Emergence of India as the pharmacy of the world: Strengthening COVID-19 Diplomacy
The world has been shaken by the global pandemic and has been battling through economic upheavals to medical shortages all across the world. These have led to a global collaboration through regional and global institutions and forums, to stay united to combat the deadly COVID-19. India has been one of the most active countries across the globe, and has become the emerging pharmacy of the world in the COVID-19 times by providing essential medical supplies, equipment and medical staff. Thereby, this article traces how India is emerging as a pharmacy of the world, along with how being a ‘medical messiah both regionally and globally’ has led India as an emerging ‘Medical COVID-19 Diplomatic partner’ paving a way as a ‘medicine game changer’.
India’s Medicine Diplomacy: A Pharmacy of the World
The hydroxychloroquine (HCQ), an anti-malaria drug has become the ‘game-changer for India’ in the COVID-19 times as India is one of the largest producers of HCQ which is being used for the treatment of the deadly coronavirus. Initially, there was a ban on the export of the pharmaceuticals, but was soon reversed with the United States of America’s President Donald John Trump demanding India send a ship of the anti-malarial drug hydroxycholoroquine to America. Of course, initially, America had threatened India for the supply of the anti-malarial drug and that did shock India, but India, being a cooperative nation sent the hydroxychloroquine to the United States of America. Later, President Trump profusely thanked our ‘Prime Minister Narendra Modi, the people of India for the support and supply of HCQ to the United States of America. This gesture wouldn’t be forgotten by America and has paved a way for closer cooperation between the two countries. For President Trump, this drug was a ‘game-changer’ in the fight against coronavirus. Soon India decided to export HCQ and other drugs to treat COVID-19 patients in twelve countries under the categories of humanitarian aid and commercial supply.
The countries of Africa and Latin America dubbed India as ‘the pharmacy of the world’, as it had exported pharmaceuticals to these countries on the grounds of humanitarian aid. Prime Minister Modi was also with the Brazilian President Jair Bolsonaro and the Israeli Prime Minister Netanyahu, as India had sent ships of medicines to them as well. The United Kingdom also thanked India for its help and support. India has also sent five million tablets of hydroxychloroquine from India to Toronto and has been a crucial stage of cooperation in the ties of India and Canada. India has also gifted five million HCQ tablets to the neighbourhood countries and countries in the Indian Ocean Region like Central Asia, Eurasia and West Asia. A total of 1.32 million PCM tablets have been given to neighbouring as well as partner countries, and apart from that, India has also spent a total of 5 million dollars to provide other medical aid like essential drugs, life-saving antibiotics, medical consumables and other laboratory and hospital equipment. India set a mission called ‘Operation Sanjeevani’ to send essential medicine and hospital supplies of 6.2 tonnes to the Maldives. India also provided a number of essential immunity-boosting medicines and medical equipment, like surgical masks, gowns, surgical gloves, thermometers, swabs, etc. to Jamaica. A donation of 4000 HCQ and 19,200 tablets on a commercial basis have been sent to the CARICOM Grouping. India has also engaged with countries like Sri Lanka, Seychelles, Mauritius and the Dominican Republic in similar initiatives. Also, Maldives and Kuwait has requested India to deploy the Indian Rapid Response Teams (RRTs) consisting of doctors, nurses and paramedics to help their people along with combating the infectious spread of the coronavirus. According to the Ministry of External Affairs, the team of young diplomats have been working tirelessly and till date, India has been able to provide 2.8 million HCQ tablets as well as grant assistance to 25 countries. 1.9 million tablets of paracetamol have also been sent to 31 countries. HCQ and paracetamol has been sent to 87 countries bases on a commercial basis.
Therefore, all these efforts by India have led it to become a leader in the realm of international cooperation of medicine supplies making it the ‘pharmacy of the world’. It has also helped India garner support and respect globally making them a messiah in the fight of the deadly virus. India’s decision to remove the export ban on the HCQ and paracetamol has paved a way for India as a major medicine manufacturing industry in the severe times of the pandemic crisis.
