 countries but again imported by 214 countries. These figures show that the demand for vaccines is much more than the supply. The top ten exporters of vaccines account for 92% of the total exports. It is interesting to note that India was the only developing country to be amongst the top ten exporters of vaccines, both in 2019 and 2020.

Table 1: Top Vaccine Exporters
S. No. Rank of Top Exporters in 2019 Rank of Top Exporters in 2020
1 Belgium Belgium
2 Ireland Ireland
3 France France
4 United Kingdom United States of America
5 United States of America Italy
6 Italy United Kingdom
7 India India
8 Netherlands Poland
9 Poland Netherlands
10 Germany Germany

Source: Trade Map, International Trade Centre

India’s vaccine exports to South Asia

India is also among the key source of vaccine exports for the South Asian region, which is home to about one-fourth of the world’s total population and has been experiencing a deadly surge of COVID-19 infections. As per a UNICEF press release, the region accounts for half of all new known infections globally. The mortality rate has been rising, crippling the existing health sector infrastructure. Trade in vaccines and other important health supplies are important means not just to save lives, but also helps create more robust healthcare systems across South Asia ahead of potential future waves of the pandemic.

As part of India’s vaccine diplomacy, about one-fourth of India’s total COVID vaccine supply has gone to South Asian countries.

The importance of India as a vaccine supplier in South Asia was well established even before the pandemic. The South Asian countries have always been dependent upon India for vaccine supplies for other diseases such as cholera, typhoid, tuberculosis, rabies, measles, mumps and rubella, polio amongst others. Since 2014, India’s exports of vaccines to South Asia have nearly doubled from $16.06 million to $34.53 million in 2018.

Source: Trade Map, International Trade Centre

India’s loss, China’s gain?

Ever since India suspended its vaccine exports, South Asian countries like Bangladesh and Sri Lanka have increased their dependence on China for COVID-19 vaccines. As per reports, China has already given 1.1 million doses of COVID-19 vaccines to Sri Lanka. Bangladesh also received its first donation of half a million vaccines from China in May 2021 and Nepal has been promised an additional one million doses. Analysts view China’s vaccine diplomacy as a means to re-gain traction and influence in the strategic Indian Ocean.

At a time when the COVID-19 crisis and vaccine diplomacy had provided India with a much-needed platform to steer regional cooperation in South Asia, being forced to halt exports on one hand and rising Chinese influence on the other can lead to heavy political and strategic implications. While protecting lives of its own population is definitely a priority, India should ramp up its production capacity to a level that it can possibly resume vaccine deliveries to other countries, most notably its immediate neighbourhood.

Samridhi Bimal is an Independent Consultant. Views expressed are personal.