AstraZeneca has served Serum a legal notice over delivery delays. Serum has just “temporarily deferred” its commitments, Mr. Poonawalla said, citing the Indian government’s halt of exports.

“This is something coming from India,” he said. “It’s not the supplier that is defaulting.”

The world is grappling with the ripple effect. A spokesman for Gavi said that India’s decision to prioritize “domestic needs” is having “a knock-on effect in other parts of the world that desperately need vaccines.” Still, in a sign of the lack of options for getting vaccines, Gavi on Thursday signed a purchase deal with an American vaccine company, called Novavax, involving doses to be made by Serum.

people are being turned away from vaccination centers that have run out of doses.

Serum has missed its expansion targets. Mr. Poonawalla said last fall that by early this year, Serum Institute would be pumping out 100 million doses per month, of which about four in 10 would go overseas.

But after a fire at a facility that was supposed to help the company ramp up vaccine production, Serum’s capacity has remained at about 72 million doses per month. A grant of more than $200 million from the Indian government should help the company reach its goal by summer, he said.

Mr. Poonawalla has also cited raw materials supplies. In April, he asked President Biden on Twitter to “lift the embargo” on raw material used to make Covid-19 vaccines. White House officials said Mr. Poonawalla mischaracterized his situation. Still, the United States said it would send raw materials to the Serum Institute to increase its vaccine production, though Mr. Poonawalla said they haven’t yet arrived.

Mr. Poonawalla has also come under scrutiny for charging different prices to the central government, to India’s states and to private hospitals. Two weeks ago, Serum said it would charge state governments about $5 per dose, about $3 more than what it charges Mr. Modi’s government.

Last week, following criticism, Mr. Poonawalla lowered the price to $4. Still, the critics point to an interview in which Mr. Poonawalla said that he was making a profit even at the central government’s price.

Mr. Poonawalla said that Serum could sell at a lower price to India’s central government because it was ordering larger volumes.

People don’t understand,” Mr. Poonawalla told The New York Times. “They just take things in isolation and then they vilify you, not realizing that this commodity is sold at $20 a dose in the world and we’re providing it for $5 or $6 in India. There’s no end to the cribbing, the complaining, the criticizing.”

includes four to five armed personnel.

In an interview with The Times of London newspaper published last week, he described receiving constant, aggressive calls demanding vaccines immediately. “‘Threats’ is an understatement,” he told the paper.

He played down the threats in his interview with The New York Times, and his office declined to disclose further specifics. Still, the comments caused an uproar in India. Some politicians demanded that he name names.

tweeted that Mr. Poonawalla’s departure to London was “shameful” and that he should reduce prices.

The Serum Institute is planning a major expansion in Britain, investing nearly $335 million for research and development, to fund clinical trials, to build out its sales office and to possibly construct a manufacturing plant, Mr. Poonawalla’s office said.

“Everyone is depending on us to be able to give this magic silver bullet in an almost infinite capacity,” Mr. Poonawalla said. “There’s this tremendous pressure from state governments, ministers, the public, friends, and they all want the vaccine. And I’m just trying to equitably distribute it as best I can.”

Selam Gebrekidan in London and Bhadra Sharma in Kathmandu, Nepal, contributed reporting.

View

Accident at Covid Hospital in India Kills at Least 22 as Cases Surge

NEW DELHI — India’s health care system shows signs of buckling under the strain of a second wave of coronavirus infections, as the authorities reported nearly 300,000 new cases on Wednesday and an accident at a Covid-19 hospital killed more than 20 people.

The accident happened at a hospital in the western state of Maharashtra after a leak in the hospital’s main oxygen tank stopped the flow of oxygen to dozens of critically ill people. Televised images showed family members wailing in the wards and nurses frantically pounding on the chests of some patients.

All week, hospitals across India have been warning about an acute oxygen shortage. Many hospital officials said they were just a few hours away from running out.

“Nobody imagined this would happen,” said Subhash Salunke, a medical adviser to the Maharashtra government.

recent political rallies held by Mr. Modi that have drawn thousands, as well as the government’s decision to allow an enormous Hindu festival to continue despite signs that it has become a superspreader event. A few days ago, Mr. Modi indicated that he wanted Hindu worshipers to stay away from this year’s festival, called the Kumbh Mela, which is held on the banks of the Ganges river considered sacred by many Hindus.

But the worshipers keep coming — 70,000 showed up on Wednesday for a holy dip, bringing the total to more than 10 million since the festival began in January — and government officials on the ground are doing little to stop them.

