Indian Defence Review

In this game of power, a nation that is able to quickly arrest the spread of virus within its own territory as well as research, develop and manufacture the vaccines, wins. For this to happen, a country must first consider such biological threats to be real. While many developed countries have been taking the issue of the pandemic either natural or man-made seriously, this can hardly be said about India. For example, India is a nuclear armed state but it does not appear that it takes a nuclear attack on her seriously. If this was the case, bomb shelters would be a common sight in major cities across India, if not all across India. This is a question of attitude and perception held by the people of India and its security establishment as a consequence. It is important that we revisit ancient texts such as the Bhagavat Gita and get over the rose-coloured glasses that we view the world with.

Imbibed with Indian ethos that invokes a regrettable sense of ‘idealism’ in its dealings with others, India remains committed to a ‘good boy’ image and banks on morality as a source for power in international politics – soft power. Indian leadership then and now has been quoting concepts and ideas presented in Vedas and Upanishads such as –वसुधैव कुटुम्बकं – [the whole world is one single family]1. However, the Upanishad mantra is not a geo-politico-socio-cultural statement; it is a matter of fact and doubtful if it has any strategic relevance in given times. Consider this – the first recorded judicial hearing was on a case related to a brother killing his own brother.2 Furthermore, the war in Mahabharata was fought between members of the same family; Arjuna’s hesitation and doubts in fulfilling his duty as a warrior against his cousins and teachers was rightly clarified by Lord Krishna by revealing him the true nature of reality – the Bhagavat Gita. Hence, it would be naive on the part of Indian decision makers to employ a concept for self-guidance to the field of international politics and formulate policies outside the realm of realism. After 17 years, India has, for the first time, compromised on its foreign policy of not accepting foreign aid amidst the second wave of COVID-19 pandemic and fiercely defending its international image of being the pharmacy of the world.3 India had committed to deliver one billion doses of COVAX of which 400 million are to be delivered by the end of 2021. However, only 28 million doses were delivered by the end of 2020. These were meant for low-middle income countries before the second wave caught the Indian administration unawares in intensity and scale. By April 2021, India had vaccinated only 111 million of its 300 million citizens falling in the high-risk group.4

India, like many other countries, has stayed away from labeling the COVID-19 a matter of national security (traditional) and restricted its approach to dealing with a pandemic. It is true that we do not yet know the origin of the pandemic from a scientific perspective based on hard evidences. However, the role of the intentionality cannot be ruled out either.5 This crisis will go down in history as a reflection of the manner in which we have organised our society, governance, conduct of international relations and our way of life itself. It further stands to clarify the difference between the perception held and existing reality for the people of India and its decision makers. For India, this pandemic, if approached in a sensible fashion, can be the foundation upon which a new India can be built during course of the 21^st century.6 Fortunately, for a great civilisational state like India, many of the aspects in dealing with a pandemic-like situation are already in place. Yet, India is facing difficulties in dealing with this grave situation in the current times. India registered a new single-day high of 3,45,799 COVID-19 cases as of April 23, and the third consecutive day with over three lakh recorded cases. As many as 2,624 deaths were also recorded on the day.7 Lack of coordination and team-spirit were amply visible during the Prime Minister’s recent online meeting with Chief Ministers wherein politics preceded everything else. The system is failing to put India’s strength in diversity and plurality to its advantage and often remains its victim. In May, India accounted for 46 percent of all new COVID-19 cases recorded worldwide.

For reasons unknown, India finds its comfort in the domain of morality as against realism. Be it a tsunami or a pandemic, India sees itself as a leader when others are in crisis and attempts to recharge its soft power bank and identity itself as a responsible nation-state. According to Admiral Arun Prakash (Retd), India’s self-description as a net security provider in the Indian Ocean Region was not well thought of and was not backed up with necessary or sufficient material condition to begin with. India waits for its turn at the United Nations Security Council (UNSC) as a permanent member and does so with complete disregard of the understanding of concept of power from its own traditional and historical perspective.8 It invokes doctrines of non-alignment to preserve its strategic autonomy and yet requires Soviet diplomatic and military assistance to execute a war in the sub-continent caused by a humanitarian crisis and to deepen economic and military bonding with the United States to address China’s rise as an economic and military power.

