Pakistan’s Private Vaccinations Draw Criticism

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ISLAMABAD, Pakistan — The coronavirus was ripping through Pakistan, and Muhammad Nasir Chaudhry was worried. Long lines and tight supplies plagued the government’s free vaccine campaign. Newspapers were filled with reports of well-connected people jumping the line for a free dose.

Then Mr. Chaudhry, a 35-year-old government consultant, discovered he could pay to leapfrog the long lines himself. He registered to take two doses of the Russian-made Sputnik V vaccine for about $80 from a private hospital. That’s a lot of money in a country where the average worker makes about $110 per month, but Mr. Chaudhry was ready to make the commitment.

Critics have assailed such private sales in Pakistan and around the world, saying that they make inoculations available only to the wealthy. But in Pakistan, like elsewhere, tight supplies have stymied those efforts. The private hospitals are out of supplies, and Mr. Chaudhry still hasn’t been vaccinated.

“I am willing to pay double the price for the vaccine, but I don’t want to wait on and on,” Mr. Chaudhry said.

bought up most of the world’s vaccine supplies to protect their own people, leaving millions of doses stockpiled and in some places unused. Less developed countries scramble over what’s left.

To speed up vaccinations, some countries have allowed doses to be sold privately. But those campaigns have been troubled by supply issues and by complaints that they simply reflect the global disparities.

blocked them over fears that counterfeit vaccines would be sold. In the United States, some well-connected companies, like Bloomberg, have secured doses for employees.

can’t find vaccines to buy. Demand has been strong. The government sets a ceiling on prices but has been locked in a dispute with private importers over how much that should be.

In April, in the city of Karachi, long lines formed when two private hospitals began selling the Sputnik V vaccine to walk-ins. Private hospitals in Islamabad, the capital, and Lahore faced a similar rush of people and ran short within days. Hospitals in the major cities have now stopped taking walk-ins, and online registration has also been put on hold.

Sputnik V isn’t the only vaccine that the government allows to be sold privately. A one-dose shot made by CanSino Biologics of China is priced at around $28. Demand has been weaker because of greater public confidence in the Russian vaccine. Still, supplies sold out quickly after the CanSino doses went on sale last month. The government has said another 13.2 million doses will arrive in June.

AGP Limited, a private pharmaceutical company that has imported 50,000 doses of Sputnik, is urging patience.

“Sputnik V received an overwhelming response in Pakistan with thousands of people being vaccinated in just a few days and an even higher number of registrations confirmed in hospitals across Pakistan,” said Umair Mukhtar, a senior official of AGP Limited. He said the company has placed large orders for more.

The government price dispute could delay further expansion. The drug regulatory authority wants Sputnik V to be sold at a lower price. AGP won an interim court order on April 1 to sell the vaccine until a final price is fixed.

For those who can afford the doses, frustration is growing. Junaid Jahangir, an Islamabad-based lawyer, said several of his friends got private inoculations. He registered with a private lab for Sputnik V but got a text message later saying that the vaccination drive was on hold.

“I am being denied a fair chance to fight this virus if I end up getting infected,” Mr. Jahangir said. “The demand is there, and I don’t see what could possibly be the reason behind the inefficiency in supply.”

Some of the people who paid for private doses justified their decision by citing media reports that some well-connected people were jumping the line to get free, public doses. In May, at least 18 low-level health care workers were suspended by the authorities in Lahore for vaccinating people out of turn after taking bribes.

Iffat Omar, an actor and talk show host, apologized publicly in April for jumping ahead of the line to get the vaccine. “I am sorry,” she said on Twitter. “I am ashamed. I apologise from the bottom of my heart. I will repent.”

Fiza Batool Gilani, an entrepreneur and the daughter of Yusuf Raza Gilani, the former prime minister, said she knows of several young people who jumped the queue and got the free government vaccine in recent weeks.

“I was myself offered out of turn, free vaccine, but I declined as I wanted to avail the private vaccine,” said Ms. Gilani. Wealthy people should pay for their doses, she said, adding that her family would pay for CanSino shots for its household staff.

Many people, like Tehmina Sadaf, don’t have that option.

