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Who should receive the COVID vaccine first in India

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The discussion and debate around who should receive the vaccine first once it is out is perplexed. In its truest sense, it is a question of logic rather than science but then again what form of logic should be entertained? Is it the medical officers and other health workers including volunteers as well as police personal that should get the priority no matter the age (not as a note of thanks for their efforts but because of their direct contact with infected patients) or is it the elderly who have been the victim of the virus in the worst way, that is, often leading to deaths should be at the top of the list. Again, should there be sub-categorisation on the basis of what disease or medical condition someone is suffering from amounting to more or less risk of the virus or on the basis of social classifications of gender, caste and even class. Yes. the priority set on the basis of caste and class will not be a complete surprise for a country like India, where finally the decision will be politically motivated rather than scientifically provoked.

Yet, assuming that a vaccine actually prevents transmission of the virus, then the priority should go to those who transmit the disease most often – younger adults, or as psychologist Erik Erikson describes as a person who is between the ages of 19 and 40, a group sandwiched between the adolescent, teenage youth and middle adulthood stage. The reason is quite simple and logical – getting protected with a vaccine is a way of protecting others, since you can’t give someone the disease if you never get it and the age group of 20-40 is the most susceptible and most likely to get the virus, they being the pillar of the working class population in India and hence more involved in the day to day economic activities. Moreover, they are more likely to physically sustain themselves without showing the symptoms or without getting medically deranged than the other ‘weaker’ age group of 50-60 or above, hence increasing the chances of spreading the virus unknowingly.

But why give the vaccine to people most likely to spread the disease rather than to people most likely to die from it? Virologist David Sanders of Purdue explains that it’s likely that Covid-19 vaccines won’t work in people with poor immune systems – those most vulnerable to the disease. But those people can still be protected to a great extent if healthy people get vaccinated on time to stop the spread. “Immunization is not about protecting the individual – it’s about protecting the society,’ he says.

According to Integrated Disease Surveillance Programme, a Health Ministry body, about half of the infections in India are in the age group of 20-40 as of August, a figure that is evident enough to show the group’s priority in receiving the vaccine.

X-axis – age group, Y-axis – share in COVID cases in percentage
Source: National Centre for Disease Control

Another set of data from the Health Ministry shows the percentage shared in the death count by different age groups –

AgeShare in total population% share in all COVID-19 deaths (as of July)
<= 14 years35%1
15-2918%3
30-4422%11
45-5915%32
60-748%39
>=752%14

Data sourced from here

These stats are alarming (because of the disproportionate share in cases and deaths) and also prove the point that the young adults need to be looked out, for them to not spread the disease to the older age groups to reduce the fatal count.

But here’s the catch: if young, healthy people unlikely to die from the virus are to be vaccinated first, the odds of any serious side effects, both short term and long, have to be extremely low. The whole process of vaccination and its efficacy will only truly make sense thereafter. And that’s one of the reasons why field testing or clinical trials is important.

There are different Phases of this testing method. Phase 1 will determine the optimal dose for a vaccine. Phase 2 enrolling hundreds of people can reveal common side effects and determine whether the vaccine prompts the body’s immune system to produce antibodies that are capable of disabling the virus (some of the milder, short run side effects can and should be tolerated keeping in mind the number of people dying on a daily basis).

Phase 3 is the time-consuming part and according to many, the most vital phase. Here, the vaccine will be compared to a placebo in the real world. At least a few hundred people in the placebo group need to get infected to demonstrate efficacy, which takes time and rigorous data collection and analysing methods for success. It is in this phase that the researchers can tell if the people who got vaccinated can still get back the virus, even silently or mildly and transmit to others. But many argue that even enrolling hundreds or even thousands of people for this phase will never be enough to reveal any rare showcase of side effects (the live polio vaccine caused a few children to get polio – about 1 in 2.8 million in India). It is thus in Phase 4, mostly a data-gathering phase, a sort of post licensure surveillance, that a vaccine’s efficiency and efficacy can be judged and verified. It will help prevent problems that might get in the way of widespread adoption of any COVID-19 vaccine. It is a step in the right direction but also something that many countries and institutions are going to skip keeping in mind the urgency of the pandemic.

But skipping Phase 3 altogether citing the urgency might backfire rather than serving the purpose of pre-emptive action (of defeating the virus). It is this Phase that countries like Russia most likely to skip to make the vaccine available at the earliest. With plans of already making a deal with India and India on its own developing the vaccines ZYCOD-D (by ZYDUS) and COVAXIN (by BHARAT BIOTECH) that are to be made available sooner between September and December, a move that may have come amidst the political pressure to ICMR are worrisome to some extent (quick trials may lead to mismanagement and faulty results). With one of its two indigenous vaccines already in Phase 3 trials, India will have both the vaccines ready by next year, that is 2021 (if the emergency approval of an earlier availability is not granted), which is not to worry about as the Oxford vaccine is to be made available to Indians before that.