India remains apologetic about its status as a nuclear power state by first professing disarmament, followed by doctrines of a Peaceful Nuclear Explosion (PNE) and No First Use (NFU). India sails with one leg in multi-lateral organisations such as BRICS (Brazil, Russia, India and China), SCO (Shanghai Cooperation Organisation) and QUAD (Quadrilateral Security Dialogue) while it struggles to make a transition from a balancing power to a leading power without realising the fact that India is facing a geo-political crisis of identity both as a continental and maritime power. India is forced to label its first mission of its nuclear powered submarine as – ‘deterrence patrol’, despite military history being very clear on the importance of offensive action in war. India’s weapon of choice in dealing with the growing menace of radical Islam [terrorism] has been non-reaction and patience – perhaps wise, but with associated cost in terms of pride lost. Finally, despite no fault of its own, India was perhaps the only country to have lost land due to partition after the Second World War and continues to pay exorbitant strategic costs in terms of its relationship with Pakistan and China to this day in consequence – a result of 1,000 years of national humiliation.

Despite having undergone numerous experiences that advocate policy contrary to India’s idealistic position in international affairs, the pandemic has once again reminded us that nationalism and national interest remain crucial in a globalised world. India’s Pharmaceutical Alliance Secretary General Sudarshan Jain states, “All countries are trying to diversify from imports of Chinese APIs and intermediaries. It is not in national interest to depend on one single source for something as crucial as medicines. India has adopted the right approach – to find alternative sources in the immediate term and to develop domestic capabilities in the medium to long term.”9

A McKinsey report of 2007 projected India’s pharmaceuticals market growth to $55 billion by 2020 driven by a steady increase in affordability and a step jump in market access. An uninterrupted high economic growth rate and pricing control measures projected this growth to $70 billion.10Furthermore, this growth was projected based on the expectation that government spending will increase in the healthcare sector with nearly 380 million people covered by the Indian government by 2020.11 The pharma industry has seen continued growth throughout the decade, with turnover at $37.2 billion, exports contributing $19.14 billion – both in 2019 – and the domestic market in 2018, standing at $18.12 billion. According to Dr Rao Vadlamudi, former President of the Indian Pharmaceuticals Association, “…at this rate, the Indian pharmaceutical industry is likely to touch the $50 billion mark by the end of 2020, in line with the expectations of a Compound Annual Growth Rate (CAGR) of 22 percent”.12 According to Daara B Patel, Secretary General of the Indian Drug Manufacturers Association, “India is the single largest provider of generic drugs globally, supplying over 50 percent of global demand for various vaccines, 40 percent of generic demand in the United States, 25 percent of all medicines in the United Kingdom and extremely low-cost medicines to African nations.”13 While this may sound pink, the indigenous capability of Indian pharmaceutical industries for novel drug development and infrastructure remains appalling albeit with some distinctions. For example, the first Typhoid Conjugate vaccine (novel), among few others in the world, was developed by Bharat Biotech in India.

Based on the recommendations of the 23^rd meeting of the National Expert Group on Vaccine Administration (NEGVAC) for COVID-19 on April 11, 2021, the DCG (I) issued permission for Restricted Use in Emergency situation inter alia, with conditions. The consensus among the members of NEGVAC was that foreign-produced vaccines for COVID-19, which have been granted emergency approval for restricted use by US FDA, EMA, UK MHRA, PMDA Japan or which are listed in the WHO’s Emergency Use Listing (EUL), may be granted Emergency Approval in India.14This, according to NEGVAC, will facilitate bulk import and fill-finish capacity. Such a decision is less to do with fighting pandemic, but is a reflection of the structural problem facing the Indian pharmaceutical industry. India’s R&D expense-to-GDP ratio stands at 0.6 percent compared to that of China which is 2.1 percent. This, according to Dr Rao Vadlamudi, “…. is the unfortunate reality for a country with the human capital and academic depth to develop quality bio-tech hubs….the Indian industry made attempts at new drug discovery and development, but the successful launch of a new drug is a very long process. Given that, Indian efforts in the area of new drug discovery still fall below the industry averages. Expecting success in this domain at the current effort levels is unrealistic…”15    

