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On January 21, 2021 India began its Vaccine Maitri campaign—a diplomatic initiative inspired by the ancient Indian philosophical doctrine of ‘Vasudhaiva Kutumbakam’ (the world is one family). Under the rubric of India’s Neighbourhood First Policy, the campaign provided the Oxford-AstraZeneca/Serum Institute of India (SII) manufactured Covishield vaccine to India’s immediate neighborhood and Bhutan and the Maldives.

The Vaccine Maitri initiative began strongly as India provided a substantial number of Covishield doses to neighboring countries like Bangladesh, Bhutan, Nepal, and Sri Lanka (excluding Pakistan and China). This increased India’s soft power within South Asia by reaffirming its role as the “Pharmacy of the World.” The temporary suspension of the Vaccine Maitri initiative at the onset of India’s second wave of the pandemic has both left India’s neighbors stranded and given China the opportunity to increase its influence in South Asia in the short term. India must first work to build credibility domestically before it can fulfill its commitments to the region and counter burgeoning Chinese influence in its neighborhood.

By April 2021, much of South Asia experienced deadly waves of the pandemic, stemming from a combination of factors: geographical proximity to India, weak health infrastructures, and a delay in the delivery of Covishield vaccines.

Tide Turns Against India 

By the end of April 2021, when India recorded 18,767,962 cases, with deaths under-reported all across the country, the Indian government suspended the Vaccine Maitri initiative to address the health emergency at home. India had by then exported 64.5 million doses of the Covishield vaccines to 85 plus countries. India’s neighbors also placed commercial orders with SII to purchase Covishield vaccines; however, these orders were postponed to meet the growing vaccine demand within India.

By April 2021, much of South Asia experienced deadly waves of the pandemic, stemming from a combination of factors: geographical proximity to India, weak health infrastructures, and a delay in the delivery of Covishield vaccines. Nepal, with a long, porous border with India, saw an exponential rise in cases in April 2021 and reported over 8,000 cases in a single day, with, at one point, a 45 percent positivity rate. Bangladesh saw a staggering rise in cases, with 38 out of 64 national districts labeled “high-risk zones” in April 2021. The COVID-19 situation in Bangladesh remains worrying as high infection and death rates are reported throughout the country. Sri Lanka faces a similar predicament as it encountered a virulent wave of the pandemic with an average increase of 800+ cases per day. Sri Lanka too is grappling with high infection rates despite lockdowns in place across the country.

India’s inability to provide vaccines to its neighbors—at a time when these countries reported spikes in cases—has demonstrated India’s limits in leading South Asia and pushed South Asian governments to look for alternative vaccines suppliers to meet domestic demands. China has stepped in as India’s image as a preeminent power in South Asia has taken a hit. Nepal and Bangladesh have criticized New Delhi for the suspension of its vaccine diplomacy initiative at a time of critical need. For example, a leading Bangladeshi businessman asked India to prove its friendship towards Bangladesh by providing the COVID-19 vaccines that Bangladesh had paid for in advance. Political leadership in Bangladesh, Nepal, and Sri Lanka have faced challenges from opposition parties over their over-dependence on India for vaccines.

This change in perception does not augur well for India since the neighborhood has traditionally been central to its strategic interests. Although some have suggested that India’s inability to provide vaccines will not affect its ties with its South Asian neighbors in the long run, in all likelihood, India will have limited diplomatic bandwidth to pursue major foreign policy goals within South Asia in the near future. For example, India is unlikely to initiate ambitious naval modernization plans to enhance power projection within the region while China has taken the lead in that respect. Similarly, India may have to negotiate with China from a position of weakness amidst the ongoing border talks after the flareup in Galwan. Poor pandemic management has reduced India’s ability to maneuver on key foreign policy issues.

China in South Asia

The suspension of the Vaccine Maitri initiative has hindered vaccination programs across much of South Asia and provided China with an opportunity to enhance its footprint in the region. China has deepened its engagement with India’s neighbor, Pakistan, by providing it with 1.2 million doses of the Chinese Sinopharm vaccine, making Pakistan the first major recipient of overseas Chinese vaccine aid. Subsequently, China’s timely provision of vaccines to India’s neighbors has demonstrated China’s ability to respond quickly to crises.

China has also supplied vaccines to Bangladesh, Sri Lanka, and Nepal, first as grants and then commercially; onlookers cannot ignore the strategic subtext of this development. China wants India to acclimatize itself to the idea that China is a leading power within South Asia and the world. As part of this, China wants to befriend India’s traditional allies in South Asia on the basis of the “Five Principles of Peaceful Coexistence” in order to eventually persuade/coerce India to accept the idea that New Delhi and Beijing can harmoniously coexist in South Asia. This clichéd notion of “harmonious co-existence” is directly linked to the Chinese principle of Tianxia (All Under Heaven) that has influenced Chinese foreign policy towards South Asia. In order to bolster its influence in South Asia, China has both increased its economic engagement with India’s neighbors in recent years and oriented its vaccine diplomacy towards providing a counterweight to Indian influence in South Asia.

India’s recent absence from a virtual meeting China hosted to discuss South Asia’s pandemic response exhibits how India opposes a growing Chinese presence in South Asia. India has countered the pandemic in South Asia by conducting virtual summits under the umbrella of the South Asian Association for Regional Cooperation (SAARC) in March 2020. China’s plans to create a “Health Silk Route” passing through South Asia are inimical to Indian interests since South Asia has traditionally been India’s backyard. India sees China’s “Health Silk Route” project as an extension of the Belt & Road Initiative (BRI), which has led some to fear that China seeks the encirclement of India. New Delhi also fears China can use the “Health Silk Route” to increase its clout in South Asia through soft power.

As India’s neighbors have addressed their vaccine supply demands by finding alternative sources, India should vaccinate its domestic population and ultimately aim to provide the remaining vaccines to its neighbors and the COVAX facility.

India’s Options

As India’s neighbors have addressed their vaccine supply demands by finding alternative sources, India should vaccinate its domestic population and ultimately aim to provide the remaining vaccines to its neighbors and the COVAX facility. This would help it restore its image as a responsible health provider within South Asia. Since Indian vaccines like Covishield and Covaxin are more effective against COVID-19 than the Chinese Sinopharm and SinoVac vaccines, India should revamp its vaccine supplies. Demand for the Indian vaccine remains high within much of South Asia.

India can start to revamp its vaccination program by requesting that its Quad allies provide it funds with which to meet its domestic shortage and vaccinate its population faster. Since the United States is likely to distribute seven million vaccines to Asian countries including India, New Delhi can use these vaccines to inoculate its own citizens. South Asian states such as Bangladesh, Nepal, and Sri Lanka can adopt a nuanced approach and manage their diplomatic relations with India and China by remaining neutral, following independent foreign policies that emphasize development.

As India diversifies its vaccination options and uses other vaccines like the indigenous Covaxin and the Russian Sputnik V vaccine, it will be able to vaccinate its local population and export the surplus vaccines within its neighborhood. The resumption of the Vaccine Maitri Initiative will not only enable India to fulfill its existing vaccination commitments within South Asia but also allow it to counter China in the region and play a role in ending the global pandemic.

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Image 1: David Talukdar via Getty Images

Image 2: Kilito Chan via Getty Images

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