The COVID-19 pandemic has upset the world in an unprecedented manner. It is not the first health catastrophe that has hit the humanity. In last century alone, the world has seen ill-effects of epidemics like Spanish flu, plague, smallpox, Ebola and SARS. However, the current pandemic is different from the previous ones in terms of the amount of disruption it has brought to the world. Since December 2019, more than 182 million people have been infected by the Coronavirus worldwide, and close to four million people have lost their lives (WHO, 2021, July 1). It has spread to almost all countries within the United Nations (UN) fold, and has restricted the movement of the people from one part of the world to another. It has also led to great economic upheaval causing job losses and displacement of workforce. In other words, this virus has posed a serious security challenge at all levels, namely global, national and human.
On one hand, this pandemic has reemphasized importance of the concept of national sovereignty. Governments have imposed necessary restrictions on international as well as domestic travels in order to contain the spread of virus; and the leaders seem to have given priority to their internal concerns. However, on the other hand, last one and half year saw extraordinary international cooperation in tackling this menace. World leaders have interacted with each other at bilateral as well as multilateral levels. They have also positively responded to each other’s demands for aid, medical supplies, and vaccines. This balancing approach can be explained as a middle path between globalism and nationalism (Mohan, 2021).
The Indian government, under Prime Minister (PM) Narendra Modi’s able leadership, has set an astounding example by striking a balance between national challenges and global commitments. While a lot of measures have been taken domestically to mitigate the ill-effects of COVID-19, the kind of role India has played at the international level is equally noteworthy. It has emerged as one of the key players in the field of medical supplies, scientific research, and vaccine development and distribution. PM Modi has also given a call for global solidarity and ‘human-centric’ approach to combat the crisis. Today, as India’s engagements with the world have expanded, qualitatively and quantitatively, the pandemic has opened a yet new chapter in India’s international relations. In this new foreign policy outlook, health and human welfare have undoubtedly taken a center stage.
This article is an attempt to highlight the role played by India at the global level during the pandemic. It tries to find out how these actions fit in India’s wider foreign policy canvass. As the country aspires towards the superpower status, this ‘health diplomacy’ is certainly crucial not only during the current global crisis, but also beyond. Therefore, the article concludes with the section on India’s potential leadership role in the post-pandemic world.
Domestic Transformation and Indian Foreign Policy
India is home to about 18 percent of world’s population; thus, accounts for one sixth of the humanity. It is the largest democracy in the world and an emerging economy. India is also one of the oldest civilizations; and is a diverse society, a mosaic of different languages and cultures. Indian government’s policy, domestic or foreign, reflects the aspirations of its 1.3 billion people.
Since 2014, many path-breaking initiatives have been taken up domestically, keeping the human welfare and development in mind. Flagship schemes like Swachh Bharat Abhiyan, Jan Dhan Yojana, Ayushman Bharat, Ujjwala Yojana, Mudra Yojana, Make in India, Skill India, Startup India, Digital India, and so on, have shown impressive outcomes, some out of which deserve a mention. In last seven years, nearly 426 million people have been connected to the formal banking system (PMJDY, 2021). Similarly, about 80 million clean cooking gas connections have been distributed (Transforming India, 2021) in order to ensure smoke-free kitchens, safeguarding the health of women and children. More than 106 million toilets were built, and six lakh villages were made open defecation free (SBM, 2021). Approximately 500 million people belonging to the poor and vulnerable families have been given access to free healthcare services (PMJAY, 2021). The government has also launched the Mudra Yojana, which is considered as world’s largest micro financing scheme, more than 75 percent beneficiaries of which are women. All these schemes are perfectly in tune with the Sustainable Development Goals (SDGs) defined by the UN.
Apart from the aforementioned initiatives, the government is also trying to ensure empowerment and transparency by providing digital accessibility to millions of its citizens. In fact, the Jan Dhan -Aadhaar- Mobile (JAM) trinity has been a success story mainly with respect to the direct benefit transfers on large scale. Moreover, government has been successful in resolving the long-standing issues through decisions like reorganization of the erstwhile state of Jammu and Kashmir, Citizenship Amendment Act, and peaceful resolution of conflicts in the North East. Even during COVID-19, some structural reforms were introduced under the aegis of Atmanirbhar Bharat Abhiyan, which included the farm laws, labor laws, and Micro, Small and Medium Enterprises (MSME) sector reforms (mygov, 2020, May 25).These policy initiatives have ushered in the process of transformation of India into a strong, prosperous and new nation (Debroy, et al., 2019, p. 1-2). And these changes are not only impacting India, but also other parts of the world.