Ms. Sadaf, 35, lives along with her husband and a seven-year old son in a working-class neighborhood on the outskirts of Islamabad. Her husband is a cleric at a mosque. She gives Quran lessons to young children. She said the pandemic had negatively impacted the family’s income of around $128 per month. “After paying the house rent and electricity bill, we are not left with much,” she said.

She had her doubts about the public vaccine, “but the price of the private vaccine is very high,” she said. “It should have been lower so that poor people like us can also afford it.”

Zia ur-Rehman contributed reporting from Karachi, Pakistan. Richard C. Paddock and Muktita Suhartono contributed reporting.

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Countries Are Scrambling for Vaccines. Mongolia Has Plenty.

Mongolia, a country of grassy hills, vast deserts and endless skies, has a population not much bigger than Chicago’s. The small democratic nation is used to living in the shadow of its powerful neighbors, Russia and China.

But during a pandemic, being a small nation sandwiched between two vaccine makers with global ambitions can have advantages.

At a time when most countries are scrambling for coronavirus vaccines, Mongolia now has enough to fully vaccinate its entire adult population, in large part thanks to deals with both China and Russia. Officials are so confident about the nation’s vaccine riches that they are promising citizens a “Covid-free summer.”

Mongolia’s success in procuring the vaccines in the span of a few months is a big victory for a low-income, developing nation. Many poor countries have been waiting in line for shots, hoping for the best. But Mongolia, using its status as a small geopolitical player between Russia and China, was able to snap up doses at a clip similar to that of much wealthier countries.

deep skepticism over their homegrown vaccines.

Mongolia is a buffer between eastern Russia, which is resource rich and mostly unpopulated, and China, which is crowded and hungry for resources. While Russia and China are often aligned on the global stage, they have a history of conflict and are wary of each others’ interests in Mongolia. Those suspicions can be seen in their vaccine diplomacy.

arrived this week. Mongolia’s most recent agreement with China’s Sinopharm Group, which is state-owned, was made days before the company received emergency authorization from the World Health Organization.

Mongolia was late to the global clamber for Covid-19 vaccines. For nearly a year officials boasted that there were no local cases. Then came an outbreak in November. Two months later, political crisis precipitated by the mishandling of the virus led to the sudden resignation of the prime minister. The prospect of continued coronavirus restrictions threatened to throw the country into further political turmoil.

The new prime minister, Oyun-Erdene Luvsannamsrai, pledged to restart the economy, which had suffered from lockdowns and border closures, particularly in the south, where Mongolian truck drivers ferry coal across the border to China’s steel mills. But these plans were complicated by surging cases, with the daily count going from hundreds a day to thousands.

“We were quite desperate,” said Bolormaa Enkhbat, an economic and development policy adviser to Mr. Luvsannamsrai.

Vero Cell vaccine. Soon after, China donated 300,000 doses of its Sinopharm vaccine to Mongolia, citing a “profound traditional friendship” as motivation.

Opening up more of the border between China and Mongolia was also a part of the vaccine discussions, Chinese and Mongolian officials said in Chinese state media. Mongolia needs China to buy its coal — exports to the country make up nearly a quarter of Mongolia’s annual economic growth. The revenues helped to pad Mongolia’s budget by a quarter last year.

After a month of back and forth, the Mongolian government struck a deal in March with Russia’s Gamaleya Research Institute, too, for one million doses of the Sputnik vaccine. Days later, Mongolia finalized an agreement to buy 330,000 additional doses of the Sinopharm vaccine.

Ulaanbaatar, Mongolia’s capital, 97 percent of the adult population has received a first dose and more than half are fully vaccinated, according to government statistics. Across the country, more than three quarters of Mongolians have already received one shot.

China has shut its border and stopped purchasing Mongolian coal.

Mongolians have also expressed a preference for Russia’s Sputnik vaccine. To get the population to take the Sinopharm shot, the government has offered each citizen 50,000 tugriks — about $18 — to get fully vaccinated. The average monthly salary in 2020 was $460.

The terms and pricing of the Sinopharm and Sputnik deals were not made public, and Mongolia’s foreign ministry declined to comment on pricing. Representatives for the Gamaleya Research Institute and Sinopharm did not respond to requests for comment.