What will finally matter is the right people receiving the vaccine first and that too in a planned manner without the influence of money, power or any social stigmas.Those not following it should be held accountable under legal grounds. Cost of the vaccines and accessibility will also play a crucial role. After all, it’s about the vaccination more than the vaccine. 

Vidhi Bubna is a freelance journalist from Mumbai who covers international relations, defence, diplomacy and social issues. Her current focus is on India-China relations.

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South Asia

Growing insecurity in Rohingya Refugee Camps: A Threat to South Asian Security?

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A young Rohingya girl holds her brother outside a youth club in Cox's Bazar, Bangladesh. © UNHCR/Vincent Tremeau

5 years have passed since the Rohingya refugee influx in August, 2017.  Bangladesh is currently hosting 1.2 million Rohingya refugees in 34 camps in its southern district of Cox’s Bazar. The increasing rate of trans-border crime in those bordering camps is not only making the Rohingya refugees vulnerable and prone to crimes but also threatening South Asian security as a whole. The Rohingya community leader’s speech of “We don’t want to stay in the camps. It’s hell.” in the ‘Go Home’ campaign in 20th June, 2022, made us rethink about the security situation in the camps and how the safety and security of Rohingya refugees is linked to South Asian Security.

Security Situation inside the Rohingya Camps

More than 1,200,000 Rohingya refugees are now living in the camps in Ukhiya and Teknaf in Cox’s Bazar, making it the largest refugee settlement in the world. While Bangladesh has the ninth-highest population density in the world, around 40,000 to 70,000 refugees are living in per square kilometre in the Rohingya camps, which is 40 times higher than the average population density in Bangladesh. With no sign of repatriation combined with the lack of economic alternatives for Rohingyas and the difficulty in maintaining law and order in overcrowded camps, frustrated Rohingyas are increasingly becoming involved in criminal activities or being targeted by criminal groups.

Currently, around 14 armed criminal gangs are operating in the camps, in which seven gangs known as Hakim Bahini, Hasan Bahini, Sadeq Bahini, Nurul Alam Bahini, Nur Mohammad Bahini and Hamid Bahini are in Teknaf and seven gangs named Munna Bahini, Asad Bahini, Jamal Bahini, Manu Bahini, Rahim Bahini, Kamal Bahini, and Giyas Bahini are active in Ukhiya camps.

According to law enforcement agencies at least 10 groups among these are engaged in 12 types of crimes including murder, rape, kidnapping, drug smuggling and human trafficking. The fighting over controlling the camps among the armed gangs is also deteriorating the security situation inside the camps. A Rohingya refugee in the camps said in an interview, “Everything seems calm in daytime. After sunset, the situation becomes fully different.” As there is no police or army surveillance from 4 pm to 8 am, camps come under the control of gangs at night. They are equipped with weapons like lead meat choppers, knives and other made weapons.

According to Prothom Alo report citing the police, in the last two and half years, more than 50 Rohingyas have been killed in clashes between Rohingya armed gangs over establishing supremacy in the camp area, drugs and gold smuggling, money laundering and extortion.  Recently, the Armed Police Battalion (APBn) has recovered M16 assault rifles with 491 bullets from a camp in Ukhiya which indicates the worsening security situation in the camps. At night Rohingya women are also taken from their houses & are return in the morning. At least 59 women have been raped in the Rohingya camp. As crimes often go unpunished, no one in the camps has the courage to speak against the criminals. Sometimes, for ensuring own security, Rohingyas themselves, including children become engaged with smuggling, narcotics trafficking and other crimes.

As of May 2022,a total of 12,97 cases have been filed against 3,023 Rohingyas. Among them, 73 cases are in charge of murder, 762 are narcotics cases, 28 cases are filed on the allegation of human trafficking, 87 for illegal weapons, 65 are rape charges, 35 for kidnapping and ransom, 10 for robberies, and 89 are other cases related to crime and violence.

Besides, it is believed that Arakan Rohingya Salvation Army (ARSA), a Rohingya insurgent group are also active in Rohingya camps and made contract with a Jamaat-ul-Mujahideen Bangladesh (JMB). ARSA is not only relying on arms like AK-47s, M-22s, M-21s and M-16 rifles but also gaining support through other means. More than 500 madrassas in the Rohingya camps are  said to be controlled by an ARSA affiliates which will help ARSA to gain sympathy, spread propaganda and extend their network.

