Smart policies can transform India into global medical hub ( Sunday Guardian)
The lack of substantive influence of India in the UN is clear from the fact that WHO has not given emergency use authorization for Bharat Biotech’s Covaxin but to China’s Sinopharm vaccine.
Bengaluru: Over the past two months, there has been a welcome change in the functioning of the Government of India while dealing with the SARS2 pandemic. The crisis caused by the second wave seems to have resulted in Prime Minister Narendra Modi looking into several of the decisions made in 2020 for the purpose of coming up with better alternatives. This is a good start, but in India the problem has always been an indifferent finish. There needs to be consistent action on the policy front such as to maximise the natural advantages the country has from its human resources. Lowering some of the Police Constable (PC) era restrictions on NGOs has been a recent example, as also greater efforts at decentralising oxygen supply and distribution, and in ensuring that regulatory hurdles to high-quality innovation and production of vaccines and therapeutics begin to get replaced with differentiated structures more suited to 21st century India. NITI Aayog was set up to ensure policy alternatives to the formulations turned out by the Lutyens Zone. If this is happening, or if it has and the rest of the government has been listening, there has not been evidence of it during the year just past.
In the US, SARS2 guru Dr Anthony Fauci has been facing criticism for his role in providing the funds ultimately deployed by the Wuhan Institute of Virology to undertake “Gain of Function” research into SARS2. This lab-developed virus has devastated the world by bringing economies to a halt, infecting hundreds of millions and killing millions. In his defence, it must be added that Dr Fauci was probably unaware that a steel wall exists in the Wuhan lab between work done for civilian use as such, and those reserved for examination and deployment by the military.
While he was sanctioning tens of millions of US dollars that he was aware would fund SARS2 researchers in Wuhan, Dr Fauci probably believed that every detail of the findings of the experiments being conducted there with money from US (and some European) taxpayers was being sent meticulously to him. This was a somewhat unrealistic assumption to make, given the structure of governance in China, a country that has been run since 1949 by the Chinese Communist Party. The highly-regarded Dr Fauci (who was among the few from the Trump administration to continue into the Biden administration in the same job) is close to Big Pharma in the US, as are several other researchers. Dr Fauci and his colleagues at the National Institute of Health, together with associates in various foundations, probably acted in the generous manner they did from 2014 to 2019 in the belief that the Chinese scientists would do much of the preliminary (and sometimes unpleasant) work of engineering a virus. Later, Big Pharma could come up with a vaccine for this. In hindsight, it may not have been the best idea to help create a superbug to later come up with an antidote in case a largely man-made killer disease escaped from the confines of the laboratory into the human population. An increasing body of evidence shows that Peter Daszak and others who swear that it is impossible that SARS2 did may be wrong. Why is a question for a future US Congressional or Special Independent Commission enquiry into the causes and consequences of SARS2 may assist in determining. Certainly, such an enquiry deserves US Congressional scrutiny as much as does an investigation into the pell-mell entry into the US Capitol by a mob, many elements in which were violent. Such an enquiry needs to break through barriers created by partisan political interest and examine the role of outside actors (state and non-state) in creating through social media a toxic and divisive brew, variants of which were swallowed by both the “Right” as well as the “Left”.
The problem in hindsight is that the creation of a bio-terror weapon of mass destruction (such as an otherwise harmless virus made deadly and transmissible through Gain of Function experiments), when combined with the creation of an antidote, represents the Golden Grail for the military, whether in the US or China. Neither superpower acknowledges the ideals of Mahatma Gandhi to be guiding their actions and policies. Judging by the results, it would appear that China got to the finish line first, flush as its facilities were with funds from the US and other Atlantic Alliance partners. The foundational policy of this alliance (of which NATO is an offshoot) has been that Russia is the predominant threat to their primacy, and that China is an opportunity rather than a threat. But for the support received since the 1980s from Taiwan, Japan, the EU and the US, the PRC would not be the superpower that it has evolved into since the early part of the present century. Slowly, much too slowly, such views appear to be changing.