While some global health experts have questioned whether Sinopharm will be able to continue to deliver on its commitments overseas, it has delivered all of the doses Mongolia ordered. China has said it can make as many as five billion doses by the end of the year, though officials have warned that the country is struggling to make enough shots for its citizens.

a third booster shot sooner than expected.

China, for its part, may be playing a long game, said Julian Dierkes, an associate professor at the University of British Columbia who specializes in Mongolian politics. Though many Mongolians may still not trust China, the Mongolian government will remember how it made its vaccines available at a critical moment.

“We could coin a phrase here: ‘The opportunity of smallness,’” he said.

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Traveling to Europe? A Country-by-Country Reopening Guide

Infections and deaths in Turkey from the coronavirus have been declining steadily following a strict three-week national lockdown, which is expected to be lifted gradually through May.

Turkey so far has fully vaccinated about 13 percent of its population of 83 million people; about three million more have received their first dose, according to Our World in Data, an online compendium of data from global sources.

While the country is currently facing a vaccine shortage, forcing it to delay the administration of second doses, the health minister, Fahrettin Koca, said 30 million more doses of the Pfizer-BioNtech vaccine would arrive in June and 50 million doses of the Sputnik V vaccine are expected to arrive from Russia within six months.

Turkey has remained open to tourists, including Americans, throughout the pandemic. Most international arrivals are required to show proof of a negative PCR test taken within 72 hours of their arrival into the country.

Coronavirus tests are not required for passengers arriving from places that Turkey considers epidemiologically safe, which include Hong Kong, China, Taiwan, Vietnam, Australia, New Zealand, Singapore, Thailand, South Korea, Israel, Japan, Latvia, Luxembourg, Ukraine and Estonia.

Passengers arriving from Brazil, South Africa and India will be required to quarantine for 14 days in government-assigned accommodations and will be released if they test negative for the virus after day 10.

Turkey offers health insurance packages starting at as little as $15 that cover foreign visitors for Covid-19 treatment and hospitalization for up to 30 days. The country treats coronavirus patients in both public and private hospitals and opened 17 new hospitals last year to provide more intensive-care capacity for Covid treatment.

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Turkey’s Second Major Wave Recedes Amid a Faltering Lockdown

ISTANBUL — Turkey’s health ministry on Saturday reported fewer than 20,000 new coronavirus cases in the previous 24 hours, a first since mid-March and 10 days into a lockdown.

The health ministry data shows 18,052 new cases and 281 new Covid deaths. The country’s seven-day average of new cases has been falling since April 20, when it hit a peak of more than 60,260 from fewer than 10,000 on March 3, according to data from the Our World in Data project at the University of Oxford. The plunge in new cases has been equally sharp, dropping to fewer than 24,000 as of Saturday.

Deaths, which lag infections by weeks, have only just begun to fall. The seven-day average peaked on May 2 at more than 355 and has now dropped to just over 320.

In what President Recep Tayyip Erdogan billed as a full lockdown, the government ordered nonessential workers to stay home, except to go to the nearest grocery store, starting on April 29, to last for almost three weeks. Day-care centers and kindergartens are open only for the children of workers exempt from the curfew.

according to Our World in Data. The country mainly uses CoronaVac, developed in China, and has also distributed a small number of doses of the Pfizer-BioNtech vaccine.

Facing difficulties in securing enough vaccine, Turkey has resorted to postponing second doses. On April 12, the health minister, Fahrettin Koca, said 30 million more doses of the Pfizer-BioNtech would arrive in June. On April 28, he announced a deal to import 50 million doses of the Sputnik V vaccine from Russia within six months.

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India’s Serum Institute Struggled to Meet Its Covid-19 Vows

NEW DELHI — Adar Poonawalla made big promises. The 40-year-old chief of the world’s largest vaccine maker pledged to take a leading role in the global effort to inoculate the poor against Covid-19. His India-based empire signed deals worth hundreds of millions of dollars to make and export doses to suffering countries.

Those promises have fallen apart. India, engulfed in a coronavirus second wave, is laying claim to his vaccines. Other countries and aid groups are now racing to find scarce doses elsewhere.