Event organizers said that worshipers were required to produce a negative coronavirus test result or be tested on the spot, but they also acknowledged that with such huge crowds, some participants could have slipped in without being tested. Photographs show a sea of worshipers packed together in the gray waters of the river, many without masks. More than 1,000 tested positive at the site in just 48 hours, according to reports by the Indian news media.

Hindu-first worldview, is giving preferential treatment to Hindus.

“It is a clear example of double standards,” said Khalid Rasheed, chairman of the Islamic Center of India, a nonprofit religious organization.

He compared the government’s apparent endorsement of the Kumbh to the way it handled a much smaller gathering of a few thousand Islamic preachers in New Delhi last March. Not only was the seminary that hosted it shut down, but hundreds of people were also detained. Officials from Mr. Modi’s party blamed the seminary for spreading the virus.

an anti-Muslim campaign across India in which Muslims were attacked with cricket bats and run out of their neighborhoods. Many of the Muslims arrested at the seminary a year ago are still awaiting trial.

Government officials have defended the Kumbh festival as safe even as the virus infects some of its most high-profile attendees, including the former king of Nepal and his wife.

Another visitor who was infected is Tirath Singh Rawat, the chief minister of Uttarakhand, which as the state hosting this year’s festival stands to make millions in revenue from the pilgrims and vendors. Mr. Rawat mingled freely in the crowds without a mask, and told those who questioned him that “faith in God will overcome the fear of the virus.”

Shailesh Bagauli, a state official, said the timing of the festival had been determined by “optimal astrological conditions” and that the government had implemented measures like mask wearing and social distancing.

On Wednesday, news of the hospital oxygen leak quickly spread around the country, raising fears that the health care system here, which is chronically underfunded, was about to collapse.

Indian news channels showed images of the oxygen leak at Zakir Hussain Hospital in the city of Nashik.

“When we reached the spot, it was all foggy,” said S.K. Bairagi, a fire chief in the city. He said it took about 30 minutes to repair the tank.

The dwindling oxygen supply is becoming one of the most alarming aspects of India’s second wave. To expedite its delivery to hospitals, India’s railway service has begun running what it calls “oxygen express” trains across the country.

India’s health ministry has said that the daily demand for oxygen at hospitals has reached about 60 percent of the country’s daily production capacity of just over 7,000 metric tons. Government officials countered news reports this week that said India had increased oxygen exports as the second wave of infections was approaching, saying those exports amounted to less than 1 percent of daily production capacity.

But the health ministry also said that it was looking to import 50,000 metric tons of medical oxygen from abroad, a sign that India’s government may be concerned about the domestic supply.

On Tuesday night, more than a dozen hospitals in New Delhi, the capital, put out an alert saying they were hours away from running out of oxygen.

In Lucknow, another major city in northern India, the Mayo Medical Center warned on Wednesday that it was down to a 15-minute backup supply and that “oxygen is not available anywhere in Lucknow.”

Later in the day, hospital officials said they had received 40 oxygen cylinders. But medical experts said that with so many people falling sick, it was a dangerous time to be running low.

“There is definitely an oxygen shortage across the country,” said Shashank Joshi, an endocrinologist and member of the Covid task force in Maharashtra. “The situation is grim.”

Mujib Mashal contributed reporting from New Delhi, andBhadra Sharma from Kathmandu, Nepal.

View

Prabal Gurung on Anti-Asian Violence, Discrimination and the Duties of Success

Prabal Gurung, the Nepalese-American designer, has been a vocal proponent of inclusion and diversity since his first show in 2009. In the wake of the Atlanta shootings and an upswing in anti-Asian violence, he talked to The New York Times about his own experiences and what his work has to do with it.

How do you grapple with what’s going on?

To watch a video of a 65-year-old woman being brutally attacked is triggering and heart-wrenching, not just for me but for my friends and people from my community. We all are so worried for our loved ones. My mother goes on walks every morning and evening. She’s 75-years-old. A couple of weeks ago, I bought a blond wig for her, and I said, “You know, just wear it when you go outside, wear a hat, wear glasses.” She tried it on. But the next day she came over to my place, and she was like: “I’m not going to wear it. Just buy me a big, strong cane.” That is the reality of this.

Is that why you were an organizer of a Black and Asian solidarity march with other designers and activists in March?

We didn’t know how many people were going to show up, but thousands and thousands of people showed up across races and gender: L.G.B.T.Q. friends, Latin friends, Black friends, Asian friends, white friends. What we recognize is that for this particular moment to turn into a movement, we have to have all the marginalized groups and our white counterparts coming together.