According to the Ministry of Finance, India’s response to the pandemic stemmed from the humane principle advocated eloquently in the Mahabharata that, “Saving a life that is in jeopardy is the origin of dharma.”16 However, unlike the Indian document, according to the US – India’s fast growing military partner – the State Department, “…the United States is first and foremost engaged in an ambitious, effective and, so far successful effort to vaccinate the American people.” It is not just the Indian government, but also industry leaders who remain devoted to India’s approach defined in terms of humanism as against nationalism.17 On February 05, 2021, the Joe Biden administration enacted the Defense Production Act (DPA) to bolster the production of the vaccines, increase the availability of testing kits and boost production of protective equipment.18 The law grants the US President the right to direct domestic manufacturing and production to address and prioritise the nation’s needs. The US decision to prioritise domestic demand is why certain raw materials, which are manufactured or whose parent companies are based in the US, are not available to India. A sub-clause in this act prevents the exports of critical raw materials required for US local vaccine manufacturers. According to Poonawala, “…if the components are not supplied on time, it could lead to vaccine shortages in the future and disrupt delivery commitments.”19 It is difficult to import essential inputs – such as culture media, raw materials, single-use tubing assemblies, specialty chemicals and consumables from the US.20 As of April 08 this year, the US had managed to vaccinate around 20 percent of its population, including a quarter of all adults; that is over 66 million people fully protected from COVID-19.21 In February, the US signed deals with Pfizer and Moderna bringing up the supply from them to 600 million, enough for 300 million people. It has ordered 100 million doses of the Johnson & Johnson vaccine and has orders with Novavax and AstraZeneca as well.22 By November 2020, Canada secured nearly 414 million vaccine doses — more than ten doses per capita for a country of 37.9 million people.23 On the other hand, according to WTO, of 700 million vaccines administered by April around the world, only 0.2 percent had been in low-income countries.24 Finally, on May 11, amid reports of a COVID-19 vaccine shortage across the country, the Indian government refused to allow the Serum Institute of India (SII) to export around 50 lakh doses of Covishield vaccine to the UK. While rejecting this request, the central government insisted that the local vaccine production be supplied to protect ‘Indians first’.25

South Africa and India introduced a proposal at WTO to temporarily waive intellectual property protections for all COVID-19 vaccines and other technologies. This proposal was officially co-sponsored by Eswatini, Kenya, Mozambique and Pakistan in November 2020.The proposal was aimed to temporarily suspend the Intellectual Property Rights around products that would protect, contain and treat COVID-19 as has been done for HIV treatments, among other drugs – but also copyrights, industrial designs and trade secrets, “until widespread vaccination is in place globally and the majority of the world’s population has developed immunity.”26 However, a small group of countries such as Australia, the US, UK, Brazil, the EU, Japan, Norway, Switzerland, and Canada stood opposed to this proposal as it would jeopardise future medical innovation, making them more vulnerable to other diseases.27

Furthermore, the pharmaceutical companies in these countries pledged alternative methods such as – offer their vaccines on a not-for-profit basis, considering differential pricing for different countries or working with local partners to make their vaccines available.28 In early May, 2021, after ten meetings in seven months that failed to produce a breakthrough on the proposal, the US reversed its stance.29 This decision was made amidst warnings from pharmaceutical companies in the US that this unprecedented step would undermine the companies’ responses to the pandemic and compromise safety and recommended that the waiver must be narrow and limited.

