Letter from… India

By Eva Rana

Last week in Parliament, Indian Prime Minister Narendra Modi’s speech almost contained a brief (rare?) glimpse of humility as he conceded that government cannot claim credit over the nation’s collective efforts at getting closer to declaring ‘victory’ against Covid-19.

Cases have been in decline on average since they peaked in September 2020 and India seems to have avoided a ‘second wave’ – might there be cause for optimism?

Modi’s rhetorical flourishes may have successfully managed public expectations to an extent, but I remain reluctant to attribute these trends to the deliberate effort of any one entity – collective or governmental. Unlike the rigorous test-and-trace programs of some Southeast Asian countries, India’s pandemic response has been far from efficient. Earlier on, the March lockdown was poorly planned and executed, leading to a migrant labour crisis which allowed the virus to spread rapidly from urban to rural spaces. Since then, local authorities have been blamed for fudging Covid-related data, such that the national average might obscure the actual scale of undetected infection rates.

The overall situation today might appear less dreary to my colleagues in the UK currently under national lockdown. But I would say it has simply been down to luck that nation-wide statistics look good despite individual missteps.

A recent survey by the Indian Council for Medical Research shows that over 20% of adult Indians have developed post-Covid antibodies. The figure is higher in the case of children, indicating that a younger demographic composition has somewhat cushioned India from the more extreme manifestations of a virus that disproportionately affects older individuals.

Looking ahead, there is some hesitancy about vaccine uptake. Covaxin – the homegrown vaccine developed by Bharat Biotech – was approved for emergency use by India’s drug regulator last month. Predictably, Modi hailed it as an instance of his ambitious ‘Atmanirbhar’ (self-reliance) campaign.

Such keenness to sanction indigenous manufacturers appears to be yet another implication of the ‘vaccine nationalism’ that some of my colleagues have explored in previous blogs. However, the All India Drug Action Network soon expressed concerns about “rushed” approval whilst the government-backed vaccine had not yet concluded Phase 3 trials.

As India now prepares to run the world’s largest inoculation drive, a conscious effort to build trust will be crucial towards restoring confidence among the public and healthcare community at large.