One of the important features of PM Modi’s foreign policy is that he has successfully linked it with domestic transformation. Through the international partnerships, an attempt has been made to attract foreign capital, technology and market access (Ganguly et al. (eds.), 2016, p. 5-6). Similarly, India’s growth story is also made an important link in its relations with the immediate and extended neighbors through what is called the ‘development partnerships’. Sharing the development experience with these smaller countries has been India’s consistent policy. Another accomplishment of recent years has been energizing and enthusing the Indian Diaspora, which today connects with the India story. These domestic aspects need to be analyzed for better understanding of India’s external behavior.
Foreign Policy Outlook
Apart from the domestic factors, India’s foreign policy takes influence from its history, culture, and geopolitical aspects. One also needs to understand the theoretical underpinnings that impact India’s diplomatic choices. The fundamental philosophy of ‘Vasudhaiva Kutumbakam’ gives an outlook, which, as External Affairs Minister (EAM) Jaishankar (2021, April 13) put it, “means both that the world is important to us and also that we are important to the world”. In the contemporary global context, it translates into international cooperation (Ibid.). Another guiding principle for India’s external behavior is, ‘Sarve Bhavantu Sukhinah, Sarvey Santu Niramaya’, meaning: may all be happy, may all be disease-free. Both these principles re-emphasis the belief in human welfare.
The humanitarian outlook was evident in India’s response to various crisis situations, even before the pandemic. In fact, it has been a constant Indian policy to help and support the other countries during their hard times. It has played the role of ‘first responder’ in events like Nepal earthquake in 2015, Easter bombings in Sri Lanka in 2019, and water crisis in Maldives in 2014 (Gokhale, 2020, April 14). It also sent humanitarian aid in the maritime neighborhood, during the Tsunami in Indonesia, civil war in Yemen, typhoon in Fiji and cyclone in Mozambique.
Moreover, keeping the same human welfare angle in mind, India has also come up with three international initiatives, which in a way define its foreign policy outlook. First, International Day of Yoga was proposed at the UN General Assembly with the objective of improving physical and mental wellbeing of all the humanity. It received overwhelming support from the global community. Second, International Solar Alliance (ISA) was established to ensure transition to clean energy and to tackle the issue of climate change. And third, Coalition for Disaster Resilient Infrastructure (CDRI) was announced in order to collectively protect people from disaster risks (Modi, 2020, May 4). All these initiatives are practical ways by which the principle of ‘world is family’ was demonstrated (Jaishankar, Ibid.).
Apart from the philosophical backdrop, India’s foreign policy can be understood in the pattern of concentric circles. The topmost priority is given to its immediate neighbors in the subcontinent, which is also reflected in the doctrine of ‘neighborhood first’. After that, come the extended neighbors in South East Asia, the Gulf, and Central Asia. The policy of ‘Act East’ is crucial in strengthening economic, strategic and cultural relations with the Indo-Pacific region (Kesavan, 2020). Relations with the P-5, i.e. five permanent members of the UN Security Council, are equally important, and have seen an upper trajectory in the recent past. Most striking feature of Indian foreign policy is its multiple engagements and maintaining balanced relations with various powers. On one hand, it has been an active member in the Quadrilateral Security Dialogue (Quad), and on the other hand, it has maintained its presence in the Russia-India-China (RIC) grouping and the Shanghai Cooperation Organization (SCO).
India’s international relations have expanded manifold in recent past. The overview of these major trends gives a backdrop to understand its external behavior during the pandemic.
HEALTH Diplomacy- India’s International Engagements during COVID-19
India has been one of the severely affected countries by the COVID-19 pandemic. Till date, it has registered about 30 million infections, which is second only to the United States (US). Similarly, more than four lakh Indians have lost their lives due to the Coronavirus (mygov, 2021, July 4), which makes India third largest country with respect to number of deaths, next to the US and Brazil. India’s ratio of deaths per million is 287 (Thakur, 2020, July 2); it is far lower compared to many other countries with higher death count. Despite this, the pandemic has put tremendous pressure on country’s governance machinery and healthcare services. Nevertheless, even while tackling the domestic challenges, India has kept its international commitments.
