What India is doing about the Covid vaccine

As the largest global drug supplier and producer of 60% of the world's vaccines, India has long been known as the " pharmacy of the world ".

Now, while the frantic hunt for the Covid-19 vaccine is taking hold, the country is playing an increasingly strategic and central role in the development, production – and, above all, the possible future distribution – of several possible Covid vaccines.

With over 7.5 million cases and around 115,000 deaths, India is also one of the countries most affected by the virus, second only to the United States.

An agreement has already been reached between the Serum Institute of India, based in the city of Pune, to produce 1 billion doses of the Oxford / AstraZeneca vaccine, seen as the precursor to the vaccine race. In anticipation of its success, it has already started production of nearly 2 million vaccine samples and is conducting a Phase 3 human clinical trial on thousands of patients across 15 Covid-19 hotspots in India.
This week, the Serum Institute of India said it is confident the AstraZeneca vaccine will be ready by December and cleared for distribution in India by March, The Guardian reports.

Adar Poonawalla, the CEO of the Serum Institute of India, said he was " very optimistic " that more than one successful vaccine is imminent.
"A lot of the data that I have unofficially seen in many of these vaccines is very promising and more than three or four vaccines will be successful very soon in the next year, " Poonawalla said.

The Serum Institute of India, which also began human experiments on a Covid intranasal vaccine this week, is just one of dozens of Indian companies vying to produce the coveted vaccine, of which there are nearly 200 different types developed across the country. world.
Johnson and Johnson, whose Covid-19 vaccine is also in phase 3 clinical trials, has struck a deal with Indian pharmaceutical company Biological E to produce up to 500 million doses if successful.

Bharat Biotech, a Hyderabad-based pharmaceutical company, has a deal to produce 1 billion doses of the University of Washington intranasal vaccine, now in clinical trials, and Indian pharmaceutical giant Dr Reddy's has a deal to make a 2/3 phase of human experimentation in India of the controversial Russian Sputnik vaccine and thus produce 100 million doses. There are also at least a dozen indigenous vaccines under development in India.

All of this places India, and thus the global South, in a strategic and powerful position in terms of vaccine distribution, particularly nationally and in non-Western countries. Poonawalla said that " 50% of the amount we produce will be kept for India and the rest will go to low and middle income countries ".

In order to have the ability to produce hundreds of millions of promised Covid vaccines, Poonawalla said the company will stop manufacturing other vaccines destined for the US and Europe, such as measles, mumps, rubella and hepatitis B. , even if it will still provide them to developing countries.

Mahima Datla, chief executive of Biological E, which will manufacture the Johnson and Johnson vaccine, took a different approach and said the company is committed to the Covax vaccine alliance, signed by 135 countries, which will push for a equitable supply and distribution of the vaccine.

" We have never made compromise decisions between India's vaccine needs and global organizations such as Unicef, " said Datla. " So far we have no obligation to reserve a certain amount of the vaccine for India ." " But in the future, there may be a gap between supply and demand that could put us in that position ."
Yet the irony is that while India is one of the largest vaccine-producing nations in the world, it faces one of the biggest global challenges in immunizing its 1.3 billion people.

India has a highly effective immunization program for newborns and pregnant women, but there is nothing in place for the rest of the population, particularly the elderly who are the most vulnerable to the coronavirus. The already overburdened health system has been pushed to breaking point by the pandemic in many areas, and parts of rural India barely have access to health care.

India, which suffers from extreme heat, also lacks adequate cold chain facilities to ensure the vaccine is kept refrigerated, and therefore effective, until it is administered. Some of the vaccines under development may need to be stored down to -70 ° C.

There is also the question of costs. The Serum Institute said it expected the vaccine to cost around $ 5 (£ 3.80). With the Indian government aiming to immunize 250 million people by July 2021, it means it will have to raise $ 1.25 billion to cover the costs.
" The complications in India will be phenomenal, " said Gagandeep Kang, an Indian professor of microbiology who is a member of the WHO's global advisory board on vaccine safety. " The main concern is scale and traceability – how do you know who got the vaccine and who didn't – and the fact that the necessary storage conditions are still unknown ."

Yet Kang said an even more worrying threat lurks in India, that of a virulent anti-vaccine movement that has already garnered a strong boost in rural villages against the measles, mumps and rubella vaccine in the past five years. Kang said he witnessed how the vaccine conspiracies spread like wildfire in WhatsApp messages written in the local language, which were very difficult to counter. " I am concerned that the longer it will take for a Covid-19 vaccination program to spread in India, the more vaccine and resistance conspiracy theories we will have to address, " Kang said.

(Extract from the foreign press review by Epr Comunicazione)