Vaccine Maitri: As cases rose and stocks shrank, most vaccine exports went where Covid much less severe than India

Under the programme, effectively suspended end of March, more than 6.6 crore doses of Covid vaccines — almost all Covishield — were sent to 93 countries. This stockpile is enough to support about 30 days of vaccination nationwide at last week’s inoculation rate — and at two doses, could cover the adult population of Delhi and Mumbai.

An analysis by The Sunday Express of the Covid burden of all 93 recipient countries since January to last week, shows that right through Vaccine Maitri, to this day, most of them were better off than India when it comes to severity of the pandemic – measured in terms of Covid case and death count per lakh population. And yet, over 60% of all exports went to these countries.

This was a goodwill gesture and earned appreciation from many. But as the second wave surges and vaccine stocks run out, it raises questions about why so much was shipped overseas so early.

“Going by public health reasons, there was no tearing hurry to export at this scale when we didn’t secure our stocks and our curve was rising,” said a senior Health Ministry official who did not wish to be named. “Of course, the bulk of it were sent under commercial contracts and Gavi (global vaccine alliance) commitments and many of these countries wouldn’t get vaccines otherwise but these supplies could have been timed and staggered better because most of these countries, going by their pandemic levels, could easily have waited a few weeks.”

Especially, since the second wave in India had reared its head in Mumbai as early as mid-February.

But that staggering didn’t happen and so until March 30, when the second wave had pushed the daily national case count above 70,000 and its treacherous upswing was barely days away, India was shipping out more doses than it had used for inoculating people at home.

On March 17, with the second surge clearly evident, External Affairs Minister S Jaishankar underlined India’s low Covid fatality and high recovery rates that “resulted from the Prime Minister’s leadership and the government’s focussed efforts” and “the external beneficial impact of India’s capability” to back the Vaccine Maitri initiative.

Ten days earlier, Union Health Minister Harsh Vardhan said: “Unlike most other countries, we have a steady supply of vaccines… We are fortunate to have a global leader… who insisted that vaccines should be provided (to other countries) with no strings attached.”

Fast-forward: shortage of vaccine and mounting case load forced India to drastically cut down exports. From over 6.4 crore doses in nine weeks since January 20, the supply overseas fell to just 18 lakh shots in April.

The Indian Express looked at WHO dashboards for all the 93 vaccine recipient countries and identified telling patterns:

• Of the 93 countries, last week as many as 88 recorded either fewer new Covid cases or deaths per lakh population than India’s.
• On April 30, the cumulative Covid case count in India stood at 1.88 crore, or 1,360/lakh population. In contrast, 50 countries that received 3.68 crore doses, or over 55% of India’s vaccine export, showed under 500 cases/lakh or less than half of India’s.
• In terms of deaths, too, on April 30, 46 countries that got 36.6 crore doses, again over 55% of India’s vaccine export, recorded cumulative deaths per lakh below 7.5, compared to India’s 15.1.
• Of this, 14 countries that received 88 lakh shots, did not report more than 1 death per lakh.
• Of the top 20 recipient countries by consignment, 14 are better off than India, on April 30, in terms of cumulative cases and deaths per lakh population.

This isn’t just the benefit of hindsight.

When exports began January 20, India’s Covid case and death counts per lakh were 769 and 11 respectively. Even that day, as many as 64 countries – which were to get over 60% of India’s vaccine exports – were faring better than India on either parameter.

Of the 6.6-crore shipment, 1 crore doses were sent as grants, 3.6 crore were sold commercially, and another 2 crore were supplied under the Covax program backed by WHO and Gavi vaccine alliance for equitable global distribution of Covid-19 vaccines to low-and-middle-income countries. Serum Institute of India’s (SII) Covishield constituted more than 99% of India’s export.

Under a licensing agreement with AstraZeneca, Pune-based SII was to supply 100 crore doses of Covishield under the Covax programme with a commitment to provide 40 crore shots by the end of 2021.

Significantly, India was the first country to contribute vaccines under the Covax programme when a shipment of 6 lakh doses left India for Ghana on February 23. In contrast, it took France another two months to contribute vaccines to Covax when France donated 1 lakh doses on April 23.

Questions were sent to the MEA and the Health Ministry asking whether India’s Covid curve was factored in when deciding how many doses to send and where. No response was received.