According to Feng Duojia, President of the China Vaccine Industry Association, this US move was a political tactic aimed at preserving the US’ reputation and leadership position and unlikely to fructify given domestic political and legal resistance within the US.30 On May 06, Germany rejected a US proposal to waive patent protection for COVID-19 vaccines, saying the greatest constraints on production were not intellectual property, but increasing capacity and ensuring quality.31 The logic governing the resistance on the part of developed nations with respect to waiver is that “the protection of intellectual property is a source of innovation and must remain so in the future”. Such a perception prevails despite the fact that much of the innovation in biological sciences is an outcome of public funding and philanthropy.32 Moreover, the top pharmaceutical giants in the US have less to do with innovation and license the research output from university and government public funded labs.33

Even while India has a robust pharmaceutical industry, it remains dependent on alien supply chains for production. It has taken a pandemic to teach India the importance of being self-sufficient in this regard as against self-reliant. In July amidst the pandemic outbreak, the Indian government announced setting up three bulk drug parks for $410 million (INR 3,000 crore) and the approval of a $949 million (INR 6,940 crore) production-linked incentive package for the promotion of domestic manufacturing of critical intermediates and APIs. In 1991, India imported only 0.3 percent of its APIs from China. Now over 60 percent of India’s pharmaceutical imports are API and intermediates, with almost 70 percent coming from China. For some life-saving drugs, including penicillin and ciprofloxacin, import dependence is more than 90 percent. While distribution of supply chains following the economic logic worldwide remained a new normal of the globalised world order, the pandemic has taught the role and importance of nationalism which operates fiercely in a pandemic-like situation. India continues to be one of the leading exporters of formulations or generic medicines to the global market, but in the case of raw materials – intermediaries and APIs – China enjoys the number one position on the global stage.34

Politics has remained at the core of dealing with the pandemic. India, as part of the QUAD grouping, in March 2021, agreed to collaborate to achieve expanded manufacturing of safe and effective COVID-19 vaccines at facilities in India, prioritising increased the capacity for vaccines authorised by the Stringent Regulatory Authorities (SRA). Japan, through Japan International Cooperation Agency (JICA), was in discussions to provide concessional yen loans for the Government of India to expand manufacturing for COVID-19 vaccines for export, with a priority on producing vaccines that have received authorisation from WHO Emergency Use Listing or Stringent Regulatory Authorities. QUAD committed to implement its plan by the launch of a senior-level Quad Vaccine Experts Group comprising top scientists and officials from our governments.35 Yet despite such an agreement to cooperate, the Indian Foreign Minister in April stated, “As a Foreign Minister, I am pushing other countries, particularly some big countries, saying – look, please keep the raw materials flowing for vaccines to be made in India”.36 US State Department spokesperson Ned Price on April 21 stated, “Our priority is ensuring the distribution of a safe and effective vaccine to millions of Americans, to all Americans who can take advantage of it. But we also know that we need to continue to demonstrate that leadership.”37

‘Power’ is the Name of the Game

The central theme in this pandemic-ridden world is – power and political science is the study of power in human affairs. However, it remains doubtful if India has understood this in its entirety. The pandemic by itself is no threat to India – sooner than later India’s vaccine production will rise aided by home grown vaccines (Bharat Bio-Tech & DRDO)38 along with a far greater focus of state machinery in delivering on the public health front. By all accounts, India has done well since the pandemic broke out in late 2019.

While it is true that there is no defence against biological warfare, it is the inherent strength of the society as a whole that matters in dealing with a situation such as the one India is now facing. Adoption of liberal democracy has left the Indian state weak and this has dealt a severe blow in coping with the pandemic. The social order in India does not function as a consequence of the state’s responsibility but more due to religious diktats. The attitude of the general public with regard to government directives for maintaining social distancing, implementing lockdowns, and wearing masks, run through friction as the relationship between the state and people has neither matured nor modernised. Constant interventions by the judiciary in reviewing decisions made by the executive, is yet another case in point.

In this game of power, a nation that is able to quickly arrest the spread of virus within its own territory as well as research, develop and manufacture the vaccines, wins. For this to happen, a country must first consider such biological threats to be real. While many developed countries have been taking the issue of the pandemic either natural or man-made seriously, this can hardly be said about India. For example, India is a nuclear armed state but it does not appear that it takes a nuclear attack on her seriously. If this was the case, bomb shelters would be a common sight in major cities across India, if not all across India. This is a question of attitude and perception held by the people of India and its security establishment as a consequence. It is important that we revisit ancient texts such as the Bhagavat Gita and get over the rose-coloured glasses that we view the world with.