Seven months ago, Covid was killing thousands of people a day in India. Authorities then reformulated their policies and strongly intensified the vaccination campaign, causing the crisis to abate.
Now, as the country welcomes the application of the billionth dose of vaccine, a feat that until recently seemed unlikely, sanitarians are launching a new warning: the turnaround is losing steam.
The pace of vaccinations has slowed down. As the temperature cools and the country prepares for the most important season of religious festivals, people flock to street markets and welcome friends and family at home without masks. And the government has turned away volunteers from the vaccination campaign, like Namanjaya Kobragade.
“This is not the time to let our guard down,” said Khobragade, coordinator of a health NGO in the eastern state of Jharkhand. “Many people have only received the first dose of the vaccine. We can’t leave them like that. We need to intensify [a campanha].”
India’s progress is an important step towards ending Covid’s global crisis and represents a significant political victory for Prime Minister Narendra Modi, whose government was heavily criticized for not making adequate preparations to tackle a devastating second wave of Covid this year .
After the virus wiped out tens of thousands of people, the Indian government invested in increasing vaccine production, halted vaccine exports and repealed rules that made it difficult for state governments to obtain immunizations and people’s adherence to drugs.
Official figures indicate that new daily cases have dropped to around 12,000, from 42,000 four months ago. The number of deaths has also halved, to around 400 a day.
Experts consider that Covid cases and deaths in India are largely underreported. Even so, life has returned to normal in many parts of the country. The malls are crowded, traffic is intense, and this month the children who have been away from school since March 2020 have finally returned to school.
But with only a quarter of its huge population fully vaccinated, the country is still deeply vulnerable. The possibility of a dangerous variant emerging is still worrying.
The central government seems to recognize that India has taken a step back. Shortly after returning from COP26, the climate conference that has been taking place in Scotland, Modi chaired a meeting in which he discussed the situation in regions of the country where less than half of the population is fully vaccinated.
“We are now preparing to take the vaccination campaign to every family,” he said in a press release, adding that health workers will knock on the door of “all families who lack the security of a double dose of the vaccine.”
Complacency contributed to the devastation left by the second wave of the virus. In January, when Covid’s numbers in the country were comparable to today’s, Modi declared victory over the coronavirus.
Encouraged by a flawed mathematical model that indicated that the pandemic was virtually over in the country, the government prioritized vaccinating health professionals and older people with comorbidities that increased their risk of dying from Covid-19.
With everyone else, the government acted with less urgency. In January, India’s Serum Institute, the world’s largest vaccine maker, reserved 100 million doses of the AstraZeneca/Oxford vaccine for India. That month, the government bought just 11 million doses and exported more than five times that number to destinations as far away as the Caribbean. “Unfortunately, we believe the pandemic was over,” said K. Srinath Reddy, president of the Public Health Foundation of India.
Then came the second wave. At its peak in May, more than 400,000 new cases of Covid were being reported each day. Demand for vaccines has skyrocketed. To meet demand, the government launched a pricing system aimed at directing doses to the most needy sectors.
But instead, cities competed for vaccines, and large companies built up stockpiles, exacerbating the shortage. In June, five months after the start of the national vaccination campaign, only 3% of the population was immunized.
Amid mounting criticism from opposition parties, Modi centralized the acquisition and distribution of the vaccine. The immunization program was strengthened, drawing on the systems and know-how that enabled the success of past vaccination campaigns against polio and other diseases.
Modi set aside billions of dollars (the government did not reveal the exact amount) from the national budget to close an advance payment agreement that allowed the Serum Institute to increase its production to 220 million doses a month. A similar deal was made with another Indian manufacturer, Bharat Biotech.
With the stocks reinforced, the government recruited an army of volunteers, including paramilitaries, teachers and religious leaders, to help bring the vaccine to the population. NGOs and charities with a history of supporting public health campaigns were called on to help organize the initiative. Priests and clerics were dispatched to reassure hesitant peasants.
Villagers in Himachal Pradesh, Himalayas, only agreed to be vaccinated after authorities climbed a mountain to consult with local deities. In the remote northeast of the country, villagers received doses of vaccine taken by drones.
The Serum Institute says that the government has already acquired a total of 1 billion doses. More than three out of four adults in the country have received at least one dose. Modi’s government is so confident it will vaccinate the country’s entire adult population, some 900 million people, by the end of the year that it lifted its eight-month ban on vaccine exports.
In Rome last month, at a G20 meeting, Modi said that by 2022 India could provide 5 billion doses to contribute to the world’s vaccination effort. It may be good news for the world, but health experts in India itself warn that the government must remain vigilant. Health professionals are having a hard time persuading millions of people to come back for a second dose.
The vaccination rate dropped sharply from the peak it reached in September, when 25 million doses were applied, so much so that today it is 3 million doses a day. The country still needs to apply more than 700 million vaccines to reach the target by the end of the year, and if current levels hold, that seems less and less likely, unless the feat two months ago is repeated a few times. .
The government seems to know it still has a long way to go. India recently asked for a $2 billion loan from the Asian Development Bank and the Asian Infrastructure and Investment Bank to finance the purchase of vaccine doses for another 300 million people.
The delivery of 1 billion doses “is an important milestone,” wrote the director of the National Vaccination Experts Group, NK Arora, in a newspaper editorial, “but the truth is that we still have a long way to go to achieve control. real from Covid”.
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