Oh, a wave of Asian designers.” Then there’s a wave of Black designers, a wave of women designers. We never say a wave of white designers. We are never considered designers on our own. So that kind of implicit bias, that kind of microaggression, we face it all the time.

Did you experience it when you were trying to get financial backing for your business?

For my 10-year anniversary I was at a potential investors meeting, and one asked, “What does the brand stand for?” I said: “The America that I see is very colorful. The dinner table that I see is very colorful. It’s diverse. That’s the America that was promised to me. That’s why I came here, because I was a misfit back home.” And he says to me, “Well, you don’t look American.” I looked at him, and I was like, “You mean to say I don’t look white?”

“It’s OK,” I said. “I’ve been in business in America for 20 years. I’m a citizen. I make more than 90 percent of my clothes in New York City. I am actively involved in social causes. I’ve contributed to my taxes.”

torrent of hate and violence against people of Asian descent around the U.S. began last spring, in the early days of the coronavirus pandemic. Community leaders say the bigotry was spurred by the rhetoric of former President Trump, who referred to the coronavirus as the “China virus.”

  • In New York, a wave of xenophobia and violence has been compounded by the economic fallout of the pandemic, which has dealt a severe blow to New York’s Asian-American communities. Many community leaders say racist assaults are being overlooked by the authorities.
  • In January, an 84-year-old man from Thailand was violently slammed to the ground in San Francisco, resulting in his death at a hospital two days later. The attack, captured on video, has become a rallying cry.
  • Eight people, including six women of Asian descent, were killed in the Atlanta massage parlor shootings on March 16. The suspect’s motives are under investigation, but Asian communities across the United States are on alert because of a surge in attacks against Asian-Americans over the past year.
  • A man has been arrested and charged with a hate crime in connection with a violent attack on a Filipino woman near Times Square on March 30. The attack sparked further outrage after security footage appeared to show bystanders failing to immediately come to the woman’s aid.
  • Part of what you are trying to do with your work is educate people about the nuances of different Asian cultures, right?

    Asian-Americans are the fastest growing immigrant group in the U.S. electorate, with roots all over the world. We are diverse. I look East Asian, right? But I’m from Southeast Asia. I sit in the center of the brown Asians and the other Asians. The wealth disparity between the richest Asian-Americans and the poorest is insanely high. I think maybe the largest of any ethnic group in this country. In spite of that, there is a myth of the model minority, of crazy rich Asians. That’s why “Parasite” is important, why “Minari” is important. Give us the platform so we can tell our stories.

    This stereotyping doesn’t make you angry?

    I’m OK with people making mistakes because it can start a dialogue that leads to a solution. I refuse to cancel people unless there’s something really harmful.

    Fashion is one of the hardest and most arduous industries, but it’s also an industry that can reward you in the most splendid, incredible way. And it is the only industry where in 10 minutes on a runway we can really change the narrative of what the culture can be. That’s the power of fashion.

    I am a living example of it, coming from a country like Nepal where nobody believed I could be a designer. To be able to live that dream and to have this platform. It’s been really incredible.


    This interview has been edited for length and clarity.

    View

    Underage Marriage Set to Rise as Covid-19 Crushes Dreams

    RAPTI SONARI, Nepal — Sapana dreamed of becoming a government official. Each night, in her hut along a bumpy dirt road, the 17-year-old lit a single solar-powered bulb dangling from the ceiling and hit the books, plotting out a future much different than her mother’s.

    But as the coronavirus crept across Nepal, closing the schools, Sapana lost focus. Stuck in her village with little to do, she struck up a friendship with an out-of-work laborer.

    They fell in love. Soon they married. Now, Sapana has given up her professional dreams, with no plans to return to school.

    “Things might have been different if I hadn’t discontinued my studies,” Sapana said recently, as she sat breastfeeding her 2-month-old son on the floor of her simple home. Her family name was withheld to protect her privacy.

    Child marriage is increasing at alarming levels in many places, the United Nations says, and the coronavirus pandemic is reversing years of hard-earned progress toward keeping young women in school.

    In a report released on Monday, the United Nations Children’s Fund predicted that an additional 10 million girls this decade will be at risk of child marriage, defined as a union before the age of 18. Henrietta Fore, UNICEF’s executive director, said that “Covid-19 has made an already difficult situation for millions of girls even worse.”

    forced by parents or other authority figures into marriage with older men. But child advocates also worry about the young women who, because of the pandemic’s impact, are drifting away from school and see early marriage as their only option, abandoning ambitions for an education and a better life.

    Many child marriages are never registered. UNICEF estimates that 650 million girls and women alive today were married in childhood. Child advocates say they are seeing an upsurge in places where it has long been a problem, such as India, Bangladesh, Nigeria, Kenya, Ethiopia and Malawi, where teen pregnancies in some areas have tripled.

