In the making of this article, a planned interview with an activist on the ground in India has been cancelled due to the interviewee falling ill and trying to safely find a COVID-19 test. Then within the space of 24 hours, a family friend in India passed away from the virus. Judging from Twitter alone, I’m not the only one sending a flow of condolences and feeling a constant sense of despair as we all watch the pandemic ravage through India.

For the last three weeks, the average number of new COVID-19 cases found in India is approximately 400,000 with nearly 4,000 deaths on average every day. Thousands have used social media as a way to get the message out on what’s really happening in the subcontinent: hospitals are running out of oxygen supplies and turning away those who are dying at the foot of the door from the deadly virus. A scramble to find oxygen tanks on the black market and families losing lives because they can’t afford medical care or don’t have access to vaccination.

What’s happening in India with regards to the pandemic is an amalgamation of what needs to be changed in the world today—an accumulation of racial, global and medical privilege that’s failing and murdering millions while keeping a select few happy, healthy and wealthy.

India is home to 1.3 billion people and also the world’s biggest vaccine manufacturer, the Serum Institute of India. However, to answer why India itself doesn’t have enough vaccines is a messy answer. Although India has halted large exports of the Oxford-AstraZeneca vaccine since March 2021, there have also been other factors to consider, such as government negligence and mixed messages from the Indian central and local governments. In addition to inequalities of the global pharmaceutical market that prioritised the West and therefore distinguished the medical assistance given to the East and West alongside pharmaceutical and corporate profiteering and unclear contracts between suppliers and producers.

On top of this, Prime Minister Narendra Modi has faced backlash for his recent election rallies that took place while COVID-19 spread through the country. He exclaimed “I have never seen such a huge crowd before! Wherever I can see, I can only see people. I can see nothing else,” to his supporters in West Bengal state on 17 April, before key local elections.

He also refused to cancel a significant Hindu festival attended by millions of devotees, who collectively took a dip in the Ganges river, in the northern city of Haridwar. A short 24 hours later, 200,000 new cases were registered, with the Vice President of the Indian Medical Association, Doctor Navjot Dahiya calling Modi a “super-spreader.” The Prime Minister had also refused to cancel cricket matches attended by thousands during the rise of coronavirus in India.

During a global pandemic that has stripped many jobs, incomes, safety, housing and most importantly, millions of innocent lives, pharmaceutical companies producing COVID-19 vaccines are gaining billions of dollars in profit. There’s even further profit being made from the sales of ‘booster shots’, something scientists are yet to confirm if necessary.

In October 2020, before this second wave hit India, countries such as India and South Africa formally proposed the World Trade Organization and Council for Trade-Related Aspects of Intellectual Property (TRIPS Council) COVID-19 vaccines patents to be temporarily waived for countries where there are mass populations. As TIME magazine reported, on 5 March 2021, as COVID-19 cases in India were surging, CEOs from major pharmaceutical companies that are invested in the COVID-19 vaccine production sent an open letter to US President Joe Biden instructing him to oppose and reject this “unfortunate proposal.”

After initially maintaining ownership over the coronavirus vaccine’s intellectual property rights, the Biden Administration reversed its stance and is now giving poorer countries access to vaccine patents.

To date, 45 per cent of Americans have received one dose of the vaccination with 23 per cent fully vaccinated in comparison to the 2 per cent in India with only 9.4 per cent of Indians. That’s only 2 million out of 1.3 billion people receiving their first dose of the vaccine in the country.

A combination of big pharma power and control, an already failing healthcare system for the majority in India and the countries where vaccinations have actually been rolled out has meant vaccine apartheid. In other terms, this simply means the countries that can afford to be vaccinated will be better off than the many poorer countries where vaccines are too expensive to import—causing prices to rise among the middle and upper class within these countries for these vaccinations, with a lack of supplies altogether.

Duke University’s Global Health Innovation Center has found that the world’s poorest 92 countries will not be able to reach a vaccination rate of 60 per cent of their populations until 2023 or later.

For example, in The Washington Post infographic reflecting vaccine inequalities, Bangladesh has a population of 163 million people but the vaccination has only been administered to 5,538 people per 100,000 whereas Israel has a population of 9 million people and 116,000 doses per 100,000 have been administered.