A Threat to South Asian Security

Since Cox’s Bazar provides a strategic route for smuggling and a shelter to Rohingyas refugees who have lack of economic alternatives, the bordering Rohingyas camps are turning into a breeding place for criminalities and the insecurity in the camps can threaten the security of the whole region.

Cox’s Bazar is used as a direct route from eastern India to Nepal for arms smugglers to reach Indian and Nepali buyer. United Liberation Front of Assam (ULFA), an insurgent group seeking independence from India, also buys arms from China and smuggles them using Bangladeshi ports and overland to India.

The Naaf river, the border between Bangladesh and Myanmar, is also the busiest drug route in the region. Almost 80% of Yaba enter in Bangladesh through Naikhyangchhari and 70% of them are stored in Rohingya camps before distributing them and Rohingyas are increasingly getting involved in peddling yaba for their survival.

Besides, drug trafficking, Rohingyas are also taking part in trans-border crimes, including human trafficking, extremism, arms fighting and the camps can be a potential base for extremist activities and the insecurity in the camps and border could transcend to Bangladesh anytime and create insecurity for the whole region of South Asia. As there is a growing concern over the recruitment of refugees by the extremist networks like Hizb-ut Tahrir and Jamaat-ul-Mujahideen Bangladesh (JMB), as well as by radical Islamist groups like HeI. It is also reported that the influence of HeI is growing among the traumatized and frustrated Rohingyas which could fuel militancy not only in Bangladesh but also across the South Asian region. Along with this, the Rohingya militant groups bordering Myanmar i.e.  Arakan Rohingya National Organization (ARNO), Rohingya National Alliance (RNA), the Arakan Rohingya Islamic Front (ARIF), and Rohingya Solidarity Organization (RSO) could also recruit from Rohingyas and threaten regional security.

From security perspective, ensuring the security of Rohingyas is directly linked to the security of the region Though Bangladesh has taken several measures to ensure the security of these displaced people, it is tough to maintain law and order in the densely populated camps near the border. Therefore, safe, sustainable and dignified return of these displaced people is the only solution. Since Rohingya refugees have also expressed their desire to go home through the “Go Home” campaign, in which thousands of Rohingyas in Ukhiya & Teknaf camps staged demonstration on World Refugee Day demanding their repatriation back to Myanmar. Bangladesh as well as the international community should act together to facilitate Rohingya repatriation to ensure the security of Rohingyas as well as the South Asian region before its too late.

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Rohingya repatriation between Myanmar-Bangladesh

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Rohingya refugees fleeing conflict and persecution in Myanmar (file photo). IOM/Mohammed

Refugees find themselves in a situation of limbo because of the prolonged refugee scenario. They are neither eligible for repatriation nor do they qualify as citizens of the host nation or a third country. However, they must deal with the harsh reality of the nature of vicious politics because of the complexity of state systems and the institutional weaknesses of international institutions.

Prolonged refugees, according to UNHCR (2004), are trapped in an impenetrable and protracted condition of limbo. Despite not being in danger or facing threats, they significantly lack access to basic rights, financial aid, and support for their psychological and social needs. As they are pushed toward outside help, they feel unable to escape the core of forced dependence.

Are Rohingya refugees in some way contributing to an ongoing, serious refugee crisis? In relation to the Rohingya crisis, statistics from UNHCR shows that more than 0.7 million Rohingya fled to Bangladesh in 2017. There are 1.1 million Rohingya refugees in Bangladesh, the prime minister of Bangladesh stated in 2018 during the 73rd United Nations General Assembly.

For this South Asian emerging nation in 2017, the flow of this deluge was nothing new. These migrants have been entering Bangladesh since the 1970s after being forcibly uprooted by the military dictatorship.

According to a survey, there were around 0.25 million refugees in Bangladesh throughout the 1990s. Nearly 0.02 million people were returned after the 2000s, but the SPDC (State Peace and Development Council) and the Bangladeshi government’s inability to settle their differences has made this process difficult to complete.

The world’s most persecuted minority, who is clearly stateless and has strong proof of persecution and genocide on account of race, ethnicity, and religion, is currently being cared for by Bangladesh. The responses of international organizations like the UN and its branches like the ICJ and IOM are not positive enough for Bangladesh in this regard to produce a permanent solution.

West African nation Gambia filed a 35-page application with the International Court of Justice (ICJ) in November 2019 against Myanmar. The ICJ’s extraordinary victory in the Gambia v. Myanmar case regarding the ethnic cleansing and genocide of Rohingya people is the first of its kind. This was founded on an “erga omnes” premise, which periodically reports on the situation of the Rohingya.