India’s Internal Pharmacy: AYUSH, Indian Institutions and Vaccine Development
India is home to Ayurveda, the Indian traditional medicinal system and the Indian Government has been actively promoting the use of Ayurveda and Yoga based immunity-boosting procedures in the times of the coronavirus. The Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy or AYUSH have been able to develop an anti-malarial Ayurvedic drug, AYUSH 64 which helps to prevent the symptoms of coronavirus, and have also suggested tablets of Guluchyadi and Sudarshanam prepared by the Kerala Ayurveda methods to help boost immunity. Also, the Ministry of AYUSH has handed over a recipe of herbal decoction to states and union territories, and have requested the promotion of commercial manufacturing of this formula, as it would help boost immunity and this has been endorsed by Prime Minister Modi on April 14. This was done keeping in mind the health of the masses. They have successfully developed a formula in the generic name Ayush Kwath or Ayush Kudineer or Ayush Joshanda, a combination of tulsi, dalchini, sunthi and black pepper which is being manufactured and sold by states, union territories and ASU drug manufacturers since April 24. The States and the Union territories' Governments have requested the AYUSH licensing authorities to consider granting a license, as well as approval for manufacturing of the Ayush Kwath formula to the interested licensed Ayurveda, Siddha, Unani drug manufacturers in accordance with the provisions of Drugs and Cosmetics Rules, 1945. Taking cue from this, a firm has also engaged in producing a range of herbal products and have already started the process of manufacturing of the ‘Ayush Kwath’. This will be available in the form of tablets and powders in the market.
Coronavirus reduces the immune response of the infected person, targeting people with low immunity. The experts from AYUSH feel that this Ayush Kwath would help improve the immune systems of the people and would help to fight the deadly COVID-19. Prime Minister Narendra Modi, through his ‘Mann Ki Baat’ radio programme, also suggested for the people to pay close attention to the importance of Ayurveda and yoga amidst the severe pandemic of COVID-19. This initiative has led to the increase in demand of Ayurvedic medicines and has created an interest for Ayurveda in the international market as well. If the interest in the Indian traditional system continues, India would boom with its Ayurveda medicines market and that would help boost immunity and fight COVID-19.
India’s top research organisations like the Indian Institute of Science, the National Institute of Immunology and the Translational Health Science Technology Institute have been working to develop a vaccine and therapeutics. The National Institute of Immunology (NII) in Delhi would be sequencing the virus to see whether the one infecting travellers from different countries is the same or has it undergone some changes. They believe that by the time, a vaccine is developed, the virus might have changed its form, and it is important to understand how exactly it is changing. They have decided to see those infected from countries like Italy, Germany, China and the United States of America and that can be done through ribonucleic acid (RNA) and NII has been studying the protein of the virus as it would be crucial in the development of the vaccine. The team at NII has also analysed blood samples of 46 people who have recovered and so, they have aimed to analyse the antibodies that have protected them. They have been given the BSL 3 (Biosafety level 3) laboratories to conduct the tests. NII believes that since every third vaccine in the world used today is developed in India, it’s upon them to deliver yet again. It is important to note that till the time a vaccination is made, it is important to maintain mass social distancing and take precautions in order to be safe.
The Indian Council of Medical Research’s National Institute of Virology has already isolated the strains of SARS-CoV-2 from three infected people who travelled from Wuhan and found it very similar to the virus found isolated in Wuhan. They concluded that there are three infections in India since January. The Translational Health Science and Technology Institute (THSTI) has been working on developing the diagnostic kits within a few months as the work is on hold as the import license to get the virus which will happen after the lockdown is lifted. The potential therapeutics may take more than a year which may include the repurposing of existing drugs, studying the new chemical compounds, designing the new compounds based on the structure of the virus as well as using the monoclonal antibodies from infected patients to treat the new patients. They also said that it may take about a year to develop a vaccine based on the samples collected. They are also permitted to access the samples from any Government approved clinical testing site subject to ethical approval and so, many hospitals in Delhi NCR have handed over the samples to Labs with BSL3 and BSL3+ facilities to research. The Indian Institute of Science (IISc) in Bengaluru have together prepared research proposals with 30 researchers to investigate the various aspects of molecular epidemiology-a study of causative, protective, genetic susceptibility or predisposing factors and also wanted to investigate the host-pathogen interactions. They have also decided to host the need for approvals from the Government for all these researches. IISc has also decided to start work on developing a COVID-19 vaccination and has also been using the COVID-19 testing using ICMR approved reagents.