Not that long ago, millions in poor black and brown countries were dying of AIDS while vaccine-waiver fights were taking place during the early noughties. Historically, Pfizer made $41.9 billion in 2000, the year where HIV activists and doctors were astonished by the company’s patented anti-fungal, fluconazole (which could be made for pennies), that was priced in a way that remained unaffordable for countries in sub-Saharan Africa.

21 years later, pharmaceutical companies in countries like India, Bangladesh, South Africa and Senegal are stating to countries like the US and the UK that they have the capacity to produce vaccines quickly and within a few months, saving millions of lives if Western manufacturers license or share their technology.

The Global North privilege, with allyship between Western countries and preferential treatment for the vaccine has shown us once again that it’s more acceptable for black and brown poor lives to be lost than for white lives to be affected. Even Biden’s hesitation to waiver patents temporarily has meant lives have been lost in the meantime, and it has to be asked, what do those lives look like?

When asking Indian millennials and gen Zers what their experience of living in India is like right now, as they try to remain safe and help their families and local communities, 25-year-old Delhi-based Aastha Tyagi, founder of Adopted Dogs of India, says “If anything, it feels like the rest of the world is speaking up while our own government and media are fast asleep. The world has been rather vocal in its criticism of Modi and helping with fundraising. India needs our government to wake up. They have left us on our own to die.”

24-year-old student Rahi Suryawanshi, who is based in Kalyan Maharashtra shares, “The COVID crisis has physically and economically devastated marginalised communities. Children from marginalised families are ergo at a very high risk of trafficking, child labour, child marriage and exploitation.”

“All of us are scrambling to find critical resources for each other; our tools being social media platforms. We’re receiving SOS messages from friends and their friends; and many of us have group chats filled with urgent help requests and leads to any available oxygen cylinders and hospital beds,” Suryawanshi added.

Among the distress, lack of resources and mixed messaging, there are also internal issues at play. “I feel the central government lacks clarity and a clear strategy when it comes to fighting COVID-19. There is chaos and confusion around. It feels like people are confused due to lack of clear messaging from the government,” shares Suneeta Karan based in Delhi, whose name has been changed for anonymity and protection.

“Hiding numbers is just making things worse. On top of it, the polarisation in the society is really pushing things on the edge though I don’t know how it is affecting our response towards fighting coronavirus on the ground.” Karan points out that most of the coverage has been limited to cities, what’s happening in the villages remains unknown while politically “it feels like Modi’s image has not taken a big hit yet. There might be discontent but his image remains safe.”

Doctor Mrinalini Josephine, a consultant psychiatrist who works in a hospital in Chennai, India shares from her personal experience, “What we need is people to understand the severity and magnitude of the problems we are facing due to the coronavirus crisis. We need more hands-on deck from the doctor’s perspective as we are swamped with duties and doctors are getting tired and turning positive as well. There have even been attacks on doctors! But the most important thing people are failing to understand is that people are dying due to lack of oxygen and resources.”

“The number of cases in India are skyrocketing. There are different strains that seem more deadly than the last. Everyday is scary as hell. And many are suffering due to a shortage of oxygen. Attenders keep asking us about the patient’s status every minute. The infection rates are rising. The number of deaths is rising. The stress is rising in the health workers. Everyone is scared,” Doctor Josephine further told Screen Shot.

“If we were to ask for something from the rest of the world, it would be oxygen, medical support and vaccines. Our people are dying because they cannot access oxygen,” says Suryawansh. “Also, donations! There are a number of NGOs accumulating cylinders, working with healthcare on the ground and in need of donations. If you have ever worn harem pants and spoken proudly of India’s ‘Om Shanti’, yoga-loving culture, now’s your chance to bring us some real Shanti.”

Though donating to fundraisers to help those in need of coronavirus-related equipment such as oxygen cylinders, PPE and pulse oximeters is crucial, it’s just as important for governments—both in India and especially across the West—to prioritise people’s lives over profit. Whether that’s through utilising the force small countries do have with creating vaccinations, removing patents across vaccinations and reducing sky-rocketed prices that leave poorer countries unable to pay for help. Failing to help India and other middle and low-income countries while we recover in the West is a tragic global loss for all.

