From whichever angle one approaches the Covid crisis in India, it is clear that the Bharatiya Janata Party (BJP) led government is responsible for a catastrophic situation.1 In early February, the Health Ministry boasted that Covid had been defeated in the country. By the middle of April, the official cumulative tally for Covid positive cases was at 13.4 million, and the death toll was at a staggering 174,308. Both figures are now substantially worse.
On April 16, Adar Poonawalla, owner of the Serum Institute of India (SII), appealed to the Biden administration to lift the embargo on vaccine-related raw materials so as to fast-track vaccine production. In the gap between medicine and death, the CEO of arguably the largest vaccine manufacturer in the world stepped in as the savior, appealing for vaccine security for developing countries.
As the largest vaccine manufacturer (by doses produced and sold) in the world, SII was invited early on (April 2020) as a scale-up partner to the consortium led by the venture capital-backed spin-out company Vaccitech Ltd., which developed the Oxford-AstraZeneca vaccine. Over the next few months, even as the consortium expanded and AstraZeneca won exclusive license rights to produce the vaccine, a great extent of its commitment to “make [the vaccine] available and accessible for low- and medium-income countries” relied on its sub-licensee SII.
Mr. Poonawalla’s demand placed him at the heart of several heroic imaginations. In the nationalist chronicling, here was the darling of the Indian nouveau elite, a person often called the “vaccine prince” of India, fighting valiantly to ensure that not only his nation, but all the poor of the developing world, had access to a life-giving vaccine. In the cosmology of the global commentariat, his tweet once again emphasized the importance of raw materials, intellectual property rights, technological knowhow, and international standards as barriers to be overcome if nations are to achieve vaccine security and biological immunity for their people. And in the subconscious of some sections of what might be broadly construed as the Left, he reignited the old dualities of the core and the periphery – the Cold War opposition between Global South and Global North – the imperialism of the West with Big Pharma on the one side, and the Third World on the other.
The TRIPs waiver and easing of global trade regulations has now become the rallying cry for citizens’ groups, NGOs, and social movements across the world. In their call for action, prominent economists like Joseph Stiglitz, Jayati Ghosh, Rohinton Medhora, and others have argued for greater funding and political support for COVAX and a short-term TRIPs waiver, along with debt restructuring, as central planks to minimize the disparities between the Global South and North. It is worrisome that the thrust of this politics in the name of vaccine imperialism continues to remain within the Cold War paradigm of the Global South versus the Global North.
Adar Poonawalla is the world’s 165th richest man, a person who, on the side, oversees a multimillion-dollar horse racing enterprise. The SII is nominally in the “Global South”; its CEO is among the class of global elite who have stellar resources, private jets, batmobiles, and residences in London, placing them in a world of luxury that is decoupled from the death and devastation unfolding around them. In an insidious inversion, the perpetrators of a vaccine famine have presented themselves as the strident defenders of vaccine sovereignty. Disaster capitalism is intimately linked to the organizational growth of fascism in the Indian context, starting at least since the late 1990s. The media may very well accord him the mantle of being the humanitarian who will give the Global South a fighting chance to defeat the virus. Remaining delimited by the framework of the Global North-South duality, however, obscures the two main battlegrounds on which anti-capitalist politics ought to be fought: the international economic governance structures around commodity flows in which the Indian state and capitalists like Adar Poonawalla are players; and the nexus between fascism and pandemic capitalism. How can social movements take on the Poonawallas, who, as we shall see, represents the brutal mercenary calculus of pandemic capitalism?
SII and India’s Vaccine Manufacturing Landscape
A full understanding of the complex international capitalist structures within which the SII fits first necessitates understanding its location within India’s vaccine manufacturing landscape, which we explore in this section.
After its consolidation as a nation-state, India’s successful Smallpox Eradication Program in the 1960s created a national health infrastructure with trained vaccinators, storage facilities, and a network for health monitoring that took it down the path to vaccine self-sufficiency. Between 1962 and 1971, nearly 19 public sector and 12 private sector vaccine manufacturing units were established. Initially strong in the urban areas, under the aegis of the Polio Vaccination Program (1985-1991), this infrastructure deepened its coverage across both the rural and urban sectors. Almost all Indian vaccine manufacturers today, like the Haffkine Institute (1895), Biological E Ltd. (1953) and Serum Institute of India Ltd. (1966) – but, notably, not Bharat Biotech (1996) – emerged during the early phases of the industry, though their fortunes now look very different.
With the onset of liberalization in the 1990s, the responsibility to develop and manufacture vaccines was gradually relinquished as the state created a conducive environment for domestic pharmaceutical companies like Ranbaxy and Cipla through Patents Acts, foreign investment regulations, and amended industrial policies. India emerged as a leading generic drug maker and vaccine supplier during this period and by the middle of the decade pharmaceutical firms had started consolidating through mergers and acquisitions.
In 1994, armed with a WHO accreditation, SII began to export its vaccines, thus placing it within global distributive networks via contracts with U.N. agencies. By 1998 SII was exporting vaccines to over 100 countries and in 2012, Cyrus Poonawalla acquired the Netherland-based vaccine maker Bilthoven Biologicals and the Czech arm of US-based Nanotherapeutics that opened up European markets for his company. Exports now contribute about 85% of the company revenues. Several factors thus came together to create the conditions that facilitated the near capture of the market by the SII: the mergers, acquisitions, and decline of public funding in the post-liberalization era that made the vaccine market more conducive to oligopolistic control; and the vast volumes of speculative capital from horse racing made it possible for the Poonawalla family to invest money in this market.
Growing out of a stud farm run by family patriarch and horse breeder-turned billionaire Cyrus Poonawalla in Pune, the Serum Institute thus had an unlikely origin for what would ultimately become a vaccine behemoth. The Poonawallas had been an old name in the horse racing circuits of India. Instead of retiring his racehorses to a quiet pasture, Cyrus Poonawalla put them to work to cultivate anti-tetanus serum under the aegis of SII, which he established in 1966. Agricultural land was bought and repurposed for the stud farm and vaccine factory, and scientists were poached from the Haffkine Institute, which was the first vaccine manufacturer in the subcontinent during the colonial period and later became a public sector undertaking. Lobbying for state protection for domestic capital and circumventing agrarian laws with the help of local authorities, the SII gradually scaled up business to produce multiple vaccines. The speculative business of horse breeding thus morphed over time into the extractive business of vaccine manufacturing.