New Delhi: Last week, the race to a Covid-19 vaccine became a 100-metre dash instead of a marathon. The headlines screamed that India was to get a vaccine in less than six weeks, by 15 August — Covaxin, developed by Bharat Biotech along with the Indian Council of Medical Research and the National Institute of Virology.
About 36 hours and scathing criticism later, the ICMR said the deadline was only meant to “cut red tape”, with a terse footnote on how the “best of India’s medical professionals and research scientists should not be second guessed for their professionalism or adherence to the highest scientific rigour”.
The 2 July letter that set the 15 August deadline and flummoxed many came from Dr Balram Bhargava, ICMR’s director general and secretary of the Department of Health Research. For several hours after it started circulating, it was rejected as a fake, with some going to the extent of terming Bhargava’s signature in green ink as “suspicious”.
Bhargava is a cardiologist, medical innovator, head of the country’s apex medical research body, and among the three key medical experts in the government in the thick of the Covid fight, but many said he should have known better than to write such a letter.
‘Impetuous and impulsive’
Those that know him for long, including some of his colleagues at the All India Institute of Medical Sciences, say while they are surprised by it, the letter is “in character” for Bhargava. They say he is a hard taskmaster, and it’s not beyond him to write a letter like this in a sudden burst of urgency.
In off-the-record conversations with ThePrint, they describe Dr Bhargava as “impetuous” and “impulsive” — a former colleague drew parallels with his “aggressive stenting” decisions to provide context to his image as an ICMR DG “who gets things done”.
“That aggression often shows in the moves he makes in spaces other than cardiology,” the former colleague said.
Another former colleague spoke about how Bhargava had “corporatised” ICMR — from a sleepy research organisation to a go-getter that was setting the pace on Covid testing and other important decisions.
However, both these former colleagues said that with the vaccine deadline, Bhargava’s “impetuosity” seemed to have “got the better” of his skills as an administrator who brings out the best in people.
ThePrint tried to reach Bhargava through calls and messages for a comment but got no response. This report will be updated if he replies.
The meeting before the letter
Bhargava’s communication to the principal investigators in the 12 sites where Covaxin is to be tested came two days after Prime Minister Narendra Modi chaired a high-level meeting to review the planning and preparations for a Covid-19 vaccine.
Among other things discussed at the meeting was who should get priority when a vaccine is ready. The priority, according to a PIB statement from that day, was “doctors, nurses, healthcare workers, non-medical frontline corona warriors, and vulnerable people among the general population”.
The statement made three other points — that vaccination should take place on an “anyone, anywhere” basis, that is, without the imposition of any domicile-related restrictions;, that vaccination must be affordable and universal, and no person should be left behind; and that the entire process from production to vaccination should be monitored and supported in real time with the use of technology.
This is despite the fact that Covid-19 vaccines are mostly being developed across the world with 12-18 month timelines.
This gave rise to many theories on the reasons behind Bhargava’s letter, and a former AIIIMS professor listed three possibilities.
“Maybe he was trying to push for early completion of Phase 1 and 2 packed together, to help make an announcement on 15 August. What should have been a quiet push ended up being a public communication with very different wording from the usually safe and bureaucratic government communications,” the former professor said.
“There are also theories about how he fought off the pressure he was under for a vaccine real quick by putting it down in writing and creating a public backlash,” he said.
“The most plausible theory is that he probably wanted recruitment for Phase 3 to start even as Phase 1 and 2 were being rushed through, so that there would be no delay in starting Phase 3. He meant to advance ethical clearance and consent etc,” he added.
Part of the influential ‘Covid triad’
Bhargava, who did his Doctor in Medicine (DM) in cardiology from King George’s Medical College, Lucknow, joined the cardiology department of AIIMS in the 1990s and was among the seven assistant professors in the department who were also on roster duty at the Prime Minister’s Officer when P.V. Narasimha Rao was PM.
His father, Dr K.P. Bhargava, was a pharmacological doctor at KGMC. Bhargava junior has talked in many interviews about how his father’s cardiac arrest was what propelled him to choose cardiology as his life’s mission at 14 years of age.
Balram Bhargava was a protégé of Dr M.K. Bhan, former professor of paediatrics at AIIMS and secretary, Department of Biotechnology. Incidentally, Bharat Biotech, the company that has developed Covaxin, had also partnered with the Department of Biotechnology for the rotavirus vaccine — a project Dr Bhan, who died earlier this year, was closely associated with.
In 2017, Bhargava’s name was among the three shortlisted for the post of AIIMS director, with the other two being Dr Randeep Guleria, who eventually got the job, and Dr V.K. Paul, the NITI Aayog member for health. It’s no coincidence they are the three most important technocrats in the government as India battles Covid-19.
Bhargava has also served as Executive Director of the School of International Biodesign (previously Stanford-India Biodesign) at AIIMS, and has worked closely in medical innovation, including with start-ups. He had developed a platinum-iridium alloy stent, which unfortunately took so much time to develop that it was outdated by the time it was ready.
Bhargava also authored a seminal paper on the effect of chewing tobacco on the vessels supplying the heart. In 2014, he was awarded a Padma Shri, while in 2019, he received the Dr Lee Jong-wook Memorial Prize for Public Health.
Free testing was his idea
The Covaxin letter is not the first instance when Dr Bhargava has faced criticism for an unusual idea — on 17 March, when India allowed private labs to test for Covid-19, he appealed to the private sector to test free of cost. Days later, the ICMR fixed a price cap of Rs 4,500 on private testing, but many believe it was Dr Bhargava’s appeal that sowed the seeds for a PIL in the Supreme Court on free testing. An interim order that threatened to throw private testing off the rails was eventually reversed.
A second AIIMS professor described Bhargava’s decisions as an example of the “AIIMS brand of socialist medicine”.
“You can take a man out of AIIMS but not take the AIIMSonian (AIIMS alumni, but often used in a broader sense to denote the AIIMS ‘family’) out of him. We do medicine for free, so we expect everybody else to do that as well,” the professor said.
“As a doctor and as an administrator, he has impeccable integrity. Nobody can ever accuse him of any impropriety. But there is no doubt that he is very well connected politically; he is among the physicians to the Vice-President,” he added.