The US will share up to 60m doses of AstraZeneca’s coronavirus vaccine with other countries, the White House has announced, amid intensifying pressure for it to lead the global fight against the pandemic. The pledge came as Joe Biden spoke with Narendra Modi, the prime minister of India, which is reportedly running out of Covid-19 vaccines just as a deadly second wave continues to devastate the country. Hospitals across the capital, Delhi, continued to issue SOS calls over acute oxygen shortages, with eight patients dying in private hospitals on Sunday when oxygen supplies ran dry. Many of the biggest hospitals in the capital said they had stopped admitting new patients as all beds were full and oxygen was running out, while Delhi’s Ganga Ram hospital said it was in “beg and borrow mode” for oxygen cylinders used in its ambulances. The US has committed to send India oxygen systems, ventilators, testing kits, therapeutic drugs and personal protective equipment. Biden “pledged America’s full support to provide emergency assistance and resources in the fight against Covid-19”, the US president tweeted. “India was there for us, and we will be there for them.” America has vaccinated more than 53% of its adult population with at least one dose of its three authorised vaccines from Pfizer, Moderna and Johnson & Johnson, and it expects to have enough supply for its entire population by early summer. This has fuelled demands for it to step up and help the rest of the world, especially as China and Russia’s aggressive international donations led to concerns that they are beating Washington at “vaccine diplomacy”. The White House announced on Monday it would distribute the AstraZeneca vaccine overseas as production allows. Andy Slavitt, the White House senior Covid-19 adviser, posted on Twitter: “US to release 60 million AstraZeneca doses to other countries as they become available.” Much of the US effort over the past year has been focused inwards, but the crisis in India has concentrated minds. The virus is ripping through a population of nearly 1.4bn, with the healthcare system on the brink of collapse. On Monday, India set another record for new coronavirus infections: a fifth day in a row at more than 350,000. It reported running out of Covid-19 vaccines, and numerous hospitals in the country are desperately low on supplies of oxygen. Tedros Adhanom Ghebreyesus, the WHO director general, described the recent surge as “beyond heartbreaking”. From Saturday, everyone in India over 18 will be eligible for a vaccine, a decision made by the government as the virus has brought India’s healthcare system to its knees, with more than 352,000 new cases on Monday and more than 2,800 more deaths. High hopes have been placed on an expanded vaccine rollout to help halt the spread of the virus. However, in several of the worst-affected states, including Rajasthan, Punjab, Jharkhand and Chhattisgarh, state governments have said there is already a shortage or complete lack of jabs, and they had been unable to order more, throwing doubt on to any expansion of vaccine rollout by 1 May, when about 900 million more people will become eligible. Almost 10% of India’s population of 1.3 billion have received one jab. Just over 1% have received both vaccines. In the week to 25 April, India recorded a cumulative 89% increase in Covid deaths compared with the week before, and a total of 2.2m new cases – the highest seven-day increase experienced anywhere in the world. Total confirmed infections have now passed 17m. Most of the onus to deliver the vaccines has fallen on India’s Serum Institute, the country’s largest vaccine producer, which produces the Oxford/AstraZeneca vaccine, known in India as Covishield. However, it has been struggling to meet demand, with capacity currently to make only 70m doses a month. Last week the government approved a $400m grant to the company to boost production to 100m doses a month by the end of May. The grim picture is thrown into sharp relief by the speedy vaccination progress of richer countries such as the US, the UK and Israel. The AstraZeneca vaccine is widely in use around the world but has not yet been authorised by the Food and Drug Administration (FDA) in the US. The US decision to distribute the AstraZeneca vaccine abroad was made easier because it does not need the doses domestically. A senior White House official told reporters on a conference call: “Given the strong portfolio of vaccines that the US already has and that have been authorised by the FDA, and given that the AstraZeneca vaccine is not authorized for use in the US, we do not need to use the AstraZeneca vaccine here during the next few months. “Therefore the US is looking at options to share the AstraZeneca doses with other countries as they become available.” Before any AstraZeneca doses can be shipped, however, they must meet the FDA’s “expectations for product quality”, the official said. Jen Psaki, the White House press secretary, said at a briefing: “We are continuing to look for a range of ways to help India so we’re talking about what we can redirect, what is available now. A lot of what they need at this moment is oxygen; that is what they will tell you. We are quite focused on that, as well as PPE, testing and other immediate needs they have now.” Sending vaccines to India, Psaki explained, will take longer. She said: “Right now we have zero doses available at AstraZeneca. We’re talking about what the FDA needs to go through, a review to ensure the safety and it’s meeting our own guidelines.” Psaki said approximately 10m doses could be released when the FDA grants approval, but warned that this would not be immediate. Asked about criticism that the US response is coming late, Psaki added: “The US has been one of the largest providers of assistance to address the Covid pandemic around the world including to India.”