In a new book, Ameer Shahul shows how vaccine development isn’t purely scientific

On September 17, 2021, India administered 2.5 crore Covid-19 vaccine doses in a single day – a staggering world record in the middle of a pandemic. But India did not achieve this feat overnight. It stemmed from decades of capacity-building, scientific innovation, and hard-won lessons about navigating the fraught intersection of health, politics, and power.

In Vaccine Nation: How Immunization Shaped India, journalist and environmentalist Ameer Shahul traces this path, unpacking the triumphs and pitfalls in India’s emergence as a “global vaccine hub”. Through the history of vaccine development, Shahul tells a broader story about Indian science itself. Of how vaccine development helped shape some of the leading national science agencies, namely the Indian Council of Medical Research and Council of Scientific and Industrial Research.

How these institutions emerged from colonial constraints, and independent India transformed these structures – through a fair share of learnings – into engines of scientific self-reliance.

From colonial tool to independent power

The narrative begins with vaccine development under colonial rule. The British prioritised vaccines to protect their military and administration; Indians were just collateral beneficiaries. While this enabled scientific breakthroughs, contributing two major vaccines to the world, it also deepened community resistance. The plague vaccine exemplifies this tension: communities resisted forcible vaccinations used to advance imperial welfare.

Shahul describes how independent India initially stumbled. Poor decisions, bureaucratic obstacles, naïve scientific administration, and misplaced priorities caused vaccine innovation to plummet in the 1950s and ’60s. Yet, there were rays of hope. In 1957, Indian scientists developed an influenza vaccine in four months – an unmatched record in India. More remarkable feats marked the decades that followed. The eradication of smallpox and the long struggle against polio demonstrated that scale and equity were achievable despite resource constraints and bureaucratic hurdles.

Although the book celebrates these successes, it does not romanticise progress alone. It also records how elite preferences for imported vaccines and global pharmaceutical lobbies repeatedly undermined indigenous capacity-building efforts. It reveals how vaccine policy sometimes reflected the interests of privileged classes rather than public health imperatives, even in independent India.

Shahul also narrates how private players emerged in the later decades, despite personal setbacks and family feuds. They undercut global giants and forced the world’s vaccine manufacturers to lower prices.

Throughout, political interests intertwine with scientific decisions. Shahul profiles figures like Haffkine, Sokhey, John, Bhan, Talwar, Varaprasad, Poonawala and others – scientists and industrialists whose commitment often succeeded despite bureaucratic sabotage and global market pressures. Yet, political will fluctuated dramatically. India cycled between periods of sustained vaccine focus and alarming withdrawals of support, causing straightforward public health exercises to be entangled in communal tensions and administrative failures.

Shahul also contextualises how contemporary vaccine hesitancy may be rooted in centuries of asymmetrical power. Pre-colonial variolation gave way to colonial forced vaccinations. Independent India repeated this pattern with the same healthcare workers who forced sterilisations now administering vaccines. This part of vaccine history teaches us how community distrust is not superstition, but rather a reflection of legitimate historical grievances. These pages carry lessons for scientists, science communicators, historians, policy makers and industrialists.

Global inequities and Indian solutions

Shahul situates India’s vaccine history within the broader geopolitics of global health. He describes colonies served as testing grounds for vaccines addressing European diseases, reflecting embedded structural inequities in research and development. The book reveals how India leveraged international partnerships with Western and Eastern blocs to advance vaccine development, but at a cost.

His discussion of vaccine patents, equity, and informed consent reveals past and present concerns in health justice. In the latter part, the book describes how not only India’s public enterprises but also its private players showed the mirror to global pharmaceuticals that profited from developing countries. Shahul recounts stories of Indian companies like Shantha Biotechnics, whose pricing pressured multinational vaccine makers to lower their costs manifold. Besides their quality also forged international partnerships, making these companies vaccine producers for the world.

Vaccine Nation exposes a basic reality: vaccine development is never purely scientific. It is also political, social, economic, and institutional. India’s emergence as a vaccine hub did not just require individual genius, but also deliberate nation-building – establishing institutions, training personnel, negotiating technology transfer, and cultivating public trust.

The book occasionally moves backwards and forward in time, particularly when tracing specific pathogens against which vaccines were developed. While this provides necessary context, it sometimes obscures narrative clarity. Some sections chronicle the history of people and places that may not be immediately relevant to the scope of the book. But in most places, such historical context gives the much-needed perspective of where India stood in the light of global developments at the time. Overall, Vaccine Nation is an engaging and essential read for scientists, students, public health professionals, and anyone interested in the history of Indian science. It points to a hopeful future in the light of current scientific developments in Indian academia and industry.

In an era of renewed global health competition and vaccines, Shahul reminds us that today’s decisions on production, equity, and access will reverberate for generations. India’s journey – marked by extraordinary achievements and preventable failures – offers crucial lessons for global health.

Joel P Joseph is a freelance science journalist and researcher.

Vaccine Nation: How Immunization Shaped India, Ameer Shahul, Pan Macmillan India.