As one of the first responses to the unfolding situation, India had evacuated number of Indian as well as foreign citizens in February 2020 from Wuhan- China, where the epidemic first broke out.The evacuations included citizens from Bangladesh, Maldives, Myanmar, South Africa and Madagascar (Economic Times, 2020, March 18). It had also sent tonnes of medical supplies, including masks, gloves, and other emergency medical equipment, to China in the beginning of the epidemic (Ibid.). Later, as the pandemic spread in other parts of the globe, Indian government launched Vande Bharat Mission to bring back its stranded citizens from abroad, which later became the world’s largest expatriation exercise (The Hindu, 2021, April 20).
In the initial days of the pandemic, India helped several countries by providing medical and other COVID-related supplies. Under the auspices of Mission SAGAR (Security and Growth for all in the Region), Indian naval ship Kesari delivered food and medical assistance to the island nations of Maldives, Madagascar, Mauritius, Seychelles and Comoros in May 2020 (Roche, 2020). This act reiterated India’s role as the ‘first responder’ in the Indian Ocean region. Similar assistance was extended to the neighbors in the Indian subcontinent, like Nepal, Bhutan and Bangladesh. Moreover, health experts from India organized online training to share medical expertise with many nations.
In recent years, India has emerged as ‘pharmacy of the world’, especially for affordable medicines. To tackle COVID crisis, it sent essential medicines to as many as 150 countries, 82 of them were sent as grants (The Economic Times, 2021, March 17). This played a crucial role especially in meeting the requirements of drugs like hydroxychloroquine (HCQ), paracetamol and others worldwide. Though some medical journals tried to create the HCQ controversy, it was widely supplied and prescribed, and was called the ‘game changer’ by the then US President, Donald Trump (Basu, 2020). Apart from this, India has one of world’s oldest plant-based traditional medicine system. To alleviate crisis, it shared with the world simple Ayurvedic home remedies to boost natural immunity (Pandit, 2021).
India also received medical supplies from across the globe. However, because of the disruption of global supply chains and domination of certain actors, the personal protective equipment (PPE) kits, healthcare equipment, ventilators, were in short supply. To resolve this problem, India increased the manufacturing of all these products. The PPE industry alone witnessed the growth by 56 times; and it started producing 4.5 lakh PPE kits on a daily average. This led to India becoming the world’s second largest PPE producer, and supplying affordable quality PPE kits to the world (Sapra, 2021).
The two sectors in which India has emerged as a key player during pandemic are, vaccines and technology. It has become the largest vaccine producer in the world. The Serum Institute of India (SII) has been producing the Oxford-AstraZeneca vaccine, named ‘Covishield’, for domestic use and exports. Another Indian bio-pharma company, Bharat Biotech, together with the Indian Council of Medical Research (ICMR), developed ‘Covaxin’ (Dhar, 2021), which is India’s indigenous COVID-19 vaccine. Thus, apart from manufacturing the vaccines developed elsewhere, India also developed its own vaccine, which made a huge difference (Jaishankar, 2021).
India has made the vaccines widely available and accessible to all. Till date, it has vaccinated close to 36 crores of its own citizens (MoHFW, 2021, July 6). Moreover, under the aegis of Vaccine Maitri initiative, it has sent 6.6 crores of vaccines to as many as 95 countries in Asia, Africa,South America and Caribbean (MEA, 2021). Out of these, more than one crore vaccine doses were given as grants; and about two crores supplied as part of the COVID-19 Vaccines Global Access (COVAX) facility (Ibid.) that was initiated to ensure fair and equitable distribution to the developing world. In addition to vaccine supply, it is helping countries in enhancing their cold chain and storage capacities. This supply proved to be crucial in many countries, as it reduced the risks for health and frontline workers. The Vaccine Maitri initiative is in line with India’s policy of ‘development partnership’ (Dhar, 2021). Besides, export of vaccines on commercial principle to upper or upper middle-income countries like Canada, Brazil and South Africa proved beneficial for either side (Ibid.).