At home, politicians and the public have castigated Mr. Poonawalla and his company, the Serum Institute of India, for raising prices mid-pandemic. Serum has suffered production problems that have kept it from expanding output at a time when India needs every dose. He has come under criticism for departing to London amid the crisis, though he said it was only a quick trip. He told a British newspaper he had received threats from politicians and some of India’s “most powerful men,” demanding that he supply them with vaccines. When he returns to India, he will travel with government-assigned armed guards.

In an interview with The New York Times, Mr. Poonawalla defended his company and its ambitions. He had no choice but to hand over vaccines to the government, he said. He cited a lack of raw materials, which he has partially blamed on the United States. Making vaccines, he said, is a painstaking process that requires investment and major risks. He said he would return to India when he had finished his business in London. He shrugged off his earlier comments about threats, saying they were “nothing we can’t handle.”

backed waiving intellectual property protections for vaccines, which could make it easier for Indian factories to make them. Still, that won’t help India’s current crisis, which as of Friday had claimed more than 230,000 lives — a figure that likely represents a vast undercount.

a horse breeder turned vaccine billionaire. Before the crisis, he was extolled in the Indian media as an example of a new class of young, worldly entrepreneurs. Photos of him and his wife, Natasha, were a staple of fashion spreads.

Serum received a $300 million grant from the Gates Foundation to supply as many as 200 million doses of Covishield and another vaccine in development to the Gavi Alliance, the public-private partnership that is overseeing Covax, the program to donate vaccines to poor countries.

Serum pledged between January and March to sell about 1.1 billion vaccine doses in coming months, according to a review of purchase agreements supplied by UNICEF. By the time India largely stopped vaccine exports, Serum had exported only about 60 million doses, about half to Gavi. India had claimed more than 120 million.

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.

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Russia Says One Dose of Sputnik Vaccine May be Enough

The first dose of Russia’s Sputnik V coronavirus vaccine provides sufficient protection on its own to be used without a second injection, the country’s Ministry of Health said on Thursday, clearing the way for a faster vaccination campaign in Russia.

The new policy arose from a debate among public health officials in Russia and a number of other countries about the benefits and drawbacks of accelerating vaccinations by skipping or delaying the second dose of vaccines that were originally designed to be administered in two shots a few weeks apart.

As is the case with other two-dose coronavirus vaccines, Sputnik V provides substantial protection, at least for the short term, after the first shot.

The ministry said in a statement that people in Russia who, for various reasons, skipped their second shot of Sputnik V were still far less likely to become sick than unvaccinated people were.

Sputnik V to be 79.4 percent effective after a single shot. Russia has previously reported an efficacy of 91.6 percent after two shots.

The observational study was less precise than a standard vaccine trial, because it compared rates of infection in single-shot recipients with the general infection rate in the population, not with a control group. The ministry did not say how many single-shot recipients were studied. A separate placebo-controlled study of the issue is still underway.

The Russian vaccine uses two common cold viruses that have been genetically modified to carry genes of the coronavirus, which prime the immune system to prevent infection. Developers of the vaccine have said the second dose lengthens the period of time a recipient is immune.

In other countries, health authorities have been wary about approving a simplified single-shot approach for vaccination using vaccines that were tested in trials using two shots.

But the first shot of Sputnik V uses the same common cold virus as the single-dose Johnson & Johnson vaccine, which already has been approved for use in the United States and other countries and has been shown to be safe and effective, with an efficacy of 72 percent in the United States.

The Russian version of this single-shot approach is called Sputnik Lite.

The two-dose Sputnik V vaccine is still being offered in Russia and to dozens of other countries. Russia’s export customers could also speed up their vaccination campaigns if they follow the Russian Ministry of Health’s lead in approving a single-dose strategy.

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With India drowning in crisis, Modi’s party loses big in a key election.

One of India’s feistiest opposition parties cruised to victory in a crucial state elections in West Bengal on Sunday, dealing a blow to Prime Minister Narendra Modi in a campaign held during a catastrophic Covid-19 surge.

