The big story about COVID-19 vaccines is emerging now, belatedly. After the noise and news about Pfizer, AstraZeneca, Moderna and other global vaccine discoveries had quietened down, came a little-known fact, pleasantly enough, though, for India: The Serum Institute of India, founded over 50 years ago, is the world’s largest manufacturer of vaccines by volume. It is likely to provide not only most of the vaccines administered in India but elsewhere in the world, once exports are permitted later this year.
The upshot is that while wealthier countries will be looking - even slogging hard-to vaccinate their populations, low-income India will be holding the trump card. The existence of the world’s largest vaccine manufacturer helps to establish the basis for a domestic network of suppliers.
On January 11, the process of transporting Serum Institute’s Covishield vaccine began after the manufacturer had received the central government’s initial purchase order of 11 million (1.1 crore) doses at Rs 200 per dose.
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According to a research study conducted by Fitch Solutions, Asian economies are likely to run to three types in 2021. Countries that can possibly vaccinate most of their people in priority groups like their elderly population and extremely vulnerable health workers by June; those nations who can do so by September and a third group of economies that will take longer. India is happily placed in the first group, says the Fitch Solutions report.
Resultantly, India is, by a long shot, the lowest income group of countries in this first list, which has much more prosperous China, Malaysia, Singapore and Hong Kong in the pecking order.
So far, richer and developed countries are fretting about shortages of vital components because they are, often, imported, and supply chains are stretched with skyrocketing global demand.
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Little surprise then that many countries have requested India either on a government-to-government (G2G) basis or by directly placing orders with the vaccine developers who are manufacturing the doses in India. India is all set to deploy its capacities in vaccine production and supply. Besides the neighbours - barring Pakistan - Brazil, Morocco, Saudi Arabia, Myanmar, Bangladesh, South Africa have made official announcements seeking vaccines from India. According to officials in the Ministry of External Affairs, the government will accord priority to all its South Asian neighbours in vaccine distribution.
As of 2020, Serum Institute is the world's largest vaccine producer by number of doses, producing around 1.5 billion doses of vaccines each year. It puts Serum Institute way ahead of global pharmaceutical majors like GlaxoSmithKline and Sanofi, which manufacture 0.69 billion and 1 billion doses of vaccine respectively, according to the Access to Vaccine Index. Other giants like Merck and Johnson and Johnson produce less than 0.2 billion doses, making them relatively minor vaccine manufacturers.
While Serum Institute is the world’s biggest, India has an embarrassment of riches: it will also access vaccines from Bharat Biotech, an Indian biotechnology company headquartered in Hyderabad, dedicated to drug discovery, drug development and manufacture of vaccines.
The Drugs Controller General of India (DCGI) recently approved Oxford-AstraZeneca’s vaccine, manufactured by Serum Institute in India as Covishield, and Bharat Biotech’s Covaxin for restricted emergency use in the country, even though question marks have been raised by some experts about the approval process of the two vaccines.
After an initial exchange of words, the two Indian companies issued a joint statement saying, “Now that two COVID-19 vaccines have been issued emergency use authorisation (EUA) in India, the focus is on manufacturing, supply, and distribution...Both companies are fully engaged in this activity and consider it our duty to the nation and the world at large to ensure a smooth roll-out of vaccines.”
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The jabs in India could start sooner than in most countries. ``The government will get the vaccines by the middle of January and the private market by April,” says well known epidemiologist, Dr Harinder Singh Ratti.
Little wonder that India is crowing. Prime Minister Narendra Modi has already offered to `protect the world’ with India’s two coronavirus vaccines. ``The world is watching how India conducts the globe’s biggest vaccination programme,” he said, addressing the 16th Pravasi Bhartiya Divas Convention on January 9.
Then the next day at a virtual interaction with Chief Ministers and administrators of Union Territories, Modi told his listeners that four more vaccines are on the way making India the `pharmacy of the world.’
The first beneficiaries of the vaccine would be three crore healthcare and frontline workers, the prime minister said.
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As per the plan, the doses in India would be administered through public and private centres by doctors, dentists, nurses and trained paramedics. Two doses would be given 21 days or 28 days apart, depending upon the vaccine used.
To be sure, a new vaccine means new technology and these stress-laden times, only a follow up of the vaccinated population and their antibodies for a couple of years, would make even vaccine manufacturers wiser.
The other more complex issue of financing the world’s largest inoculation programme remains unclear. Will the Government of India have Rs 80,000 crore available this year and possibly in 2022 to buy and distribute vaccines to everyone in the country, as per an estimate drawn up by the Serum Institute of India? There are no clear answers, but by any yardstick, it is a challenge of epic proportions.
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Experts are unanimous on one thing though: do not avoid vaccination.
Rajiv Nath, Managing Director - Hindustan Syringes and Medical Devices Ltd, said, “Even though the COVID-19 vaccine is meant primarily for adults, it is surprising that there is apprehension among a section of the population, even though all of us know that the faster the general population, especially the high-risk population gets immunised, the better would be the chances of restoring normalcy.”
That is the bottom line that a majority of vaccine users would do well to understand.