“We must learn to live together as brothers or perish together as fools.“
—Martin Luther King, Jr.
India is a big subject in global sustainability. This fact existed long before the COVID-19 pandemic. However, the dual crises—the pandemic and climate change—have put not only the Indian people but every global citizen together in the karma of health. This essay correlates with my previous two pieces titled “TITANIC Or CINATIT” and “The M-shaped Society.” What goes around comes around; this is a simple explanation of karma. The ship of covid TITANIC has reached its final destination, India.
India holds the key to determining the global success of the seventeen United Nations Sustainable Development Goals. Prior to the pandemic, India faced pressing problems such as environmental degradation, extensive poverty and gender inequality. In his book, Beyond Religion, the Dalai Lama cautioned:
“As the glaciers recede, all the effects of deforestation, which is already taking its toll in greater levels of flooding. In the long run, deglaciation in Tibet could contribute to drastic climate change and severe water shortages and desertification in China, India, Pakistan, and Southeast Asia. This would be catastrophic for the whole world.”
India is at the foot of the Himalayas. The country will be the first affected by the adverse effects of human-induced climate change. Early this February at least 31 people died and 165 people were missing following a Himalayan glacier disaster. Satellite images show a landslide and avalanche were the more likely causes of the disaster. India suffers water shortages but it is also the world’s biggest virtual exporter of water. These problems are worsening due to the pandemic. The discrepancy between the haves and have-nots in the country is widening in terms of accessing modern technology and vaccination. Tech-savvy Indians write code to secure vaccination whereas millions of others don’t even have access to smartphones or the internet, currently the only route to a jab.
The Reality of “Better to Give than to Receive”
It is ironic that India boasts to be “the pharmacy of the world” but the people of India suffer from covid vaccine shortages. India halted vaccine exports due to domestic covid crisis. The ongoing restrictions on vaccine exports have already created supply problems for the WHO-backed COVAX program, a global initiative to ensure fair and equitable access to covid vaccines. Before India’s covid crisis became out of hand, Serum Institute of India (SII), which is the world’s largest vaccine manufacturer, supplied developing countries with COVID-19 vaccine doses via COVAX.
Indian drugs are indeed competitively cheaper than those in China. I remember a few years ago I watched a Chinese blockbuster called “Dying to Survive (我不是藥神)” in which a Chinese leukemia patient smuggled cheap and unproven cancer medicine from India for Chinese cancer survivors. Like the U.S., Chinese drugs see a hike in prices in recent years although they’re not as exorbitant as on the American pharmaceutical market. The karma of Indian pharma begins from unaffordable medical care for the most-needy people.
One major reason that India is a strong competitor of China in pharmaceutical manufacturing is that Indian drug makers can produce essential medicines at cheaper prices. They pay lower wages. Preventing salary abuse is a human right. Salary abuse explains why most people in India were in the global low-income tier in 2020. According to Pew Research Center, in the last year prior to the pandemic, some 1.2 billion people in India account for 30% of the world’s low-income population. During the pandemic, the number of the Indian population that has fallen into poverty has increased.
Globally, in particular in the States, if C-suite professionals dislike seeing a zero or two missing in their total compensation, why should manual workers at the low rungs in the labor market accept gross wages that fail to honor their hard labor? Aristotle believed that no one in ancient Greece should have more than five times the wealth of the poorest person. His idea is 2,400 years old. But it might be today’s solution to narrow the income gap if we put up a wage ceiling to bookend the minimum wage laws. Narrowing the income gap will maintain a well-functioning democracy with a majority middle class, making a W-shaped society as I put it.
My theory is if the U.S. and India can narrow the income gap, a democratic and equitable international order will become the norm. The 21st century is the Asian Century. India’s success is humanity’s success to achieve sustainable development. Democracy is not to impose but to invite. Technology is to strengthen transparency but not to indulge greed. Socrates had famously said, “The unexamined life is not worth living.” Only when we do well can we influence others to do well. Narrowing the income gap is a good start to shape two basic principles of secular ethics—the recognition of our shared humanity and the understanding of interdependence. For further reading, Beyond Religion by the Dalai Lama is my inspiration.
Herd immunity vs Herd mentality
If we could turn back time and if vaccine manufacturing countries could have replaced their habitual finger pointing and politicizing with information transparency and cooperation, the size and scale of covid infections could have been diminished around the world.
But there’s no ifs in reality. We only have lessons learned. China had a head start to develop a new vaccine last year when Hubei province became a coronavirus hotbed. But its draconian measures to control the spread of the virus led to a lack of infected people to complete late-stage trials for COVID-19 vaccines. In the meantime, the U.S. ranked at the top with the world’s most infections. This circumstance enabled American vaccine manufacturers to conduct the Phase 3 clinical trials directly at the source. According to the United Nations Children’s Fund (UNICEF), the U.S. tops the world as home to 110 COVID-19 vaccine developers, followed by 41 in China and 22 in Canada.
