With India experiencing a devastating second wave of the coronavirus pandemic, questions are being asked about how the country — which is home to the world’s largest vaccine manufacturer — got to this tragic point.India continues to report massive numbers of new infections. On Tuesday, it passed the grim milestone of having reported over 20 million Covid cases and at least 226,188 people have died from the virus, although the reported death toll is believed to be lower than the actual death toll.In the meantime, India’s vaccination program is struggling to make an impact and supplies are problematic, despite the country having halted vaccine exports in March in order to focus on domestic inoculations.The sharp rise in infections seen in India since February has been attributed to the allowing of a large religious festival and election rallies, as well as the spread of a more infectious variant of the virus. Prime Minister Narendra Modi and his governing Bharatiya Janata Party have been criticized for a lack of caution and preparedness, and accused of putting politics and campaigning above public safety.A war of words over the government’s vaccination strategy has also ensued. Ruling lawmakers have been criticized for allowing millions of doses to be exported earlier in the year.To date, India has administered around 160 million doses of a coronavirus vaccine (the predominant shots being used are the AstraZeneca shot, produced locally as Covishield, as well as an indigenous vaccine called Covaxin developed by Bharat Biotech). In April it approved Russia’s Sputnik V vaccine for use and the first batch of doses arrived at the start of May, although it has not yet been deployed.Only 30 million people have had the complete two doses of a Covid vaccine in India so far, government data shows. That’s a small number (just over 2%%) of India’s total population of 1.3 billion people — although around a quarter of that total are under 15 years old and, as such, are not eligible for a vaccine yet.Since May 1, anyone aged 18 or over is eligible for a Covid vaccine although this expansion of the vaccination program has been hampered given the shortages of doses that have been reported throughout the country by national media.Dr. Chandrakant Lahariya, a doctor based in New Delhi who is also a vaccines, public policy and health systems expert, told CNBC Wednesday that India’s large adult population makes the immunization effort difficult.“Even if the projected supply was available, India has opened the vaccination to a far bigger population than probably any setting can expect the vaccines (to cover). It is essentially an outcome of limited supply and a vaccination policy which is not mindful of supplies. No amount of advanced planning could have assured that sort of supply, which is needed now with the opening of vaccination for 940 million people in India,” he said.Vaccine supplies are “unlikely to change drastically,” Lahariya said. “India needs anywhere between 200 to 250 million doses a month to function Covid-19 vaccination drives to full capacity and it has around 70-80 million doses a month. Clearly, there is a long way to get (to) that kind of supply,” he noted.Vaccine warsThe shortcomings in vaccine supplies has inevitably led to a deflection of blame with vaccine manufacturers in the firing line. Questions over vaccine prices, manufacturing capacity and the destination of supplies have beset the world’s largest vaccine manufacturer, the Serum Institute of India, and Bharat Biotech, the Hyderabad-based pharmaceutical company that manufactures Covaxin.Both have had their vaccine price structures (that is, different prices for doses destined for central government, state governments and private hospitals) criticized, which led the SII’s CEO to later reduce prices amid a public backlash.By cnbc.com