Top parties, including Mr. Modi’s Bharatiya Janata organization, had campaigned relentlessly in West Bengal, one of India’s most populous states and a stronghold of opposition to Mr. Modi, India’s most powerful prime minister in decades. Mr. Modi and other politicians held enormous rallies up and down the state, which critics said helped spread the virus.

Many Indians were stunned that the elections were even held. The entire country is facing its greatest crisis in decades, experiencing vast sickness and death from a second wave of the virus. Hospitals are so full that people are dying in the streets.

Cremation grounds are working day and night, burning thousands of bodies. The country is rife with the more lethal and more transmissible B.1.1.7 variant of the coronavirus first found in Britain, as well as a homegrown variant, B.1.617. Experts are worried that the unchecked outbreak will spawn more dangerous variants.

A.P. reported.

On Saturday, India reported nearly 3,700 deaths, its highest daily toll yet. Over the weekend, the country logged 401,993 new cases and then 392,488, tallies that no other country has ever seen. And experts say the real toll is far higher.

Critics have blasted Mr. Modi’s handling of the crisis. A sudden, harsh lockdown imposed early in the pandemic sent millions of laborers scrambling back to their home villages and disrupted the economy. When cases dropped, his government failed to heed warnings of a potential resurgence from scientists, and its own Covid-19 task force did not meet for months. Mr. Modi himself declared a premature victory over Covid in late January, during what proved to be a mere lull in infections.

Mamata Banerjee, India’s only female chief minister, who has developed her own cult of personality and a reputation as a street fighter strong enough to ward off the most withering attacks from the B.J.P., as Mr. Modi’s Hindu nationalist party is commonly known.

Mr. Modi posted a Twitter message on Sunday night that said, “Congratulations to Mamata Didi,” which means sister Mamata.

“The Centre will continue to extend all possible support to the West Bengal Government to fulfill people’s aspirations and also to overcome the COVID-19 pandemic,” Mr. Modi wrote.

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Russian Attempts to Expand Sputnik Vaccine Sets Off Discord in Europe

BRATISLAVA, Slovakia — When Slovakia’s prime minister welcomed a military aircraft carrying 200,000 doses of the Sputnik V vaccine from Russia in March, he posed proudly for photographs on the tarmac in front of crates stuffed with what he expected to be his country’s medical salvation.

Slovakia at the time had the world’s highest per-capita death rate from Covid-19, and the arrival of the Russian vaccine offered a rare glimmer of hope. For Russia it offered big benefits, too: a small but symbolically important new market for its product in the European Union, which has so far declined to register the vaccine and urged member states to hold off on orders until approval is granted.

But the effort by the Slovakian leader, Igor Matovic, soon blew up in his face, costing him his job and almost toppling the whole government — just three months after it adopted a new security strategy rooted in unequivocal support for NATO and wariness of Russia.

The strongly pro-Western Slovak government, torn between its commitment to abide by European rules and desperation for a way out of the health crisis, spasmed in crisis for weeks.

Sputnik V, the world’s first registered vaccine, is the medical breakthrough proclaimed last summer by President Vladimir V. Putin of Russia, but it has already proved itself to be remarkably effective in spreading disarray and division in Europe.

In France, President Emmanuel Macron talked to Mr. Putin recently about possible deliveries of Sputnik, which Mr. Macron’s own foreign minister derided as a “propaganda tool.” The Austrian chancellor, Sebastian Kurz, furious that European regulators have been slow in approving Sputnik, has clashed with Germany’s leader, Angela Merkel, over the bloc’s vaccination program, which so far involves only Western vaccines.

But Slovakia provides the most concrete example of how Russia’s vaccine diplomacy has had side effects that can be highly toxic.

The decision by Mr. Matovic, then the Slovakian prime minister, to order two million doses of Sputnik V set the country at odds with the European Union and brought one of Eastern Europe’s most stoutly pro-Western governments to the brink of collapse as junior partners in a fractious governing coalition, outraged by the import of Sputnik, defected.

said in a tweet in February that Mr. Putin offered Sputnik V to the world as a “weapon to divide and rule.” And Poland said it was considering buying Chinese vaccines, despite similar concerns about it, but would definitely not order Sputnik V.

