Profits of doom: How India’s black market has thrived on misery during its second wave of Covid

When Kanika Saxena transferred Rs 18,000 (£173) to a man to get Remdesivir injections for a Covid-19 patient who was in a critical condition, little did she know that she would end up being cheated.

“We waited seven hours for this man to deliver the injections. I tried calling him from at least nine, ten different numbers, but he never picked up. He stopped responding to texts after I sent him a screenshot showing that the money had been transferred to his account,” she said.

This is not an isolated incident in India, a country that has been overwhelmed by a deadly second wave of the virus as its healthcare system crumbles. Hospitals have been sending SOS messages about the shortage of oxygen, while patients are left unattended as beds run out, and people are forced to obtain medical supplies using their own resources.

The crisis has forced people desperate to procure medicines and oxygen for their loved ones to turn to the black market, or to call dealers’ numbers which are circulating on social media. Several have fallen prey to scams and lost their money while waiting for life-saving medicines.

Indranil Mukherjee, an author based in Delhi, told The Independent that he called several numbers which were shared on social media while trying to find an oxygen cylinder for a friend.

Out of those calls, only one man agreed to deliver a 20-litre cylinder after a payment of Rs 7,000 (£67) was made. He assured Mr Mukherjee that the cylinder would be delivered within 48 hours of transferring the money, but the cylinder never came. Mr Mukherjee said the vendor’s phone has since been switched off.

India reported 360,960 new coronavirus cases in the 24 hours prior to Wednesday morning, taking the tally of infections to nearly 18 million. 3,293 fatalities were reported, taking the death toll to 201,187.

The central government, led by prime minister Narendra Modi, has come under severe criticism for not preparing well in advance and for allowing religious gatherings. Mr Modi himself addressed massive rallies ahead of the state elections.

Some have taken to social media to vent their frustration about the government response, as well as to seek help and warn others about the wave of unrestrained black-market sales and scams.

“People are stuck because ethics say they shouldn’t buy anything from the black market, but the desperate situation forces them to go for unethical practices,” said public health expert Amulya Nidhi, from the public health forum Jan Swasthya Abhiyan.

Mr Nidhi also said there’s no limit to the price being asked for oxygen cylinders and Remdesivir on the black market.

Mr Modi last week chaired a meeting with senior government officials and noted that the misuse and black-marketing of Remdesivir must be checked. The sale of Remdesivir, which is widely used for treating Covid-19 patients, has increased following a surge in coronavirus cases in the country. The central government last week announced that it would increase production capacity for Remdesivir, but people have already been paying at least six times the normal price to procure the medicine.

Bobby Vijayan told The Independent that his friend bought six vials of Remdesivir at Rs 130,000 (£1,254) after being told by a hospital in Gurugram that patients needed to obtain the medicine themselves. They couldn’t find it anywhere in the Delhi region, and had to transport it from Jaipur to Gurugram, he said.

This is despite the central government capping the price of Remdesivir. Pharmaceutical companies manufacturing the drug dropped the price to between Rs 899 (£8) and Rs 3,490 (£33) per vial, which is much less expensive than the prices people have to pay on the black market in the face of shortages at hospitals and pharmacies.

Praveen Josyula, who is part of a team of volunteers helping those in need, said that the team was approached by someone who offered to sell them four Remdesivir injections at Rs 40,000-45,000 (£384-£432) each.

Lekha D Bhat, assistant professor in the department of epidemiology and public health at the Central University of Tamil Nadu, told The Independent that the black-market crisis is “artificially created and supported because India is a pharmaceutical leader with net-positive export results, and we have the capacity to meet the population’s requirements”.

She said one of the reasons the black market is flourishing is a lack of awareness. “People are panicked and end up hoarding essential medicines; equipment like oximeters, inhalers, cylinders. Such responses by the people facilitate the black market,” she said.

The government is now trying to educate people about Remdesivir, with the All India Institute of Medical Sciences director Randeep Guleria advising people against hoarding the medicine or oxygen cylinders at home. Medanta chairman Naresh Trehan said Remdesivir only decreases viral load in people who need it, and it should be given only after doctors have looked at the test results, symptoms and comorbidities of a patient. 

Professor K Rajasekharan Nayar of the Global Institute of Public Health said that, as with other products that find their way onto India’s black market, the scale of the demand for medicines and medical supplies, along with people’s desperate need for them, is the driving force for such activity. He said that the “lack of preparation and non-availability of appropriate institutional support in many states have also contributed to this pattern”.

Prof Nayar said that the need right now is for a “health intelligence service”, which would include clinical, public health and administrative staff who would monitor trends.

The black market has room for negotiation. Saloni Sharma, 28, said a worker at a local pharmacy in Delhi told her they had run out of oximeters, but agreed to supply them if she was willing to pay a little extra. Ms Sharma said the worker gave her family a discount after they found him another customer for the same oximeter.

Police in various states have started cracking down on those taking part in the black-marketeering of oxygen cylinders or Remdesivir. Delhi police on Tuesday arrested three people who were involved in hoarding and selling oxygen cylinders at high prices. Uttar Pradesh police arrested six people last week and recovered 127 vials of the Remdesivir injection. 

The Delhi high court said this week that it had received information that an oxygen cylinder was being sold for Rs 1 lakh (£965) and asked the city government to take action against those responsible.

Sales on the black market, which is thriving on the misery of those struggling during the pandemic, will increase at least for the next two to three weeks, said Ms Bhat. “By then, the government, as well as manufacturers, professional bodies and other stakeholders, will be able to develop a working plan” to respond to the problem, she said.

Mr Nayar said that the increase in sales will depend on how long the wave lasts and whether a “third wave” or further variants of the virus emerge.

The Indian government’s decision to offer vaccination to all adults from 1 May is likely to lead to an increase in black-market sales. Several states have already warned that they may not be able to meet the demand. 

“For a shorter duration, there will be a spur in black-market sales of vaccines,” said Ms Bhat.

While until now the central government has been providing all vaccines and allocating them to states, new rules from 1 May mean it will receive 50 per cent of the vaccines produced by manufacturers.

The manufacturers will be able to supply the remaining 50 per cent of doses to states, as well as making them available on the open market at a fixed rate that both the Serum Institute of India and Bharat Biotech have already announced.

Some experts have called for the vaccines to be made freely available to all eligible Indian citizens. “The economic incentives are set clearly in favour of private hospitals to procure most of the 50 per cent quota, and there is no way to ensure the final recipients will get it even at the prescribed rate of Rs 600,” said Rijo M John, adjunct professor at Rajagiri College of Social Sciences.

He said that when the private sector was allowed to conduct Covid-19 tests, there was rampant profiteering by many private players despite the limits set on pricing.

“The pricing is such that it is many times higher than the daily wage of most casual labourers in India, who constitute a fourth of India’s workforce. We cannot control a pandemic by only enabling the rich to access vaccines. For an infectious disease such as Covid-19, it is in the interest of the state to get as many people vaccinated as possible,” he said.

While the Serum Institute has set the price for its Covishield vaccine at Rs 600 (£5.82) for private hospitals, Bharat Biotech’s Covaxin will be available to these hospitals for Rs 1,200 (£11.63).