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Pakistan plans to launch its immunization program against Covid next week, beginning with health workers providing free doses of a vaccine manufactured in China.

Next door, in mid-January, arch-rival India started one of the world’s largest inoculation drives against the disease. The vaccine superpower has also started sending millions of free doses to friendly neighbors in the region in what is known as “vaccine diplomacy” – India produces about 60 percent of vaccines worldwide.

Pakistan is, unsurprisingly, not a recipient. Since gaining independence from Britain in 1947, the two nuclear-armed competitors have fought three wars, with the last conflict between them happening in 1971. In 2019, they entered the verge of war over the disputed territory of Kashmir.

Pakistan plans to inoculate free of charge at least 70 per cent of its 220 million individuals against Covid. Regulators have licensed three candidates for emergency use: the Oxford-AstraZeneca vaccine, the Sinopharm vaccine made in China, and the Sputnik V vaccine developed in Russia. Another CanSino Biologics vaccine made in China is in final clinical trials in Pakistan. More than 530,000 infections and 11,514 deaths have been confirmed by the government.

To begin with, China has pledged to donate 500,000 Sinopharm doses to Pakistan, and it is expected that the first batches will arrive on the weekend. “This is nothing. We will need a lot more vaccines,” I was told by Usman Ghani of Sindh Medical Stores, a leading vaccine importer based in Karachi.

To be sure, Pakistan will try to import doses from all over the world, including through the ambitious scheme of the World Health Organization or WHO, Covax, which works to produce, buy and distribute vaccines to more than 180 nations. But there are concerns that, at the expense of the poorer ones, wealthy countries might hoard jabs. That is where India could play a key role in ensuring that vaccines do not starve its neighbor.
Pharmaceutical trade between the two countries has been stable, despite the volatile relationships. Pakistan’s pharma imports from India were valued at over $62 m (£45 m) in 2018. Approximately 60-70% of the active ingredients used in drugs sold in Pakistan are

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More significantly, according to Mr Ghani, almost 90 percent of the vaccines administered in Pakistan come from India. Indian vaccines are, he adds, “world-class, affordable and shipping is easy” The bulk of these vaccines are provided through the state-funded immunization program in Pakistan, which annually targets 14 million newborns and pregnant women. Although mothers are inoculated against tetanus, children are given jabs against 10 diseases.

Mr Ghani claims that in the near future, Pakistan will obtain vaccines from India. Covishield (the local name for the Oxford-AstraZeneca vaccine produced in the UK) and Covaxin, locally manufactured by the pharmaceutical company Bharat Biotech, were given the green light by India’s drug regulator. “India already has got so many vaccine orders from all over the world. We have cordial relations with vaccine makers across the border. We will try our best to get supplies, but it will take time,” says Mr Ghani.

A spokesman for the Indian foreign ministry said that he was not “aware of any request for India-made vaccines” Many assume that when India starts to supply doses, it is a matter of time. “We will harm ourselves if we don’t cooperate on vaccines,” says Mr. Ghani.

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