CARE India is providing PPE kits to frontline workers as well as oxygen cylinders and medicines to COVID-19 care facilities. It is also working to establish temporary COVID hospitals and care centres.

Action Aid is using funds to distribute sanitation kits, set up help desks to provide information and connect people with healthcare services, arrange direct cash transfers to people in need, establish testing and vaccination camps and reach out to vulnerable groups, including migrants, to ensure they are not being overlooked.

Unicef is working to provide desperately needed supplies to India’s frontline healthcare workers, including PPE kits and personal care products. It also supports the government to help children continue learning from home by setting up mobile learning centres for children that don’t have access to digital equipment.

In response to the current crisis, Feeding India has collaborated with the logistics company Delhivery to launch the India Needs Oxygen campaign, sourcing and distributing oxygen concentrators and related supplies to hospitals in India.

People For Change is providing daily food ration kits to the trans community and sex workers in Jamshedpur, Jharkhand, many of whom are at heightened risk of COVID complications due to high HIV rates. Donate to their fundraiser on the crowdfunding platform Milaap.

Activists in India have also compiled a Google Doc of crowdfunding initiatives for families and minority communities in need.

Among the 1.3 billion Indians, some have had the chance to follow his provision in the comfort of their home while others are struggling and risking their lives just to get some food for their family. How exactly has COVID-19, and the unavoidable lockdown it brought with it, exposed more than ever India’s deep social inequalities? 

People from India have always seen the country’s social inequalities, but the coronavirus outbreak has amplified the situation. Indian correspondent for The Guardian, Amrit Dhillon, recently wrote a brutally honest article titled As the wealthy quaff wine in comfort, India’s poor are thrown to the wolves, in which she summarised her experience of India’s lockdown to: “If, like me, you have a live-in maid who happens to have picked up some beautician skills, you are ‘condemned’ to confinement in a spa. Shall I have a facial today? Or a pedicure? No, let’s settle for a massage. It will relieve my lockdown tension.” For rich and middle-class people in India, being under lockdown is a very similar experience to a holiday—Dhillon describes it as “an enforced period of recreation or a chance for self-improvement.”

In the same breath, the newly imposed shutdown means one thing for India’s poorest population: things are about to get way worse. Street vendors are barred from selling their products outside, workers who usually get paid by the day will end up with no money at all and, meanwhile, the Indian government is struggling to offer people any kind of potential help. Poor communities are left with nothing; no work, no money, and no food.

Although the lockdown is also affecting working-class families in the UK, Italy, Spain and the rest of Europe, Dhillon highlights that for most of us in “[more egalitarian] societies, the lockdown experience is not marked by the same sharp disparities as in India.” Most EU citizens have access to smartphones or the necessary technology to connect with our friends and families and check up on them while feeling support and affection.

In India, millions of migrant workers are separated from the rest of their families who stayed in their hometown. Labourers have no choice but to stay in ‘rented accommodation’, which Dhillon describes as “dingy cells usually shared with six or seven other labourers.”

The lockdown is also catastrophic for the Muslim citizens that lost their homes during the anti-Muslim riots that started at the end of February in Delhi. At the time, many houses were burned down by Hindu mobs who killed 53 Muslims and injured thousands. Families ran away, some of them ended up living in the Eidgah relief camp in tents set up in the courtyard of a mosque.

But Eidgah was only temporary and on Monday the Delhi authorities forced the families to leave the crowded camp in order to contain the coronavirus outbreak. Muslims have been given the minimum rent for a small room (which equals to £33) and nothing more. While some citizens went to live with family members in other cities, others were left homeless.

As China, a country next to India, slowly gets back to business, the situation in India becomes alarming. Although it is obviously necessary for the Indian government to focus its attention on fighting the coronavirus pandemic, what does that mean for poor communities who were already struggling before this? As many questions are left unanswered for now, one thing is clear to me: we should feel grateful that we have a roof over our heads and cupboards filled with food instead of losing it over Houseparty lagging during peak hours. In the end, it’s all about perspective.