By Isaac Gomes
Kolkata: India is the largest manufacturer of vaccines in the world. For years, it has manufactured and exported more vaccines than any other country. The Serum Institute of India is the world’s largest vaccine manufacturer, producing more than 60 million doses of the AstraZeneca and Oxford vaccine every month (Source: Business Insider India 02.05.21).
It makes vaccines for measles, tetanus, diphtheria, hepatitis and many other diseases. It specializes in generic versions, exports to 170 countries. Therefore, when Serum declared in January this year that it was ready to with its Covid Vaccine (Covishield), followed shortly by Bharat Biotech (Covaxin), WHO along with many world leaders, greeted India’s Covid vaccine breakthrough.
In fact, on January 9, Prime Minister Narendra Modi proudly declared: “Today, India is ready to save humanity with two ‘Made in India’ Covid-19 vaccines. India has done this earlier and it is doing it now as well.” Following the launch, India also exported 65 million doses to about 90 countries including its neighbors.
Yet suddenly its vaccination drive against Covid-19 has lost its steam in the face of the second wave where the daily case load is hovering between an alarming of 375,000 and 400,000 and a daily death rate (under-reported) of 4,000 plus.
In the face of this onslaught when the country needed Covid-19 vaccines the most, Biocon Executive Chairman Kiran Mazumdar-Shaw has expressed her concern over the shortage of vaccines and sought better transparency from the government regarding their availability to allay the fears of citizens. (Business Today 11.05.21).
Amid the deadly second Covid-19 wave, India opened its Covid-19 vaccination drive for all above the age of 18 years from May 1. Currently, India’s two vaccine makers produce an estimated 70 million doses each month of the two approved shots — AstraZeneca, made by the Serum Institute of India, and another by Bharat Biotech.
Against this shortage of vaccine and the inability of Serum to meet its domestic and export commitment (the Government of India has presently banned vaccine export), there is a growing demand that to fight Covid on a war footing, the world’s leading pharmaceutical multinationals waive their Intellectual Property rights so that many companies in India and other countries could manufacture Covid vaccines to bridge the vaccine shortfall.
But Kiran Mazumdar-Shaw emphatically pointed out that India being the largest vaccine manufacturer of the world cannot hide behind this excuse. She said the main bottleneck for the sudden vaccine shortage was access to raw materials and consumables, bulk of which comes from the USA. USA has blocked export of these materials but is now considering relaxing the ban. She also said even if Compulsory Licensing was granted by the government, it would take years for a company manufacture of Vaccines was a very technical and complex process.
She said logistics and management of vaccines and also the differential vaccine pricing between the federal and the states were the root causes. She also said the Central Government leveraging its bargaining power should have stocked vaccines in January 2021 itself instead of ordering now. The result is there is alarming rise in infection including the rural areas and slowing down of vaccination due to supply crisis where most states are running out of vaccines.
She said that the Central Government should have centrally procured all vaccines (as it was doing till date) and distributed them among the states, and a small percentage to private hospitals. Regarding Vaccine Management, she suggested that the Centre should just send the vaccines to the states and leave with them the decision on their utilization according to size and Covid-positivity rate of a district. She emphasized on Vaccine Transparency – that the Centre should announce regularly the quota it has allocated to each state which should maintain a Daily Dashboard on the doses it has received and administered therefrom.
As mentioned above, India’s two vaccine makers produce an estimated 7 crore doses per month. Considering India’s population of 140 crore, we need at least 200 crore doses (2 doses per person). At the current rate, it will take at least one year to vaccinate 100 crore eligible population. By that time the virus will change its strain/mutation. This means new genre vaccines will need to be developed. A single dose vaccine may reduce this timeframe.
The government has behaved like a bully with its indigenous manufacturers. It beat them down to a price below the $3 tag that COVAX had determined as the minimum viable price for Covid-19 vaccines. It sanctioned a price of only 150 rupees a dose to Serum and 200 rupees to Bharat Biotech, and released orders for small quantities to them just five days before the launch of the vaccination campaign, on January 16.
The government also didn’t support the manufacturers with funds, either through grants or as advance payments against future supplies. The manufacturers had to stockpile at their own risk. Then, on April 19, the government agreed to give Rs 3,000 crore to Serum and Rs 1,500 crore to Bharat Biotech to enhance their manufacturing capacities. This met Serum’s long-standing appeal for funds (Science The Wire 22.04.21).
At a time when more and more citizens should have been vaccinated (ideally door-to-door) to combat this alarmingly rising Pandemic, the overnight policy of increasing the gap of Covishield 1st and 2nd doses from 6-8 weeks to 12-16 weeks is simply a concerted attempt to cover up for the shortage of the Vaccine supply, thus putting the lives of citizens to peril. In fact, the UK has just done the reverse the other day – it has brought down the gap from 12 to 8 weeks. Intriguingly, for Covaxin the gap between the 1st and 2nd doses remains the same 4 weeks!