A recent survey by the Globsec research group found that, among those willing to be vaccinated, only 1 percent of Poles and Romanians and 2 percent of Lithuanians would choose Sputnik over American and European brands. Even in Hungary, the lone European Union member to start inoculating its citizens with Russia’s product, only 4 percent want Sputnik V.

But in Slovakia, around 15 percent of those willing to be vaccinated expressed a preference for the Russian vaccine, offering Moscow an opportunity to break out of the quarantine imposed by deep suspicion elsewhere.

That Russia targeted Slovakia as a place to widen Sputnik’s narrow beachhead in Europe was evident long before Mr. Matovic decided to order the vaccine.

video on Facebook in January saying that he was ready to help broker a deal with Moscow for the delivery of Sputnik.

His pitch appealed to the generally Russia-friendly sentiments of many ordinary Slovaks, particularly those of an anti-establishment bent.

Martin Smatana, a former Health Ministry official in Bratislava, said he had been amazed by how many of his friends want the Russian vaccine and say, “Screw the system, use Sputnik.”

a report this past week, the European Union’s foreign service said that Russia’s drive to promote Sputnik abroad was aimed at “sowing distrust” in Europe’s medicines regulator and stoking divisions.

In response, the Russian state investment agency spearheading Sputnik’s export drive lamented that the vaccine, which it hails as a “vaccine for all mankind,” has fallen victim to “unfortunate daily information attacks.” On Friday, after Brazil raised concerns about Sputnik, complaining of inadequate data, the vaccine’s developer in Moscow, the Gamaleya Institute, issued an angry statement complaining that “unethical forces continuously attack the Sputnik V vaccine for competitive and political reasons.”

The testy arguments in Slovakia over the vaccine reached a peak in April when the country’s drug regulatory agency claimed that Mr. Matovic had fallen for a Russian bait-and-switch. It said the vaccine doses sent to Slovakia at a cost of around $2 million differed from the Sputnik V reviewed favorably in a peer-reviewed February article in The Lancet, a respected British medical journal.

The Slovak claim, denounced by Moscow as “sabotage,” cast doubt on Sputnik’s main selling point: a proven efficacy rate of over 90 percent against Covid-19. The Lancet gave the vaccine 91.6 percent efficacy in February, and Russian scientists have since claimed a “real world” rate 97.6 percent.

But the main issue with Sputnik has never been whether it works — most experts believe it does — but Russia’s repeated failure to follow procedure and provide all the data needed by foreign regulators to assess safety. Slovakia’s regulator made its damning statement not because it had discovered any specific problems with Sputnik but “due to the lack of data from the manufacturer, inconsistencies in dosage forms and inability to compare the batches used in different studies and countries.”

The 200,000 doses that Russia delivered in March were still all unused at a pharmaceutical company in eastern Slovakia as of last week. But Mr. Matovic said Russia had already returned the money paid by Slovakia.

Pavol Babos, a political analyst in Bratislava, said Mr. Matovic was “never pro-Russian” but “very naïve.” Desperate for a way to slow the pandemic and lift his own slumping ratings, the prime minister, Mr. Babos added, “fell into a trap set by Russian propaganda.”

But Mr. Matovic scoffed at accusations that Moscow had played him to promote its own geopolitical agenda. The Russians, he said, “wanted to help, but instead of thanking them we said, ‘You are stupid, and you are cheating people around the world.’”

Most at fault, Mr. Matovic said, was the State Institute for Drug Control, which asserted that the Sputnik V batches Russia sent to Slovakia did “not have the same characteristics and properties” as the version V reviewed by The Lancet. This, he said, “was an extremely incorrect political statement.”

Zuzana Batova, the institute’s director, who has received death threats from aggressive Sputnik fans, declined to be interviewed, saying she did not want to pour oil on the fire.

The head of the Biomedical Research Center, which carried out a series of 14 tests in Slovakia on the Russian vaccine, said she had no concerns over whether Sputnik V works but was troubled by Russia’s lack of transparency.

While the potential side effects of the AstraZeneca and Johnson & Johnson vaccines have been documented in detail publicly, the center’s chief, Silvia Pastorekova, said, “We know nothing about Sputnik’s side effects.”

