Indian Prime Minister Narendra Modi and his health ministry drew criticism from doctors and independent scientists who questioned the drug recommendations that he and the Indian Council of Medical Research (ICMR) made. The same group also questioned their lack of transparency on data related to the variants of the virus that emerged from India.
The ICMR is one of the oldest medical research bodies in the world. While it was less-known in the past years, it has taken a bigger role during the COVID-19 pandemic, and it has been given a powerful position that made it controversial in the country's fight against the virus.
Critics speak against COVID-19 therapies
India struggled to curb its COVID-19 surge in the summer, public health experts have warned that the country was ill-prepared to face another wave of infections. Critics have been outspoken regarding the ICMR's decisions, which ended up benefitting the pharmaceutical industry instead of the patients. (Related: Rising coronavirus infection and death rates plague India and Brazil, following covid vaccine rollouts in both countries.)
One of the critics is physician S. P. Kalantri, director professor of medicine at the Mahatma Gandhi Institute of Medical Sciences in Sevagram in the state of Maharashtra, who helps run a 1,000-bed hospital. In an article published in The Lancet, he criticized the ICMR for allowing the health ministry to recommend the anti-malarial drug hydroxychloroquine as a therapy for COVID-19. The drug remained on India's coronavirus guidelines almost a year after it was discarded as a treatment for the virus in the United States.
While Kalantri's hospital in Sevagram refused to prescribe hydroxychloroquine to treat the disease, desperate patients simply bought it where available. "Countrywide, the doctors started writing these prescriptions, which artificially inflated the cost for Covid management," Kalantri said.
Criticisms of the ICMR did not stop with Kalantri. The government and the ICMR were also accused of withholding data on the COVID-19 variants already in India, which did not help physicians treating COVID-19 patients.
They also criticized how the government promoted homegrown vaccine Covaxin before it passed key clinical trials.
Covaxin was approved in January without going through Phase III trials. The two-dose therapy showed 78 percent efficacy in preventing mild, moderate and severe infections, it's also said to work well against other variants.
India's drug regulator, the Central Drugs Standard Control Organization, used arbitrary language in approving the vaccine. It stated that Covacin had been approved for "restricted use in an emergency situation."
The decision was criticized widely for its lack of transparency. They also complained that the organization didn't fully disclose how much funding it has provided for the local shot, leading to accusations of the vaccine's approval being driven by political pressure.
ICMR speak amidst criticisms
Aparna Mukherjee, a New Delhi-based senior scientist at the ICMR said that there are numerous therapies that looked promising, and the organization's guidelines have been evolving as new evidence emerges.
"It’s very easy to criticize when something is put forward," Mukherjee said. "When you know there is some possibility that this drug might work, then just because it is in shortage you cannot say don’t use it."
Mukherjee acknowledged that the ICMR’s remit did widen during the pandemic and said that it was because of the “need of the hour.” The organization has taken on added responsibilities, including testing and procurement of diagnostic equipment.
India's states are now easing lockdowns even though only 6 percent of its population has been vaccinated. Experts questioned whether or not this would result in India experiencing new waves of infections and whether its health network will be better prepared.
"There is a distinct uneasiness in the scientific community on the government’s handling of the pandemic," said Lalit Kant, former head of the ICMR's epidemiology and communicable diseases division. "If we want the third wave to be managed appropriately then we need evidence-based insights."
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