However, Bangladesh continues to push for international organizations to take humanitarian action through the UN. Though this worry might attract their attention and drive them to consider ensuring human rights for these forcibly displaced persons, it has instead placed a heavy load on Bangladesh.

Tom Andrews, the UN special rapporteur on Myanmar, issued a warning to the international bodies regarding the Rohingya crisis just a few days ago during his visit to Bangladesh in December 2021. Bangladesh “cannot and should not bear this duty alone,” he said, urging foreign groups to express grave concern. He went on to say that Myanmar, not Bangladesh, was the origin of the conflict and where it will ultimately be resolved.

Bangladesh, a developing nation with a population of 160 million, is being horribly impacted by the Rohingya people in terms of social, economic, and political spheres. Rohingyas have been in a condition of limbo since at least 2017, which is now more than five years ago.

They have been relocated, assisted, and given security by Bangladesh and several international organizations, but they still yearn for a long-lasting solution.

Bangladesh has been taking every action imaginable to bring the Rohingya refugees’ home. Since the 2017 refugee inflow, the Bangladeshi government has worked with various international groups to promote peaceful voluntary repatriation; however, the Myanmar military junta has consistently resisted these efforts. Refugees from the Rohingya minority are currently suffering greatly as a result of the political unrest in Myanmar.

As Cox’s Bazar’s refugee camps are already overflowing with 1.1 million Rohingya refugees, the Bangladesh is moving them to Bhasan Char in order to provide for them improved living conditions.

International organizations had doubts regarding the safety and security of the Island; however, Bangladesh eventually persuaded them to cooperate. Bangladesh was left with no choice but to relocate some Rohingya refugees to Bhasan Char. Bangladesh now faces a security danger from overcrowded camps. The Rohingya camps in Bangladesh are home to numerous terrorist and armed rebel organizations. One of them is the Arakan Rohingya Salvation Army (ARSA). Despite the issues, Bangladesh has continued to push for bilateral discussions while also applying international pressure to the junta.

Myanmar, on the other hand, is a lawless state that disobeys international law and order. The arrangements established for the peaceful return of Rohingya refugees were broken.

In Myanmar, the regime has been increasingly hostile since the military takeover. Myanmar is utterly unwilling to help the Rohingya refugees develop a strong sense of desire for return. There is no “supranational” authority in anarchy, which is advantageous for Myanmar. It is now time for the international community to recognize that the Rohingya refugee crisis has grown into a regional security issue.

Myanmar-related news indicates a new genocide. the country’s rebel and protest groups are being repressed by the military junta with violence.

The Myanmar military is still buying new weapons from China and Russia, including the SU-30SME multi-role heavy fighter, the YAK-130 light attack advanced jet trainer, the K-8W advanced trainer, and Ming class attack submarine, among others, despite an arms embargo. The world community is concerned that these weapons could accidentally attack defenseless populations. A peaceful voluntary return will face further obstacles as a result of internal unrest in Myanmar.

The Rohingya catastrophe, which forced 1.1 million individuals to leave their country of birth due to state-sponsored persecution, was of a size that is easy to comprehend. When the state commits the crime, the environment becomes more hostile. The main duty of the state is to uphold the rights and interests of its citizens.

Refugees are currently skeptical of the military junta in Myanmar. They have a long and painful history of persecuting people. Therefore, persuading the refugees to return home voluntarily won’t be simple. Myanmar must extend their hands in mutually beneficial ways. More discussions between international parties, including the Rohingya, will build confidence and facilitate a peaceful voluntary return of the Rohingya refugees. Humanity and peace should ultimately triumph over all other factors.

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Why the implementation of the CHT peace agreement is still elusive?

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When the “Top boxer” of Bangladesh, for the past eight years, Sura Krishna Chakma raised the national flag of Bangladesh in the first-ever professional boxing tournament held in last month, it reminds the contribution of the UK Ching Marma and other minority people who fought valiantly in the Liberation war of Bangladesh in 1971.

Bangladesh began its independence journey with a population that is ethnically homogeneous, with less than 1% of the population being ethnically diverse. However, Bangladesh had struggled to deal with Chittagong Hill Tracts’ (CHT) tribal people as they have been waging an insurgency movement for autonomy. Later, Peace Accord was signed aiming to end the conflict in 1997. But, after 25 years of its signature, the treaty is still failing to instil trust among national political parties and factional groups. Currently, the situation in the CHT area is a complex mix of conflicts and negotiations. The area is also beset by ethnic tensions between indigenous communities and groups, interferences from neighbouring states, widespread poverty, resource scarcity, and low literacy rates.