Not every country has the manufacturing capacity for covid vaccines. And many developing countries don’t have the medical facilities or purchasing power for COVID-19 vaccines. But the best hope for the ship covid TITANIC not to sink is to achieve herd immunity among the global population of eight billion. Herd immunity is when a large part of the population—that is the herd—is immune to a virus. This can be achieved either because people got vaccinated or had already been infected. We definitely do not want a majority of passengers on the ship to get infected, so the majority of passengers getting vaccination is the way to achieve herd immunity.
Life does not make it easy for us, does it? A coalition of countries, led by India and South Africa, have petitioned the WHO to waive intellectual property rights so generic drug makers can begin producing the vaccines. But the drug makers from the U.S. and Europe oppose the idea, saying patents and the profits that flow from them are the lifeblood of innovation. I wonder if the incompetence of controlling covid infections in the U.S. last year was a well-thought-through strategic plan to ensure a large clinical trial population for the covid vaccines. If this is the unsaid and underreported intention of vaccine manufacturers, I’d strongly recommend they read Beyond Religion by the Dalai Lama to strengthen their professional ethics.
The Holiness wrote “The fundamental problem, I believe, is that at every level we are giving too much attention to the external, material aspects of life while neglecting moral ethics and inner value.”
So the karma for Indian people, especially those underprivileged souls, is to get infected for herd immunity. The danger of this option to achieve herd immunity is allowing coronavirus strain to mutate. As one of the three subtypes of coronavirus B.1.617 variant, the Delta Variant is a fast-spreading coronavirus originating from India. According to the WHO, as of June 6, the Delta Variant has spread to 62 countries, becoming the dominant strain in the U.K, Guangzhou China, and Taiwan. The virus can often be asymptomatic and spread much faster than other “Variants of Concerned” under WHO’s naming system—Beta variant (South Africa) and Gamma variant (Brazil). According to a study in Britain, the Delta Variant cases have roughly doubled every seven days, although admittedly from a low base. However, covid jabs are most effective against the most severe outcome such as death, and less effective against less severe ones, such as asymptomatic infection.
Last year we experienced panic buying ahead of covid lockdowns. This year when a U.S. pipeline was under cyberattack and suspended service, panic buying of gasoline was seen in some states in the east coast. Herd mentality is a key cause of panic buying. When we don’t see people wearing masks, we tend to follow suit and relax our own covid precautionary measures. This is herd mentality in which people tend to copy what other people are doing on a largely emotional, rather than rational, basis. Herd mentality is rampant especially when information is restricted and leadership is incompetent. On the leaky ship of covid TITANIC, I’ve seen passengers of different classes scuttling toward the direction they believe it’s safe but it’s not. The more people come together at one corner, the more likely the crowd will attract a bigger crowd. This is herd mentality. If you see someone get a jab and you follow suit, this is herd mentality. The more we are vaccinated, the sooner we will get herd immunity.
The nexus of Indian pharma and the environment
The negative impact of the production of pharmaceutical products on the natural environment is as dirty as e-waste recycling. I did an in-depth academic paper on e-waste recycling last year. Pharma pollution affects more directly and seriously those living near production plants. Their water and food sources are contaminated with waste pharma products. This is a global issue that the world must face. If big pharma doesn’t like to pay heavy fines to clean up contaminated rivers and soil, should it develop products with the theme “How not to take medicine to treat this problem?” Why not introduce paid health services such as online and in-person informational courses and activities about improving one’s attention and emotional support to reach the placebo sweet spot?
According to Pharmaceutical Technology, the U.S. Food and Drug Administration and European Medicines Agency have not included environmental standards in their good manufacturing practices guidelines. The karma of Indian pharma sounds like a Superfund site, a polluted location in the U.S. that requires a long-term cleanup, except that it is located in India. This sounds like a lifelong case study of how pharma can get away with murder. If their living environment is as polluted as a sewer, where specimens collected from the sampling sites were contaminated with antimicrobials, how can Indian people improve their well-being?
Indian people have contributed too much to the world and yet they received very little from the world. So are the natural resources of the country being overly exploited.
As the Delta Variant infectious cases rise exponentially in India, the country has been sluggish in distributing covid vaccines domestically. Covid-beleaguered India looks grim now and it needs lots of help from the international community. Since humanity is on the same boat, getting ourselves vaccinated is not enough. Why not save others’ lives to save ourselves too? The longer the first and second-class passengers are indifferent to the sufferings of the third-class passengers, the more likely new strains of coronavirus variants will be mutated and infect more people onboard, including some of the exclusive dignitaries in the first class.
We are living in the karma of Indian pharma. Drug pollution has polluted an increasing larger area that threatens human’s and non-human’s existence.
We don’t want to live in the covid karma 2.0, 3.0, 4.0 and so forth as a result of a more contagious virus.
Are you in this global fight to stop this covid nightmare that has haunted us for more than a year and half?
Shall we do what we can to save the ship by changing the course to a more sustainable future, that is the ship of CINATIT?