VIRUS HAS NO NATIONALITY
A virus should never be named after a country. The WHO was quick to condemn mention of SARS-CoV-2 (SARS2) as the China or Wuhan virus, and has given it a simple alternative nomenclature. In contrast, the complex numerical names of some of the variants that have evolved (or been developed, the jury is still out) since the first strain escaped into the human population in 2019 have ensured that these get named in the media for the countries where they were first discovered in the human population: the UK, the Brazilian, the South African and the Indian variants. The latter is what has been devastating large parts of Southeast Asia. The widespread use by the media and the public across multiple countries of the term “Indian virus” (rather than the overly complex numerical nomenclature used by global health authorities) is not a factor that promotes feelings of good fellowship with India or even with those of Indian origin, many of whom are facing discrimination as a consequence. The common factor in such variants is the E484K mutation, thereby strengthening the possibility of a common origin. Viruses mutate, and it is therefore no surprise that the variant in India has mutated into at least three different strains—B.1.617.1, B.1.617.2 and B.1.617.3. As these names are not the easiest to remember, the term “Indian virus” has come into widespread use across the world without attracting the level of criticism (especially from the WHO) that followed any use of the term “China virus” or “Wuhan virus”. There is also no “US virus”, despite multiple strains having been discovered in the human population in that country, such as that once active in California. Being a superpower and a Permanent Member of the UNSC helps in ensuring that the rest of the world does not pick on China or the US in the manner that it does countries that are less influential.
Nobel Prize winner for medicine and eminent virologist, David Baltimore, former President of Caltech or California Institute of Technology, commented on the original SARS2 virus: “The furin cleavage site in the viral sequence, with its arginine codons, was the smoking gun for the origin of the virus. These features make a powerful challenge to the idea of a natural origin for SARS2,” (Source: tweet by virologist Prof Richard Ebright, Professor of Virology at Rutgers University. https://twitter.com/R_H_Ebright/status/1390131060445437955. Others may be cited. Nicholas Wade “The origin of COVID: Did people or nature open Pandora’s box at Wuhan?” Bulletin of the Atomic Scientists. May 5, 2021.)
Now we have an even more efficient and more deadly and transmissible version circulating in India, where mutations have occurred in precisely those super-efficient structural parts of the virus that raise the most suspicions of having been developed in a laboratory rather than in nature. Doctors treating cases state that overnight the lung turns opaque on X-Ray once the patient complains of breathlessness, indicating the increased speed of deadly action. Doctors and other frontline warriors are themselves dying in increasing numbers, including the former President of the Indian Medical Association. The world must therefore know how the SARS2 virus originated, as well as have robust biodefence prepared including epidemiological, virological surveillance, threats-assessments, and vaccines/therapeutics/diagnostics remedial measures.
EFFORTS TO HOLD WHO TO ACCOUNT
Dr Harsh Vardhan, the Health Minister of India, was appointed Chairman of the Executive Board of WHO for one year, demits this powerful position at the World Health Assembly being held 24 May to 1 June, 2021. The Union Health Minister must have worked ceaselessly to try and find out more facts about the origins and nature of the pandemic than the WHO has publicly let on. If, as many believe, much of the Wuhan experiments were being done together with the PLA, it is understandable why so little has come out about SARS2 from that country. What is incomprehensible is the seeming lack of success (or effort) by WHO to get to the roots of the pandemic rather than rubber stamp whatever it has heard from interlocuters in Beijing. The Government of India needs to educate the Indian public the ways in which he sought to increase transparency about the origins of SARS2 during this critically significant tenure at the top of the oversight board of that organisation. Dr Harsh Vardhan needs to hold a press conference on the subject when he demits office, preferably in Geneva itself, as he must have worked hard in the powerful position he has held for one critical year to ensure transparency and accountability for a pandemic that has ravaged the country that he has been chosen to serve as Union Minister for Health, not to mention Science & Technology.
