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External Affairs Minister participates in a panel discussion at the Raisina Dialogue 2021- “The Health Central: India, SDGs, Vaccines & Global Expectations”

April 13, 2021

Mark Suzman: Hello, it is a great pleasure to be part of the Raisina Dialogue this year. I'm Mark Suzman, the chief executive officer of the Bill and Melinda Gates Foundation. And I'm welcoming to what should be a fascinating conversation, the Honourable Minister of External Affairs, S. Jaishankar and Professor K. VijayRaghavan, the Principal Scientific Adviser to the Government of India. At the Gates Foundation, we have had a long tradition of strong partnerships with the Government of India and with the private sector and civil society, both working in India and beyond, on health issues and also many others. But this year, the topic of the health central is the most appropriate topic we could possibly be discussing. Never before has global health taken such a central role in global affairs and I would argue never before has India had taken such a central global role, given its importance in terms of scientific research and development, vaccine manufacturing and other related activities dealing with COVID-19.

COVID-19 pandemic has impacted lives and livelihoods across the world in an unprecedented way. And there's also been an unprecedented response across researchers, healthcare workers, business leaders, grassroots organisations, and India has been at the forefront of this effort. So Minister Jaishankar, if I could start with you, I would like to congratulate India for administering more than a 100 million doses of COVID-19 vaccines. At the same time, one of the key themes of Prime Minister Modi's narrative of the global response to COVID-19 has been the ancient Sanskrit phrase "Vasudhaiva Kutumbakam”, which translates as the world is one family. Could you talk a little bit more about how this principle has guided India's response and actions globally?

Dr. S. Jaishankar: Thank you. Thank you, Mark and it's a pleasure to be with you and with Vijay, at this panel today. Look, "Vasudhaiva Kutumbakam” is an outlook. Literally, it means world is a family. Now, when I say it's an outlook, it means both that the world is important to us and also that we are important to the world. Now, in today's world, that translates into international cooperation. Now, I would argue, international cooperation is good. But I think being good is not just being good. I think being good is also being smart, that there are values you derive out of international cooperation, things which wouldn't be possible if you didn't have international cooperation. And if you look today, it isn't just a question of our saying "Vasudhaiva Kutumbakam”, we actually mean what we say, and we have a practical ways of demonstrating it.

This is a very practical, delivery oriented government. And you spoke about vaccines; we delivered vaccines to a lot of countries. But even before the pandemic, if you look in terms of humanitarian assistance, whether it was an earthquake in Nepal, or a civil war in Yemen, or a cyclone in Mozambique, or a typhoon in Fiji, or a mudslide in Sri Lanka, or whether it is taking the Paris agenda forward through initiatives like the International Solar Alliance, or how to respond collectively towards disaster resilience. So, there are very practical ways by which we have demonstrated our belief in the world as a family. And the vaccine is only the recent example. And for those who actually question international cooperation, I want people to also understand this, that our ability to make vaccines, as Vijay would confirm is itself a result of international cooperation. So international cooperation is not a one-way street where we are giving things to other people and somewhere short changing ourselves, I think people need to understand that.

Mark Suzman: Well, thank you for that. And certainly from the perspective of the Gates Foundation, our cooperation in India over the last 20 years has included a great deal of scientific partnership and collaboration including with what are now the large global vaccine manufacturers, where partnerships with us and with the GAVI vaccine Alliance, a part of what have helped transform India into a global leader it is today.

But Dr. VijayRaghavan, if I could just push you a little bit more on that, in the spirit of your role as co-chair of the taskforce on scientific innovation related to COVID-19, even with that background, I think it's been a pretty unprecedented effort in India and in terms of how you've accelerated and scaled out vaccine development and could you shed a little bit more light about your just how you've done that and what you think lies behind that.

Dr. K. VijayRaghavan: Thank you very much, Mark. It's a pleasure to be here with you and our External Affairs Minister. And, as we just heard, international collaboration is just that it's a collaboration. And if you look at the start of the pandemic, India was in a position where PPE's, healthcare equipment ventilators, were all in short supply because of a global supply chain being affected because of a few strong nodes dominating. Now we learn from that lesson very rapidly and immediately did two things. We scaled up the manufacturing of all this, but at the vaccine front, we did something, which is pretty impressive. In addition to scaling up our manufacturing of vaccines developed elsewhere we also developed vaccines here. And that's something quite impressive. India became immediately not just a huge vaccine exporter and manufacturer, but also a vaccine developer. Not just the big companies, but our start-ups, our academia went into vaccine development and deployment. And you're going to see the outcome of that very soon. So this reflects a very changed situation where not only could be served the current pandemic well, but our preparedness for the next one, and a preparedness for global service on this front has been an incredibly wrapped up.

