The Vaccine War, Producer: Pallavi Joshi, Director and Writer: Vivek Agnihotri. 2023, 2 hrs, 30 mins. Hindi.

Introduction

Cinema and art, as I wrote in an earlier issue of this journal [1], play an important role in developing our moral imagination. But they do so only when they depict these processes correctly. Yet, now Indian cinema seems to have moved away from incorrect depictions to blatant falsehoods. Vaccine wars is a shining example. I want to use this review for two purposes: first, to critically examine the film, and second, to have a conversation on what the current political climate means for bioethicists in India. The movie, as most readers will know, is based on Balaram Bhargava’s book, Going Viral. Bhargava is the head of the Indian Council of Medical Research (ICMR). The book itself heaps praises on India’s early response to the pandemic, praises the Prime Minister for his belief in the Indian scientific community, and dismisses those who critiqued India’s response which was done in a scientific, critical and well-reasoned manner, as possessing a “Macaulay mind-set” [2]. It reads more like a government press release, than one written by a scientist who heads our apex medical research body. But this is not a review of the book, and so I will not dwell on it. I only mention it so that going into the movie, one knows what to expect — government propaganda — and an insult to the memory of those who have lost their lives to the pandemic.

Vaccine war

The movie stars Nana Patekar, Pallavi Joshi, Nivedita Bhattacharya, Sapthami Gowda, and Girija Oak in lead roles, and says that it is India’s first “bio-science film” (whatever that means). The movie is replete with inaccuracies, which start minutes into the film. The first claim that the scientists have “proved,” of course, that it was China that launched a bioeconomic war. The only problem is, there are no facts to buttress the claim. Words like “atmanirbhar”, “anti-national”, “orchestrated campaigns against India”, familiar to us in the government discourse to dismiss any dissent, or critical thinking, are found being repeated over and over in the film.

According to the movie, on January 1, 2020, the ICMR discovers an unidentified virus from China, causing fatalities with symptoms resembling cold and fever associated with pneumonia. At the centre of the movie, is the coverage of the Covid-19 pandemic and the supposedly rapid development of vaccines to combat the virus. The character of Patekar is built up as a lovable simpleton who doesn’t use a smartphone, wants people to eat without spoons as “fingertips trigger hunger”, adds ghee to food for “intelligence”. Bhargava and his team exclaim that it’s the first time someone is backing them. The Prime Minister also pops up (albeit only once, quite low key for a propaganda film) and is described by his Cabinet Secretary, played by Anupam Kher, as a man who wants results, one who does not believe in jargon, and trusts in science. Like the quintessential propaganda film, the movie claims that this is the first time that the scientists have been supported. Far from being gripping, one finds oneself unable to sit through this blatant whitewashing of death and havoc that was wreaked on the country’s public health system.

However, I want to talk about something the film deals with poorly, and how that impacts our work as bioethicists. First, the portrayal of dissent and critiques and its implications for the bioethics discourse, second, the silence of the film on the shortage of essential resources, and third, the importance of truth and moral courage for our work as bioethicists.

As a discipline, bioethics grew in the West during the civil rights movement, and the feminist movement, in the aftermath of the Holocaust [3]. The field inherently calls for those of us who are “doing bioethics” to demonstrate moral courage and stress the importance of truth — objective scientific truth backed by evidence. But the movie fails to do that. Those who questioned government’s actions are vilified and painted as anti-nationals. Since then, we have come across multiple unanswered bioethics dilemmas. For example, a director of Bharat Biotech has since admitted to skipping “mandatory” steps in the process of qualifying Covaxin [4]. There are also reports that the Central Drugs Standard Control Organisation (CDSCO) may have overlooked discrepancies in the clinical trial data of Covaxin [5]. This is just illustrative of the cavalcade of regulatory issues that the vaccine was developed under. All of this is missed by the movie. How do we then treat it as something that is perhaps more believable than propaganda? It is necessary, for the citizenry to develop a scientific temper, and not be criticised for it. In The Discovery Of India, Nehru, who is credited with coining scientific temper writes, “The scientific approach, the adventurous and yet critical temper of science, the search for truth and new knowledge, the refusal to accept anything without testing and trial, the capacity to change previous conclusions in the face of new evidence, the reliance on observed fact and not on pre-conceived theory, the hard discipline of the mind, all this is necessary, not merely for the application of science but for life itself and the solution of its many problems.”[6] For Nehru, “[t]he impact of science and the modern world have brought a greater appreciation of facts, a more critical faculty, a weighing of evidence, a refusal to accept tradition merely because it is tradition.”[6] This was inserted in Article 51A (h) of the Indian Constitution by the 42^nd amendment, and encourages the citizen to “develop the scientific temper, humanism and the spirit of inquiry and reform”. In a democracy, we should have the freedom to criticise the government whenever necessary and not be vilified or criminalised for it. Yet, in a space where the broader health of democracy is in peril, and the space for dissent and critique is shrinking, I think bioethicists have an important role to play.

Secondly, there is a gaping hole in the film’s coverage of the shortage of resources in India’s pandemic response. That government-run hospitals, perhaps the last bastion of public health in India, were not able to keep up with the surge in patients requiring hospitalisation and frequently ran out of beds to admit patients or oxygen and essential medicines for patients who are already admitted. The waiting time for admissions was long. Databases were developed by the civil society to keep a track of the beds in different parts of the country. How can a film on Covid-19 be made without the bodies floating in the Ganga, or people asphyxiating outside hospitals?

In the movie, the journalist who questions becomes the antagonist and the character playing Dr Bhargava calls her a “terrorist”. Our work as bioethicists, like journalists, inherently requires us to demonstrate moral courage, despite the vilification campaigns and defamation suits. The Indian bioethics fraternity has to speak up now, against movies like this, against the discrimination that now seems rampant in our society, against the calls for genocide of Muslims that we hear every day, and against the failing transparency in our medical systems including AYUSH. If we do not do that, individually, and through a collective voice, we risk losing our fundamental freedoms, but also our legitimacy as those professionals who play an important role in ensuring justice, autonomy, beneficence, and non-maleficence in medicine. If not for ourselves, we must do it for the patients.

Conclusion

Though the movie claims to be the story of India’s scientists, it is hardly that. The film misses the considerable shortages in resources that the scientists themselves were working with. The film could have been used not as a nationalist trope but a truthful depiction of bioethical, medical, and public health failures and what we could have done better. Truth in the movie, is sacrificed at the altar of nationalistic jingoism. In the end, it would be apposite to end with a statement of one of the true heroes of the struggle against Covid — Dr Gagandeep Kang, who succinctly captures what the movie should have done, as also the role that we must play as bioethicists. Writing in The Hindu, she says “The COVID-19 Pandemic resulted in increased resources as well as an awareness of science in society. When newspapers track numbers and try to decipher what they mean, it is an opportunity to communicate the value of science and counter the challenges brought about by a lack of scientific temper… Are science and scientists trusted and heard in India? … We can continue to accept what is developed and learned in other parts of the world without necessarily contributing to the process of discovery and development. The real question is, can we thrive as a society without scientific temper?” [7].