Prime Minister Narendra Modi also took a review on India’s efforts to develop a vaccine, drug discovery, diagnosis and testing. Indian companies have a reputation for their quality, manufacturing capacity and global presence. In addition to that, they have come up with 30 vaccine development researches. Hence, the drug development has three approaches to it such as the repurposing of the existing drugs with at least four drugs are undergoing synthesis and examined within this category. Secondly, there has been a development of new candidate drugs and molecules aimed for high performance computational approaches with verification in laboratories, and finally plant extracts products should be examined for the general anti-viral properties. In the sector of diagnosis and testing, many academic research institutions as well as start-ups have developed tests for the RT-PCR approach as well as for the antibody detection, and has also been linked to laboratories all over the country. There is a problem of importing reagents for testing as it has been addressed by consortia of the Indian start-ups and industry because of the need to meet the current requirements, which hold the promise of development of a robust long-term industry within this area. Prime Minister Modi also spoke about coordination and speed should become a naturally embedded part of the standard operating procedure, and in a state of crisis, they should work for scientific functioning. He also appreciated the scientific accumulation of computer science, chemistry and biotechnology needed in the drug discovery and suggested that all this should be linked through a hackathon and the successful candidates should be taken by the start-ups for further development.
India is regarded as the pharmacy of the world, and through AYUSH, India has been able to become an internal pharmacy with the help of the products using the traditional medicine system in India and has also paved a way for an internal manufacturing market within India. If this is successful, India can think of successfully starting to export to other countries and that would also help build and open up the traditional Ayurvedic medicinal product market from India. India has been the third most successful country in developing vaccines as being trying to develop vaccinations to fight the COVID-19, and India is blessed with the best research teams which are sure to develop a vaccine soon, and can be the pioneer in vaccinations all across the world and that could help India carve its name as the ‘vaccine hub of the world’.
India, a diplomatic ‘game-changer’ in COVID-19
India has been selected to be the new Chairperson of the World Health Organisation (WHO) and the decision was made last year by WHO’s South-East Asia Group for a term of 3 years. India would be taking over from Japan, its all-weather friend. India as a Chairperson comes in at a time when the world is being traumatised by the deadly coronavirus and India’s efforts to send HCQ and paracetamol medicines have garnered a great amount of respect and belief for India as a humanitarian partner for being transparent and accountable, and has been highly applauded by Tedros Adhanom Ghebreyesus, the Chief of WHO due to the efforts put by the Indian Council of Medical Research to strengthen COVID-19 surveillance and also credited for its involvement globally to develop a vaccination in collaboration with other countries.
India also has been actively involved in developing vaccines all over the world, and it has collaborated with several foreign agencies in the field of research, aiming to develop a vaccine to combat the COVID-19 virus. India has been proactively engaging with countries to devise methods and plans to coordinate their responses. The International Centre for Genetic Engineering and Biotechnology (ICGEB) would be collaborating with ICGEB, Trieste (Italy) and already substantial progress has been made in the field of diagnostic and therapy. The website of National Centre for Biological Sciences quoted “they are contributing to the national efforts on COVID-19 through immediate and medium-term solutions aiming for disease surveillance, modelling, use of genomics and bioinformatics in order to understand the evolution of the virus and map the disease susceptibilityâ€. The National Institute of Immunology, a pioneer and premier institute for developing vaccines has formed a core team of ten top scientists from different streams like drug repurposing, antibody characterisation, diagnostics to develop the vaccine to combat the coronavirus. They have already adopted a developed vaccine for cancer for which trails are being done in Chennai, and previously, NII had developed vaccines for leprosy and tuberculosis. Though, they did say that developing a vaccine is challenging, but the help given to them by ICMR and the other government bodies in developing a treatment have only strengthened their goal of saving the lives of people across the world.