Mark Suzman: So within that context, Minister, if I can come back to you, there's been a lot of discussion about equitable access to vaccines globally. Clearly, this is a pressing issue of our time. We know and certainly within the United States, for example, where I'm speaking from, while there have been significant support to Covax, there has not been a lot of support around actual distribution of vaccines into other countries or other parts of the world. Whereas India, through your Vaccine Maitri initiative, you have 85 countries already, I believe, have had access to vaccines that otherwise wouldn't have had. So in that context, it would be great to hear just your thoughts on how interviews and platforms like that, but also Covax and other bilateral and multilateral approaches, both for the current crisis, but also, this is something the world is going to have to grapple with going forward as to what the right strategy for future challenges in health and beyond health are.

Dr. S. Jaishankar: Well Mark, I'd like to really pick up on a point which Vijay made before answering your question, which is, we are fighting this pandemic, but even as we are doing this, we need to understand, the analogy I draw is a typhoon. Once you have a typhoon, be sure they're going to be more. So everything we are doing, we are doing for now, but everything we are doing is also preparing ourselves for what is to come. Now, I think equitable access is critically important in this because we all know that no one will be safe till everyone is safe. But while we know that we don't necessarily practice it. So, quite honestly, the global tendency has been to sort of circle the wagons and say, well, I'm going to look after myself, mostly. Now, I understand that, I'm not against that. I think, if any country is under stress, if the numbers are going up, which by the way they are for us right now, I think it's completely legitimate that we apply, and repurpose our production to where the immediate challenge is.

But the fact is that to the extent that you have margins and the ability and the obligation to help others, I think it's the decent thing to do, as I said, doing good is also doing smart. Now, in our case, our vaccine producers had some contractual commitments, they had commitments to Covax as you know, where we actually helped health workers in a number of African countries, with some of our own neighbours in South Asia, with the CARICOM with the FIPIC. Because with countries like small countries, it isn't just the ability to buy, they don't have actually the wherewithal to really access the market. So I think it's important and again, while we are discussing vaccines right now understandably, I want you to look at it in terms of a larger picture, because in my view, one of the real debates about globalisation has been the equity and fairness of globalisation. It is because globalisation has not been beneficial between societies and within societies. But you had people questioning the virtues of globalisation, and those who are truly committed to globalisation and wanted to do well, should, I think devote themselves to that.

And I look at our partnership, the government's partnership with the Gates Foundation, as a kind of global fairness coalition, if you would, that we are making an effort really to make sure that the weaker, vulnerable, less privileged people within societies and among countries don't get left behind. But to this, other than doing what we are doing, I think, this idea, it’s important that there are additional capabilities, because it isn't enough. Unless you have greater production, distributive justice by itself will not be adequate. And I think that sense of India as an additional engine of global growth, as Vijay referred, for example, to the fact that you have India developed vaccine as well. So which is a very, very important development. So I think, part of India's rise would be really to demonstrate additional capabilities. And I think the world would be better served by those additional capabilities. Capabilities, which are in the hands of a country, which embraces the world, which actually, as I said, believes in international cooperation, whose heritage is to do that, and who, by the way, is prepared to sort of put its money where its mouth is, or at least its capability, where its mouth is, and as we have seen, whether it's hydroxychloroquine, or whether now vaccines, we have stepped forward. I think it's something which is worth underlining.

Mark Suzman: As well, I very much support your vision of a global fairness coalition, if I can, and the Gates Foundation, you know, our core mission when we were set up over 20 years ago, which is carved on our headquarters outside Seattle is that every person deserves the chance to a healthy and productive life. And in fact, the outrage that Bill and Melinda Gates felt when they saw that many easy to access, particularly health treatments, but also in agriculture and financial inclusion and sanitation, since which the rich world got routine access to were not being distributed across the developing world is really the driving force behind all our work. And in that context, that's also been a core element of our partnership with Indians, I say initially in vaccines, where India has already become and developed strong local vaccines like around the rotavirus, but also for domestic use and for global use. Link to that is a vision of South South development, which India again, has been at the forefront of and I think part of what we're seeing now, I hope is a different kind of sets of South South partnerships, which India is being a pioneer of. And as you, Minister just talk a little bit about how you see that vision going forward beyond health, again including health but beyond health.