    In Nepal, where the legal age for marriage is 20, the situation seems especially acute. Interlocking problems particular to the country and this moment make it difficult for many young women to avoid early marriage.

    One of Asia’s poorest nations, Nepal relies on remittances and tourism. The pandemic has devastated both. Usually, at this time of year, foreign tourists head for the mountains to begin expensive treks into the Annapurna Range and up the slopes of Mount Everest. This year, the money that flows from them into so many layers of Nepal’s economy has all but dried up.

    In 2019, Nepal earned $8.25 billion from foreign remittances. But with most of the world’s economies hurting, that remittance stream has also dwindled. Legions of young Nepali men, many of them single, have recently returned home.

    Many others have lost their jobs in Nepal’s cities. A great number of young men now roam around their mountainside villages, bored and broke. That was how Sapana met her husband, Hardas.

    Hardas, who said he was around 20, used to work as a traveling mason, often in cities such as Kathmandu and Nepalgunj. But after he was laid off in April, at the beginning of the pandemic, he came back to his native Rapti Sonari, a small town of about 10,000 people, 300 miles west of Kathmandu.

    The houses are spread out in a maze of dirt roads beneath the hills. Most are made from mud and stone. Sapana’s father, Ram Dayal, bought an auto rickshaw right before the lockdown hit. Now he has monthly payments of 30,000 rupees, around $250, and almost no customers.

    Mr. Dayal was not happy that his daughter married so young, but he conceded that her leaving the house helped ease his financial burden. He has five other mouths to feed.

    “She would have had a better life if she completed 10th grade,” Mr. Dayal said.

    Ghumni, his wife and Sapana’s mother, agreed. She, too, was a child bride and ended up with four children and zero education.

    Activists who fight child marriage say they are working in the most difficult conditions they have ever faced, even as the problem worsens. Nepal has imposed harsh restrictions on vehicular movement. When infections surged, activists were confined indoors like everybody else. Several said that the number of child marriages in their areas had doubled or nearly doubled during the pandemic.

    “We are at back to square one,” said Hira Khatri, an anti-child-marriage activist in the district that includes Rapti Sonari.

    Two years ago, Ms. Khatri said, she intervened and stopped seven child marriages in her village. It did not make her popular. Many families in Nepal are eager to marry off their young daughters. Some villagers threatened to kill her, Ms. Khatri said, and they threw used condoms outside her house to humiliate her.

    The police have not been much help. The officers based in villages have been much more focused on enforcing quarantine rules and keeping an eye on virus cases. Some police officials expressed a reluctance to get involved.

    “These are serious criminal charges,” said Om Bahadur Rana, a police official in Nepalgunj. “If we file a case because of a child marriage, it could hurt the young people’s chance of ever getting a government job.”

    Across central Nepal, many families shared stories of watching their daughters disappear into early marriages.

    Mayawati, 17, who also lives in Rapti Sonari, dreamed of studying agriculture. But her family’s struggles during the pandemic made her feel guilty about being a burden to her parents. She dropped out of school, then married a man who worked as a menial laborer. Her dreams, too, have quietly slipped away.

    “We have no money,” said Mayawati, whose last name was also withheld. “How was I supposed to continue my studies?”

    Mayawati said that most of her friends who had married during the lockdown were now pregnant.

    Some people in Nepal feel strongly about what they see as the benefits of child marriage. Several elders in the Madhesi community, based on the southern plains near the border of India, said they had falsified their daughters’ birth certificates to avoid getting in trouble.

    “Marrying daughters in their young age has made me happier. It’s our practice,” said Mina Kondu, who said she recently doctored her 16-year-old daughter’s birth certificate, making her appear to be 19, which was still below the legal age but close enough, the family believed.

    “The police cannot stop us,” she said.

    Ms. Kondu, who lives in a village about three hours’ drive from Sapana’s, said that if the families didn’t arrange for their daughters to marry young, the daughters would do it anyway, without permission, and dishonor the family.

    Sapana’s family has accepted her recent marriage. In the span of a couple months, Sapana has shifted from studying for school to taking care of her baby and her new husband.

    She collects grass to feed the family’s four buffaloes.

    She washes clothes.

    She cooks rice and flat bread.

    “I couldn’t complete my studies, that’s true,” she said. “My son will do that.”

    And then she added, after a moment, “Hopefully, he will marry when he’s fully grown.”

    Bhadra Sharma reported from Rapti Sonari, Nepal, and Jeffrey Gettleman from New Delhi.

    View