Why peace in the CHT is still elusive?

In recent years, remote areas of CHT have become more prone to violence due to the involvement of various active groups in the area. The four ethnic political groups – PCJSS, Jana Samhati Samiti (Reformist-MN Larma), United People’s Democratic Front (UPDF) and UPDF (Ganatantrik) – in the region appear to be at odds with one another. They have no ideological disagreements but are involved in inter-conflict for narrow self-interest rather than protecting the minority rights. All factions have specific armed wings with advanced weapons such as rocket launchers, automatic sniper rifles, and heavy machine guns, according to law enforcement. They extort wood trade, cooking markets, livestock markets, transportation, and a variety of other services, each on their own turf. Ransom for the abduction of ethnic groups and Bangalis are also a major source of income. Contractors also have to pay at the rate of 10 percent of the original budget. To stay safe, locals were forced to maintain good relationships with all parties. They are compelled to pay monthly tributes to remain in their homes. There are even reports of indigenous women being abducted and raped by rival groups. They are so vulnerable and frightened that they do not even move after the sunset. The inter-group conflicts have claimed more than 1100 lives since the signing of the peace accord. Although according to the terms of the accord, the guerrillas were to surrender and surrender their weapons but many haven’t surrendered arms yet.

What’s to blame for the present unrest?

The agreement’s lethargic implementation has reignited separatist tendencies among the Paharis. Recently, the Kuki-Chin National Front (KNF), an insurgent organization of small ethnic group, demanded a separate state in CHT with full autonomy and threatened strict armed movement. Prior to this, The UPDF, a breakaway group, continues to oppose the treaty and seeks full regional autonomy.

The most pressing concern in CHT, however, is extensive Christianization among the tribal population. ‘Evangelization’ is generally carried out by the missionaries through a number of NGOs operating under the umbrella of “development partner.” Christian missionaries use money and other worldly trappings to entice poor tribal people to become Christians. So far, 4344 families in CHT became Christian in the last two decades and the number of churches increased dramatically from 274 in 1998 to 644 in 2022. It’s worth noting that more than a third of the Bandarban district’s tribal population is now Christian.

Impact of the Peace Accord on the Situation of ethnic People

Certainly, the Peace Accord made room and rendered opportunities for the CHT’s development. In these 25 years, comprehensive and systematic development efforts have contributed to the socio-economic development of the Pahari people, which immensely contributed in reducing the gap between the Pahari and Bengalis. Many tribes are well-integrated into mainstream middle-class Bangladeshi society, with officers and ambassadors serving in Bangladesh’s military and diplomatic corps.

With its contrasting topography of hilly terrains, immense lakes, wide-open spaces, as well as rich ethnic and cultural diversity, tourism industry flourished in the CHT. Tourism boosted due to the infrastructural projects connecting the remote and mystic parts with the main areas of the country and security ensured by the law enforcement agencies from the precarious hilly terrain to the remote bordering area. The treaty also integrated the CHT people into the mainstream economy, while permitting them to retain their specific ethnic and cultural identities.

The ‘Small Ethnic Groups Cultural Organisation Act 2010’ was passed in order to safeguard and foster the cultural expressions of Bangladesh’s small ethnic groups. Small ethnic groups’ rights are now more recognized by the government in Bangladesh than before. The development allocation per capita in the CHT districts is significantly higher than in the rest other districts. The government has amended some laws to allow for the implementation of the peace accord mainly the formation of the ‘CHT Regional Council’ and the ‘Ministry of CHT Affairs’, establishing the ‘Land commission’ to deal with conflicts over land and natural resource rights. The government is also gradually reducing military camps. The number decreased from 546 to 206. Another feature of post-agreement development in the hills has been the influx of development partners and the extension of NGOs and INGOs in the CHT area.

Way Forward

The first and foremost, the Bangladesh Government must take into cognizance the factors behind the failure of establishing peace in CHT areas to ensure peace in the hilly region. Secondly, the implementation of the remaining articles should also need to be prioritized. So far, out of 78 provisions, 48 provisions of the Accord have been implemented. Hill people strongly believe that the implementation of the Accord is the key to solving problems in the CHT. Thirdly, it is crucial to control the armed factions to evict violence and restore peace to CHT on an urgent basis. Fourthly, both the Hill and the Bengali people emphasize that land disputes need to be resolved immediately. And finally, there is a need for consolidating the progress achieved so far.

Nevertheless, an established misconception is prevailing among the hilly people that their voices are not heard and they are treated differently from the rest of the Bengalis. To eradicate this misconception and build trust and harmony, more initiatives should be undertaken by the government.

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