Dr. S. Jaishankar: You know, again, Mark, South South cooperation has been around for a long time. I think a lot of people sincerely and genuinely are committed to it. But it's important, I think, with greater globalisation, stronger interlinkages, interdependence, more technology, and also more challenges to make that a reality. I think a lot of it is today to take the fancy words in international relations and make them into practical initiatives and foundations like yours, clearly make a difference there. Now, when we speak of South South cooperation, for us a large part of that is within Asia, and also our relationship with Africa. And we have, certainly in the last six years, since Prime Minister Modi came to office; we have really stepped on the bus. I mean today, out of 54 African countries, for example, I think in 51 countries, we have projects of some kind either grant or lines of credit, a lot of them on lines of credit. And it's for people who, in a sense or not, who may not believe in it, or were a bit cynical, often people think of it as self-interest. And I grant you, I mean in international relations, there is an element of that. But I think if you look at a lot of what we have done, and some of the examples, I mean, a country like Mauritania, it's the other end of Africa. I mean, my strategic interest there is not particularly high. But the fact that we could go out there and build a milk processing plant, or the fact that we've been very active in water treatment systems in Tanzania and Mozambique, or in reviving, we've done a textile plant in Kenya, or cement plant in Djibouti, sugar in different countries. And a lot of what we are now trying to do, using technology, we have a very ambitious initiative for tele-health and tele-education. And I think one of the lessons of COVID, is going to be a greater digital reliance. So what we've been trying to do is really in a sense, as I said, helping them to fish rather than giving them fish. And through enhancing capability building, whether it's a human capability, or whether it's an asset creation, we really today have a footprint, which extends from the Pacific Island all the way through Asia, Africa, to the Caribbean. And sometimes in value terms, it may not be much, but it means a lot to the country concerned. I mean, one of the things, I met the president of St. Vincent and the Grenadines, and we actually helped them to revive an arrowroot production factory, which meant an enormous amount to them.

We are working, in fact, this is our biggest project today abroad, which is on a petroleum refinery in Mongolia, which is of a totally different scale. So my point is today, a country like India has both in terms of our belief, in terms of our heritage and history and in terms of our world strategy, that if we want to see a rebalanced world where there is much, you know, the diversity of the world is fully expressive in terms of better power distribution, better capability distribution, I think it makes eminent sense to go out there and work with other countries and build up their capabilities. Obviously, we earn goodwill, but I think you actually create in the long term, a much better world and we will focus on those areas, which we are better at, which are obviously our strengths. I think we're doing a lot of IT abroad, a lot of digital stuff abroad. Agriculture, I think is now an increasing area of interest. But my senses, particularly post pandemic, and I'm sure Vijay will bear this out, I think there's enormous interest in health security. And I see that really as a completely new area of priority international cooperation that is opening up and I can assure you that we will be there doing whatever is within the realm of possibilities on our part.

Mark Suzman: Well, one of the areas that I think is most important in that and has the most potential is in the scientific realm and the digital realm. And as you mentioned, digital financial inclusion, for example, is an area where we have partnered again with the Reserve Bank of India and others to help bring delegations from countries like Nigeria and Indonesia to learn from the Indian example on expanding financial access to the poorest. And Vijay, if I come back to you in areas that the Minister already touched on a couple of agricultural science as you and I had a recent conversation around some partnerships there and things like other health areas like antimicrobial resistance or global health security, and technology. You know, I'm curious both how you see cooperation in research can be better enabled, including the role of your partnerships with foundations like ours, but also, just where you see the highest potential for applying science and technology to these national and global problems.

Dr. K. VijayRaghavan: Thank you, Mark. You know, as the Minister just pointed out, the reach of India's interactions globally, points to a truly global view of a sense of community, and now taking this one step further into areas such as agriculture and health, which you pointed out, the pandemic has highlighted a simple point that we must look at these issues in a comprehensive manner, or one health and not matters such as what do I do with biology? What do I do with you know, spill overs? What do I do with agricultural pests? Now, this one health perspective is a big challenge. The West has addressed this so far, by pouring in huge amounts of resources into solving problems in a manner, which is disproportionately again to hammer on an end. And this is not tenable to scale globally. India's approach which combines quality science in partnership with the best in the West and elsewhere, but also with a digital reach, which allows us to estimate who needs what precisely and deliver according to that requirement, rather than a broad brush requirement, which may be either excessive in some areas, or missing in others. For this kind of a digital feedback mechanism, combined with real touch material changes in agricultural health, What some people have referred to as the bridigital, bridging the digital and the other divide is something which India has become very good at. The payments portal, which you talked about is one example, scaling that has been absolutely terrific.

