What happened?
On 17 April, Coronavirus Resource Center, John Hopkins University, reported 14,291,917 confirmed COVID-19 cases in India. It has successfully administered 117,223,509 doses of the COVID-19 vaccine. As of 17 April, India had fully vaccinated 14,847,254 people.

On 16 April, according to the data from an independent data aggregator of daily COVID-19 figures, India recorded 2,33,728 cases and 1,338 deaths marking the highest single-day spike so far.

What is the background?
First, rise in cases in India. The country ranks second after the US, which accounts for most of the confirmed cases globally. As of 17 April, Brazil reported 13,832,455 confirmed cases, becoming the third country with the most COVID-19 caseload, followed by France and Russia. India being a densely populated country, has performed relatively better than most of the developed countries.

Second, the inoculation drive. In terms of vaccination, India remains at the top. According to the Indian Ministry of Health and Family Welfare, India is administering 40,556,055 doses on an average per day. However, due to the huge population, the percentage of people fully vaccinated remains low. India is slowly ramping up the production of the vaccines by allowing the production of other vaccines such as the Sputnik V. On 15 April, the Indian government allowed Haffkine Bio-Pharmaceutical Corporation Limited to produce COVAX on a technology transfer basis for one year.

Third, the internal and external crisis due to the second wave. The states and Union Territories have reported a sudden spike in the cases. Maharashtra, Kerala, Tamil Nadu, Uttar Pradesh, Andhra Pradesh, and Delhi account for most of the total cases. This has resulted in high demands for COVID-19 vaccines and health equipment such as oxygen cylinders, ventilators, hospital beds, and scarcity of burial space. The domestic crisis has resulted in a larger global impact. The increase in the COVID-19 cases domestically has adversely affected India's vaccine diplomacy. The country has drastically reduced the export of COVAX and Covishield as it is internally grappled with the second wave of COVID-19. 

Fourth, the uncertainty around the double mutant Indian variant of the virus. On 25 March, The Indian SARS-CoV-2 Consortium on Genomics discovered an Indian variant with two mutations in the same virus. However, it is uncertain that the Indian variant is responsible for a sudden spike in the cases. 

What does it mean?
First, the unpreparedness for the second wave. Although India performs relatively better than most developed countries, it was not entirely prepared for a virulent second wave. The ongoing domestic and external health crisis reflects India's inability to foresee the emergence of the second wave. 

Second, the urgent need to ramp up vaccine production. Keeping in mind the huge population, the Indian government needs to involve more pharmaceutical companies to produce COVID-19 vaccines on a technology transfer basis. The country also needs to import vaccines to curb the shortage, if required. India needs to increase the number of doses administered per day. This will help in curbing the shortage domestically and internationally. 

Third, increased healthcare investment. Taking lessons from the pandemic, India must increase the investment in the healthcare sector. It needs to rethink its inadequate investment in the healthcare sector.