India has supplied more doses of Covid-19 vaccine elsewhere than it has administered to its own people, a top Indian diplomat told the United Nations General Assembly last week.
Notwithstanding global praise for its altruism, the government in New Delhi is reassessing its international supplies, with a worrying spike of new infections at home.
As at Tuesday, India has exported 64 million doses to about 84 countries, while a million fewer doses had been administered within India.
But outbound vaccine supplies have been tightened as the number of daily cases has shot up from less than 20,000 to more than 50,000, with the Ministry of Health and Family Welfare warning the situation had gone from "bad to worse".
Domestic demand for vaccines is anticipated to go up from today as the world's second-most populated country starts vaccinating all citizens aged 45 and above, aiming to inoculate 300 million people by August.
Before this, only health and front-line workers, those aged above 60, and those above 45 with chronic illnesses were eligible.
Despite the reassessment, India will continue supplying other countries "in a phased manner", sources said.
"We have not imposed any ban on exports of vaccines, unlike many other countries," the sources said.
Over the past few days, Foreign Minister S. Jaishankar, keen to dispel any notion that India's vaccine diplomacy has stalled, tweeted pictures of shipments of India-made vaccines arriving in various destinations, including Palestine, Paraguay, Niger, Zimbabwe and Fiji.
"Reaching Ramallah. Made in India vaccines arrive in Palestine," he tweeted on Tuesday.
India rolled out its ambitious vaccine export programme, rivalling China's, in a move to fortify its international influence.
The programme was underpinned by India's manufacturing prowess in the pharmaceutical sector. The South Asian country is the world's third-largest producer of medicine and supplies nearly 60 per cent of global demand for vaccines.
India has approved two vaccines for public use. One is Covishield, which is the name for the Oxford-AstraZeneca vaccine that is being manufactured by the Serum Institute of India (SII). The other is the indigenously developed Covaxin from Bharat Biotech.
Mr Oommen C. Kurian, head of the health initiative at the Observer Research Foundation, a think-tank, said the Narendra Modi-led government had taken a "big domestic political risk" by exporting vaccines.
"If India still continues to export large numbers of doses without expanding immunisation considerably now that cases, as well as deaths, are rising, the Bharatiya Janata Party's core constituency may not like it. The government is, therefore, likely being cautious," he told The Straits Times.
"Two weeks down the line, we don't know how many vaccines we will need. We may even choose to go for universal vaccination in some districts or even states."
The squeeze by India has hit Covishield supplies to 64 low-income countries through the Covax Facility, an international vaccine-sharing initiative.
Covax said last week that some deliveries anticipated last month were now expected this month, because of an increased demand within India.
Covax has received 28 million Covishield doses and was expecting an additional 40 million to be available last month, and up to 50 million this month.
SII is expected to supply 240 million vaccine doses to Covax, with about 97 million of these earmarked for India as part of Covax's interim global distribution forecast.
"India has drawn only 10 million doses from this Covax quota so far, which is well within its planned allocation," Mr Kurian said.
"The biggest beneficiary of the Covax SII vaccine - India - was doing all right, so to speak, when initial Covax allocations were planned. Now we are in trouble, so allocations are understandably being recalibrated."
At least two Indian states - Rajasthan and Odisha - have complained about vaccine shortages, forcing them to scale down their vaccination efforts. The federal government, however, maintains that supplies are adequate and that exports have not come at the cost of national interest.
India is expected to soon approve a third vaccine - the Russian-made Sputnik V - in an effort to ramp up availability. It will be distributed domestically by Dr Reddy's Laboratories, a company headquartered in Hyderabad.
But Ms Nissy Solomon, a senior research associate at the Centre for Public Policy Research, noted that India's vaccine approval system had subjected foreign vaccine makers to "umpteen regulatory compliances", restricting their production.