This now can scale it to other aspects, combining high quality sensors, electronics, feedback into decision making, and going back to what people need at the farm level. There partnerships with the Gates Foundation, other similar organisations is important, because technologies which have been developed for all sorts of other reasons, and which have come with all sorts of bells and whistles now needs to be broken up into modules, which can be adapted to this new global demand. And that's something we must partner and ensure that not only India, but all the world has access too.

Mark Suzman: So minister, if I could turn back to you in that context, you know, that you mentioned the global health security agenda. And that is being vigorously discussed in global forums like the G7 and the G20. And that's on aspects both of how we continue to respond to the current crisis, which is very much with us and will be for a while longer and its implications, and also prepare and respond to future crises. And I'm actually serving on a G20 High Level panel on to provide advice to the G20 on financing for future pandemic preparedness. Unfortunately, I would say the historical pattern is once crises move close to the rear-view mirror, global cooperation around, it tends to falter. But there are often fine words, but not a lot of actions and deeds. And we're facing not just this global health security, but also you mentioned early climate change. And I am just curious to see both, how optimistic you are, that the global community will tackle these differently and just where you see India's approach and potentially distinctive contribution?

Dr. S. Jaishankar: Well, look, Mark, in a way, I think, you know, today, India is the laboratory. It is, to some degree in certain areas, an example. It's certainly an additional capability. We hope in many cases, it's a good partner. And I think it's also important we tell our own story effectively so that people really understand what's going on. You know, I have a 400 800 story which I'm actually surprised to see how little it's been picked up in the global media. And the 400 is the 400 million people into whose bank accounts we put in money, without it getting lost on the way and 800 million people, where there are 800 million people who actually got food from the government all through last year, because of the lockdown and the disruption. Now, if you go anywhere in the world and say, listen guys, I just paid out 400 million people, and I've fed 800 million people, you should make waves. For whatever reasons we can, it's a different subject; you can debate why it hasn't got the kind of attention and focus that it should have.

But the answer to your question, how confident I am about the global community, I don't differ with you. I think that has been the experience that things do tend to move to the rear-view mirror and the, objects look farther and farther away, as you look at the rear-view mirror. But I think that is why it is important for countries to step forward, and make sure that that spotlight is not taken away. And certainly a lot of what we do, I mean, it wasn't that our health cooperation with say Africa, as you know, it wasn't that it took place in crisis, and it got switched off. So we would certainly like to remain steady, reliable, good exemplary partners, if you would, for the global south. And in many cases, for countries not from the south as well. And I want to add one more thing. And this is not a health security or even a developmental point. Look, there are powers and powers, I mean, every big power rising is unique. I would like to be an enlightened power, which does not do what all the others did before me, which is to shut the door as soon as you enter the room. I would like to make sure that the door is open for other powers to come in. I mean I truly believe for example, the rise of Africa. Actually, the world will not be multipolar until the rise of Africa, for example, it not just the rise of Africa, actually it takes place. So to me to go back to your first question, the world is a family, I would like to be an enlightened power, which not only organises its own rise, but which also facilitates the rise of others so that as I said, the real diversity of this world is fully reflected in international affairs. And to do that, I must keep looking at those challenges and crisis as they come and work with other countries. And that is exactly what the foreign policy vision of my Prime Minister is. And that's what we try to do in India diplomacy.

Mark Suzman: Well, thank you, Minister, I think I couldn't think of a better note to close on. And as a South African, I'm very pleased to hear your vision about the importance and the future role of Africa. And as a global citizen leading a global Foundation, I'm even more pleased to hear about your vision of your enlightened approach to global affairs, which really is a both and I think, to your 400 800 stories certainly, we at the Gates Foundation have been highlighting how India's domestic response on your food security, on access to financial inclusion is both an amazing feat in itself, but also a great model for those countries across the rest of Asia, in Africa and across the world to follow. And as we look forward into what will still be a very challenging period in terms of addressing the COVID response and global health security. I think we're both reassured and excited to hear India's commitment to continued global leadership. And even more excited to continue to be a partner with Vijay and across the scientific community in the research and development community in India, which is an incredibly vibrant one. So without a huge thank you to both of you for joining me today.

Dr. S. Jaishankar: Thank you.

Dr. K. VijayRaghavan: Thank you very much. Thank you.

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