The Russian vaccine, she said, passed all of her team’s tests but failed to win approval from the state regulator because more than three-quarters of the documents required to meet European norms had either not been submitted or were incomplete.

“We are part of the European family and we should accept the rules of the family,” Ms. Pastorekova said.

Monika Pronczuk contributed reporting from Brussels, and Kristina Hamarova from Bratislava.

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Modi’s Party Is Set to Lose a Key Election, Held Under the Cloud of Covid

NEW DELHI — One of India’s feistiest opposition parties was leading in early results on Sunday from elections in the state of West Bengal, a closely watched race held during a catastrophic surge of Covid-19 infections.

Top parties had campaigned relentlessly in West Bengal, one of India’s most populous states and a stronghold of opposition to Narendra Modi, the powerful prime minister. Even with cases soaring and more and more people dying across India, Mr. Modi and other politicians held enormous rallies up and down the state, which critics said helped to spread the disease.

By early Sunday afternoon, Mr. Modi’s Bharatiya Janata Party was trailing despite its heavy investment in West Bengal, a prize it desperately wanted to win. The party looked likely to win more seats in the state assembly than it did in the last election — a sign of how dominant it has become nationwide. Nevertheless, the All India Trinamool Congress party, which holds power in the state, seemed to be safely ahead.

Mamata Banerjee, India’s only female chief minister, who has developed her own cult of personality and a reputation as a street fighter strong enough to ward off the most withering attacks from the B.J.P., as Mr. Modi’s Hindu nationalist party is commonly known.

very divisive religious and citizenship issues, will remain a stronghold of the B.J.P.

working day and night, burning thousands of bodies. In New Delhi, there is an acute shortage of medical oxygen, and dozens have died gasping for breath in their hospital beds.

On Sunday, India reported around 400,000 new infections and nearly 3,700 deaths, its highest daily toll yet. Experts say that is a vast undercount and that the real toll is far higher.

Mr. Modi was scheduled to meet with his health minister on Sunday to discuss the oxygen shortage and concerns that doctors and nurses are overwhelmed and exhausted. On Saturday, Indian officials announced that the first batch of the Russian vaccine, Sputnik V, had arrived, a boost to India’s flagging inoculation campaign.

Critics have blasted Mr. Modi’s handling of the crisis. His government failed to heed warnings from scientists, and its own Covid-19 task force did not meet for months. To signal that India was open for business, Mr. Modi himself declared a premature victory over Covid in late January, during what proved to be a mere lull in infections.

the emergence of more dangerous variants and the sluggish vaccine campaign, is believed to have fueled the staggering number of infections, the worst numbers the world has seen.

The West Bengal election was held in stages, beginning in late March and running through last week. Many critics said it should have been called off, or that rallies, at the very least, should have been stopped.

But that did not happen. Mr. Modi’s party went on the attack, telling Hindu voters that if they didn’t vote for Mr. Modi’s party, their most deeply held religious beliefs might be in danger.

Ms. Banerjee, 66, who has led the state for a decade, dismissed that as nonsense. Long popular among Muslims and other minorities, she also appealed directly to Hindus, painting the B.J.P. as outsiders to her state who were intent on stirring up trouble.

Mr. Modi traveled to West Bengal about a dozen times for packed rallies (often failing to wear a mask, along with many people in the crowds). His face was so ubiquitous that people joked that he seemed to be running for chief minister, the top state-level executive in India’s decentralized system.

Ms. Banerjee’s campaign slogan was simple and nativist: “Bengal chooses its own daughter.”

Even with this likely loss, Mr. Modi’s party is by far the dominant political outfit in India, and there is no other political figure who comes close to his popularity.

Still, given how hard he fought to win West Bengal, some analysts saw Sunday’s results as a blow to him, with Ms. Banerjee and other regional figures — specifically, M.K. Stalin in Tamil Nadu and Pinarayi Vijayan in Kerala — gaining strength.

“This government is now battling a public backlash on their mishandling of the Covid pandemic,” said Arati Jerath, a well-known political commentator. “I think it is bad news for Modi that three powerful regional chieftains are emerging from these elections.”

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