SINOpharm BUT NOT COVAXIN: WHY?
Irrespective of the variants, a combination of vaccines and complementary therapeutics will reduce further the mortality and morbidity due to Covid. This has been the case with every epidemic in history. India is well-positioned in both, and all that is needed is a hundred smart policies just as earlier the concept of a hundred smart cities was developed. It must not be forgotten that SARS2 shows the potential efficacy of engineered and disseminated biological agents in paralysing economies, melting down societies and in causing millions of deaths and hundreds of millions of severe morbidity casualties.
To assume that such tactics will not be used would be to court collective danger. Unfortunately, at every step of the way, bio-terrorism provides opportunities for deniability. Therefore, the onus cannot be on the party suspected of malfeasance to allay concerns via “spin” or otherwise. There must be a clear-cut and immediate way for affected countries to be able to rush to verify as to what happened in the “culprit” country or entity. The Quad needs to work on this, with India in the lead. Relying on the UN as India has consistently done (despite its lowly status compared to the P-5) may not work. As has been said, the UN P-5 system of vetoing the rights of others to inspect the potential cause of the bio-terror or lab-leak is unacceptable. Organizations such as WHO are under the control of the P-5 that can block access for the affected/impacted to visit the source of the problem.
This was in stark view in the case of the hiding of everything for over a year by PRC. Which is why an operational arm should be with the Quad to monitor and take action. The lack of substantive influence of India in the UN is clear from the fact that, as has been pointed out, WHO has not given emergency use authorization for Bharat Biotech’s vaccine COVAXIN but on 5 May 2021 stated: “WHO today listed the Sinopharm COVID-19 vaccine for emergency use, giving the green light for this vaccine to be rolled out globally.”
It is a sign of the world we live in (rather than the world the Lutyens Zone assumes we live in) that authorities in China have been distributing five types of SARS2 vaccine before WHO approved even one of them (or before May 5, 2021). The Chinese vaccine was the one mainly used in Seychelles “the world’s most vaccinated nation” using Chinese vaccines donated by the UAE. Seychelles only has a population of 100,000 and has vaccinated 60%. Despite this, it has a high infection rate. SE Asia too uses PRC-made vaccines liberally. The region is now going through a second wave. For whatever reason, the PRC itself seems to have recovered from the pandemic and seems in much better shape than either the US or India, the two biggest democracies on the globe.
STRATEGY FOR VICTORY
The “Vaccine Maitri” program thought up by Prime Minister Modi and implemented by External Affairs Minister S. Jaishankar needs to be combined with a strategy for (a) identifying and boosting production of vaccines from the present low number of suppliers to more. Given the wealth of expertise in pharma in India, this is entirely possible, (b) identifying drugs that are proving effective against SARS2 as well as those (including some pricey items) that are more hype than reality and hold more hot air than hope, (c) decentralising oxygen production and supply through increase in the number of oxygen concentrators. The cores need to be imported into India from Europe and the containers made in India, rather than importing the entire equipment from China at inflated prices. Health infrastructure needs to be improved. North Block and the RBI need to stop acting like Uncle Scrooge and ensure flow of funds to those individuals and enterprises in pain caused by the effects of the pandemic. 5:5:5 needs to be the goal. An additional expenditure of 5% of GDP annually over three years, especially to small and medium enterprises and to the unemployed and under-employed. Fiscal rectitude or monetary timidity needs change should such policies cause economic contraction.
India can emerge as the vaccine and pharma hub of the world, not in the indefinite future but by the close of 2021 itself, if a hundred smart policies are developed and implemented. This makes not just political sense but still more importantly, it makes humanitarian sense as well. 2021 needs to be much more productive and much less disruptive than SARS2 made 2020. This is the challenge facing Prime Minister Narendra Modi and those who have been chosen by him to man the higher reaches of the policymaking establishment.