The injustice of India’s surging COVID-19 deaths

July 4, 2021

From the July-August 2021 issue of News & Letters

by Yanis Iqba

Aligarh, IndiaIndia is in the throes of the second wave of the COVID-19 pandemic. There are horrific scenes of people dying due to the lack of medical oxygen, hospital beds and so on. There is neither enough space for the dead in the crematoriums and graveyards, nor enough wood for the pyres. The bodies of more than 100 people have been dumped into the river Ganges.

Since late April, India has consistently recorded more than 300,000 COVID-19 cases daily, with an average death toll of 2,000-3,000. Medical experts say that the actual deaths and infections could be ten times the official numbers.

A COVID-19 antigen testing centre in Warora Maharashtra, India.

While the corpses of poor citizens kept piling up, the wealthiest were able to fly in private jets to Europe and other places to secure themselves. They were the same people who in 2020 lobbied the government to ease curfews and restrictions.

Manufacturing, construction, shopping malls and many other sectors were permitted to resume without serious measures to ensure workers’ safety. The wealth of India’s bourgeoisie has increased astronomically since the pandemic, while working people struggle with inadequate medical facilities.


The first reason behind the Indian health crisis is a chaotic vaccination campaign. As of mid-May, only 141.6 million people have received at least one vaccine dose, which is about 10% of India’s population of 1.35 billion. The country has fully vaccinated just over 40 million people, or 2.9% of its population.

One factor behind the slowdown is the government’s decision to plan the vaccine rollout over the internet, asking residents to create an account on the government’s “CoWin” website, and then register for an appointment. But half the population doesn’t have internet access. Apart from this, the structural dynamics behind the vaccination failure are located in the initiation of market liberalization.

In April 2021, the central government deregulated vaccine prices, directing manufacturers to supply 50% of vaccines to the central government at the set price of Rs 150 ($2) per dose, and to distribute the remainder to states and private hospitals at whatever cost they wish. Accordingly, the two Indian vaccine producers—Serum Institute of India (SII) and Bharat Biotech International (BBI)—raised the prices of vaccines by two to six times in just a week. The center transferred the job of vaccination to the states, without providing any funding—in fact making them pay higher prices. It has set up a pricing system whereby state governments, already short of finances, have to pay up to four times what the central government pays for the same vaccines.

Meanwhile, private vaccination centers—where two-thirds of Indians receive their healthcare—are buying at an even higher level and charging exorbitant prices. The vaccine prices are now so unaffordable that informal workers are forced to spend about half of the household’s monthly salary on vaccinating all its adult members. No wonder Adar Poonawalla, CEO of SII, increased his personal wealth by 85% during the pandemic.

The central government has allowed BBI to be a monopoly producer of this vaccine and has even supplied public money (Rs 1,500 crore or $205 million) to this private company to expand capacity so that it can strengthen its monopoly position. It has similarly given Rs 3,000 crore ($410 million) to SII to expand capacity, while keeping its monopoly position as the producer of Covishield intact.


The Indian government spends only 1.3% of its Gross Domestic Product on the healthcare system, while it has the world’s third largest military budget—$73 billion per year. In late 2020, the Indian government stated that it had eight medical doctors, 17 nurses and 5.3 beds for every 10,000 Indians. It had just 2.3 critical care beds for 100,000 people, and a mere 48,000 ventilators. Indians pay exorbitant amounts of their income in out-of-pocket healthcare expenses because of this destruction of public healthcare, the growth of for-profit hospitals and the underdevelopment of medical insurance schemes.

In a 1966 speech to the Medical Committee for Human Rights, Martin Luther King Jr. declared: “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” This is most visible in India today, where innumerable people are dying due to a system torn apart by murderous, profit-making impulses. It is high time that we recognize the deleterious impact of neoliberal rationality on the health sector of India. If not, the country will keep reeling under the impact of the pandemic.

May 29, 2021

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