Global vaccination geopolitics is an analogy of the emerging new tripolar world order.


THE “BY THREE” WORLD: An old practice unique to Bengaluru city is two or three people sharing a cup of coffee, bowl of soup or a serving of food in a restaurant by ordering “one by two” or “one by three” coffee etc. The server then provides extra empty cups or plates so that the drink or food can be split into two or three portions. “By three” can now be a metaphor for global vaccination geopolitics, for globalization and for the emerging tripolar world order.
THE VACCINE WORLD ORDER: This pandemic has split the world into three groups. The western axis “Capitalist haves” with patented expensive vaccines, with unacceptable terms and conditions such as indemnifying against any adverse reactions, sovereign guarantees and providing national assets abroad as security for payments. The US Pfizer vaccine exemplifies this. They rather hoard and let vaccine stocks expire rather than supply the needy. Their sense of entitlement and double standards have always been obvious. The eastern axis “Socialist autocrats” have vaccines that are either ineffective like the Chinese vaccines, or are difficult to mass produce like the second dose of the Sputnik V vaccine. Their efficacy and safety profile data are unavailable. Hence, the rest of the world does not want these vaccines, though they are easily available at a lower price. The rest of the world or the southern axis is led by a tolerant, inclusive India, which is the world’s biggest manufacturer of vaccines and generic drugs, and the largest and most generous supplier to the World Health Organisation and the rest of the world. Its popularity is due to high quality, proven safety, low price, unrestricted, adequate supplies of vaccines and drugs, often free to very poor populations worldwide. Covaxin, an Indian vaccine, offered compensation for any adverse reaction, so sure it was about its safety in sharp contrast to Pfizer’s demand for sovereign indemnification.
UNIVERSAL VACCINATION: Universal vaccination and health are achievable with modern science, facilities and financing. While the western axis is pushing for western capitalist democracy to replace autocrats in the eastern axis by regime change, through popular revolt triggered by information and financial war, they have achieved universal suffering instead of universal suffrage. Meanwhile, India is remaining neutral and focusing on vaccinating the rest of the world and providing disaster relief including food and medicines. Currently ten Covid 19 vaccines are approved for use in India, the inactivated virus Covaxin, five non replicating viral vector vaccines dominated by Covishield, two protein subunit vaccines, one RNA vaccine, and the world’s first DNA vaccine. 14 other vaccines are in clinical trials in India including a potential game changer nasal vaccine.
GLOBALISATION OF HEALTH PROBLEMS: Universal spread of contagions through rapid mass transport of travellers, migrants and refugees is the globalisation we have achieved. The obesity pandemic associated with diabetes, hypertension, cardiovascular disease due to junk convenience foods promoted by the multinational food industry has spread with the unhealthy western lifestyle to the rest of the world. Global adverse effects of pollution and climate change are other types of undesirable globalization affecting our health.
GLOBAL SUPPLIES AND WEST-EAST-SOUTH AXIS: The globalisation of world economy and supply chains has now got disrupted into three parts, the west-east-south axis. Resource rich nations like Russia and other major exporters decide the price and availability of energy, food, rare resources and other essentials. China dominates manufacturing and global supply chains. The western axis dominates the global commercial and financial institutions and mechanisms. Western technology companies monopolise data, media, communication and technology. This fractured globalisation leaves India and many nations of the south axis to survive on their own means. Instead of global benefits we now have global health, wealth, food, and resource inequity
A BENIGN SUPERPOWER AS EMERGENT THIRD POLE: A single wheel unicycle is unstable, a bicycle is not so stable but a three-wheeled tricycle provides stability with manoeuvrability. The post-cold war unipolar world has split into a tripolar world. In most democracies there is a right, a left and a moderate centre. In this tripolar world of geopolitics, India is the moderate balancing and stabilizing centre. India is the world’s largest functional democracy with 18% or nearly a fifth (1.4 of 7.9 billion) of the world population; has the fifth largest economy; is second worldwide in farm outputs; and is the world’s biggest source of medicines, vaccines, and health workers. India is also a leading provider of inexpensive outer space and software facilities. It has the second largest active-duty military personnel in the world who contribute to the UN peacekeeping force, global disaster evacuation and relief. India has a No First Use (NFU) nuclear policy and is not an expansionist aggressor against neighbours nor does it have an expeditionary military.
INDIA PROVIDING GLOBAL LEADERSHIP: The disruption of the world order and economy, and the devastation caused by pollution, climate change, bio- and conventional wars needs Indian international participation for common good. India with its unity in diversity, democracy and election mechanism is an international role model. India has promoted health through Yoga and renewable energy through International Solar Alliance. India has to help its young workforce to master strategic cutting edge technologies, provide biometrics (e.g. “Aadhar”) based services, financial (e.g. Unified Payments Interface, UPI), technological and logistics interoperability and set up resilient global supply chains for the ageing West and East axis and help the rest of the South axis. Indian global leadership is needed to establish a fair rule-based global order including in trade and use of common spaces like international waters, Arctic and Antarctica and outer space. The world needs India more than ever as a stabilizing third pole to achieve universal health, peace and prosperity.
Dr P.S. Venkatesh Rao is a Consultant Endocrine, Breast & Laparoscopic Surgeon in Bengaluru.