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 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.