India has been proactive in its COVID-19 diplomacy, as apart from helping and supplying essential medicines to the various countries, India has emerged as a pioneer of COVID-19 combating methods, which has strengthened their diplomatic position among the SAARC, the BRICS, NAM and the Quad countries making it a complete game-changer in the coronavirus times. SAARC members on 15 March held a video conference and this was attended by our Prime Minister Narendra Modi. Our Prime Minister Modi wanted the creation of a dedicated website developed by SAARC Disaster Management Centre (SDMC-IU) Gandhinagar. There was a need to develop a health network and so, ‘SAARC COVID-19 Information Exchange Platform (COINEX)’ would help exchange specialised information and health professional tools on COVID-19, and also facilitate various online training resources and e-learning modules. India also introduced its in house mobile App ‘Aarogya Setu’ for COVID-19 community outreach and intervention. India also presented a comprehensive response which was essential in putting up with a production line for essential materials, medicines and enhancing their research capabilities and also drugs and vaccines development. This way, India reaffirmed its strong commitment for a peaceful and healthy region of SAARC nations.
Similarly, the BRICS video conference was held under the Chairmanship of Russia and the theme for this year was “BRICS Partnership for Global Stability, Shared Security and Innovative Growth†and discussed the steps needed to be taken to combat the COVID-19. India was represented by Dr S Jaishankar who spoke about the ‘Aarogya Setu Citizen App’ and the ‘Pradhan Mantri Garib Kalyan Package’ and discussed how there was a need to provide support to businesses especially the MSMEs and also advertised Ayurveda which was effective in building immunity.
On 4 May, an online Summit of the Non Aligned Movement (NAM) Contact Group was hosted by the current Chairman of NAM, President of Republic of Azerbaijan HE Ilham Aliyev with its theme was “United against COVID-19†and the objective of the Summit was “to promote international solidarity in the fight against the COVID-19 pandemic and to mobilise efforts of States and international organisations to address the pandemicâ€. India, without naming any country, spoke about terrorism and fake news being used in the severe times of the deadly COVID-19. Prime Minister Modi said that India is regarded as the pharmacy of the world and has sent medicines to 120 countries out of which 59 countries are of the NAM. India has been making efforts to develop remedies and vaccines and India is home to the world’s oldest plant-based traditional medicine system and agreed to share the Ayurvedic home remedies which would help people boost their natural immunity.
It is very well apparent that India has been regarded as a pharmacy of the world for its extensive way of Medical Diplomacy across the world, and it has also, paved a way for its internal medicine market by advertising the importance of Ayurveda and Yoga and this has led an increase in the demand for AYUSH medicines, which has led the Ministry of AYUSH to increase their manufacturing bases in states and union territories. India is regarded as the third largest vaccine hub in the world, and has also been actively working through its various medical institutions and laboratories for the development of vaccines. By collaborating with other international institutions and research centres, India is also trying to internationally build a vaccine to do away with the deadly coronavirus. India as a regional player in the SAARC has also been effective in combating coronavirus and has also been helpful by sending medicines to its neighbouring countries and rightly honoured its Act East Policy and its Neighbourhood First Policy. India has also provided medical assistance and medicines to the countries in the Indian Ocean Region (IOR). They are extremely important for India in the bigger picture of the Indo-Pacific, and by helping these countries, it has honoured its SAGAR initiative as well. India has been an active member of the Quad and has also been a member of the BRICS. It has helped both these institutions by its medical Diplomacy in the COVID-19 times which has led India to be a perfect balancer between the Quad and BRICS, leaving an excellent impression of a classic Diplomatic partner. Therefore, India has indeed emerged as a brilliant ‘medical messiah’, and that’s why it has also been applauded by the World Health Organisation (WHO), the United Nations (UN) and the International Monetary Fund (IMF). India has emerged as a bankable, trustworthy diplomatic partner in the current COVID-19 crisis.
(Gitanjali Sinha Roy is a Ph.D. scholar in the Department of East Asian Studies, University of Delhi and at the moment, she is a visiting scholar at the University of Tokyo.)