In another move to make vaccines accessible to all the humanity, India and South Africa have tabled a joint proposal to the World Trade Organization (WTO) to temporarily suspend the intellectual property rights related to COVID-19 vaccines and medicines. Although WTO members have not reached a consensus on this, several countries have backed the proposal (Pandit, 2021). Another challenge came when the US put restrictions on the export of critical raw materials needed for the Covishield vaccine. However, after a sustained diplomatic effort, this embargo was lifted, along with other supporting measures. Indian diplomats have been consistently in discussions with foreign manufacturers for procurement of doses, or even for possible local manufacturing (Shringla, 2021, June 30). It has already approved the Russian vaccine, Sputnik V, which is also being manufactured in India now. A diplomatic push was also exerted to persuade European countries to accept Indian vaccines for travel purposes. These developments show how vaccine diplomacy has enhanced India’s global clout.
India has also played a crucial role in the domain of technology. Its technology industry has always been known for its cutting-edge innovation and global success. During pandemic, this sector delivered substantively. Medical sector saw tele-consultation and health administration through innovative apps like Arogya Setu for tracking the spread of virus and CoWIN for facilitating vaccinations. India has also offered these tech innovations to other countries as open source. In the CoWIN Global Conclave on July 5, 2021, PM Modi expressed that India will offer this app to the world as ‘digital public good’. About 50 countries have shown interest in adopting this app for carrying out their vaccinations (NDTV, 2021, July 5).
While Indian government was cooperating and assisting its foreign partners in their fight against the Coronavirus, PM Modi also tried to engage with the world leaders at multilateral levels. He called the video conference of the South Asian Association for Regional Cooperation (SAARC) leaders in March 2020, and proposed creation of SAARC COVID-19 emergency fund. At the SCO summit, he proposed creation of a working group on traditional medicine. And at the BRICS (Brazil-Russia-India-China-South Africa) forum, he gave a call for collaboration in digital health. His recent slogan of ‘one earth, one health’ at the G-7 summit signaled at global unity, solidarity and cooperation during health crises (Livemint, 2021, June 13).
The constructive role played by India during this difficult time has created immense goodwill especially among the smaller countries in the immediate and extended neighborhood. But more than that, it has helped the country during its crisis situation. When India was fighting the deadly second wave, the entire world community stood behind it, as aid and supplies poured in from all directions. It received nearly 50 oxygen plants, about 20000 ventilators and thousands of oxygen cylinders, oxygen concentrators, drugs like Remdesivir, Tocilizumab and other medical supplies from all across the world (MEA, 2021). These supplies played significant role in India’s fight against the Coronavirus.
Conclusion: HEALTH Diplomacy in the Post-pandemic World
Subsequent sections in this article have proved that India’s calibrated external engagements during the pandemic cannot be seen as reactionary or in isolation. They were very much a continuation of the overall foreign policy trajectory that India has followed in recent years. Similarly, it is also obvious that the HEALTH diplomacy that has emerged through this crisis will continue to guide India’s international relations in future.
It is worth noting that in most of the previous health crises, India was at the receiving end and was completely dependent on the developed countries for medicines, technology and vaccines. This scenario has rapidly changed in last couple of years. India has not only emerged as the pharmacy of the world, but also as a destination for medical tourism. During COVID-19, India has proved that it can play an important role in securing its own citizens, and can still be helpful for other countries in the region. This trend is going to strengthen its leadership in the healthcare sector in near future.
One has to consider the challenges pertaining to political, strategic and economic fronts. India first has to get its own public health sector in order. The process of domestic transformation has to go on vigorously to match its global ambitions. Though India is being heard at the global level, it still does not have a place at the high table. There is also a larger need for reforming the global governance bodies, especially the UN, which has proved to be inadequate in dealing with contemporary challenges. Countries like India can play a positive role in creating a just, responsive and ‘healthy’ global order that will have human welfare at its core.
In India’s outlook, the concept of Health is not confined to medical crises. It encompasses the mental and physical wellbeing of the humanity, which needs a sustained and integrated approach. Therefore, there has to be synergy between various initiatives like Yoga Day, International Solar Alliance, disaster management drills, climate resilient development projects, digital health, and cooperation in traditional medicines. Moreover, India’s relations with other countries should be enhanced in its strong areas like healthcare, education, skill development and technology. A first step has been taken in this direction, however, there is still a long way to go.
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