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We will have an abundant supply of Remdesivir by the second week of May: Biocon chief Kiran Mazumdar Shaw

Biocon Executive Chairperson Kiran Mazumdar Shaw says scarcity of critical anti-COVID-19 drugs Remdesivir and Itolizumab will end in 4-6 weeks as suppliers like her own company ramp up output that fell when the pandemic was receding. She said market pricing of vaccines is a must for the much-needed acceleration in inoculation.

April 19, 2021 / 08:51 PM IST

The second wave of COVID-19 has hit India with ferocity. Desperate pleas for help abound in social media as families struggle for hospital beds, oxygen, and drugs used to treat the virus. Biocon, which manufactures two critical drugs, Remdesivir and Itolizumab, is ramping up manufacturing to meet the sudden surge in demand. Its top boss Kiran Mazumdar Shaw spoke to Moneycontrol on the factors that led to India dropping the ball in its fight against COVID-19 and the solutions ahead.

Q: First of all, how has the last week been for you? The news flow has been very alarming.

Kiran: It has been a very, very difficult time for us, in many ways. This whole situation is so alarming. And for someone who is manufacturing two very critical drugs that are needed to basically deal with this current crisis of the second wave, it has been non-stop trying to ramp up production, catering to demand. There's a sudden surge of demand. And it's been really very challenging to try and meet it, and very alarming to see that hospitals are full, patients are struggling, these drugs are given in a hospital setting, so you can understand the kind of gravity of the situation.

Q: In fact, I saw a lot of requests on social media for Remdesivir as well as Itolizumab. There also seems to be panic because hospitals are now asking many patients to source this on their own

Kiran:  I think what we need to do is to make sure that we alleviate the panic that there is today in hospitals and in people's minds. So, I think what we're doing, obviously, is ramping up production. Remdesivir is a drug that was licensed to a number of Indian companies. We've been one of them. And it is adequate supply, once you basically gear up production. The problem is that all of us slowed down production. Production was at a very, very low level because the first wave was seen to have subsided, and you know, that we are in a safe place.

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COVID-19 Vaccine

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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I think we ought to have vaccinated much faster and then once again, I think we've missed an opportunity, in my view. And now we're paying the price for that because I've seen one thing that anybody who has taken even one shot of vaccine, even if they get re-infected, it is not severe. I think that would tell you how important it is to vaccinate. And, we are of course ramping up the production. I personally believe that by the second week of May, you will have an abundant supply of Remdesivir in the country. As far as Itolizumab and Tocilizumab are concerned, I think by end of May, early June you will have adequate supply to cater to the market. So I think you are going to be very challenged for 4-6 weeks and that is what we have to endure.

I think the hospitals are doing an amazing job, but doctors are getting fatigued, nurses are getting fatigued, because all these hospitals are being overwhelmed. And I think it is important for us to know that if anyone has been re-infected, you should not be rushing to the hospital.

Q: Do you think the government should have capped the prices of Remdesivir? Will it disincentivize manufacturers?

Kiran: I don't think they're going to really get affected by the price cap because the price that they've actually announced is something that I think most companies will be okay with. What really worries me is the price cap on vaccines. I think that is the biggest blunder that the government has made, in my view.

I think the government has made such a blunder because they have kept the price of vaccines at $2, whereas the international public price is $3. And they have actually put our vaccine makers at a disadvantage. This is ridiculous. I think our vaccine makers need to have a fair price. I think the government procuring at $2 is one thing. But I think they should understand that the private markets must be much higher, and they will pay much higher. This is a life-saving vaccine. And RT PCR test costing more than a vaccine is absurd. And the fact that people who take vaccines are willing to spend 1,000 rupees to get an antibody test is another absurdity.

So, I really don't know why the government is so hellbent on controlling vaccines. So, I'm very, very concerned that the government is refusing to admit that they made a mistake. And they are going to continue to hurt the sector. I don't know how they're going to address the pricing of the Sputnik vaccine, or how they're going to allow the import of other vaccines, which now they're allowing through an automatic approval route because nobody's going to be willing to sell the vaccine at 150 rupees.

Q: Shouldn't there be more clarity on the number of orders, advance paid, rollout- the next steps?

Kiran: First and foremost, I think they had many months to prepare for vaccine deployment. They should have got into vaccine procurement, they should have worked out how many doses each state government ought to get in a phased way. I really don't know when all that planning was done. If it was, then why is there so much, panic and chaos right now? And of course, we have given away many, many vaccines to other countries.

So, you know, I don't think there was a clear understanding that you know, we do need to vaccinate fast. And that, you know, we could have actually, certainly exported vaccines once we started getting into a safe place.

Q: But isn't that also because none of us anticipated that the second wave would hit us with such ferocity?

Kiran: Yes, that is a fact. Even though there were many epidemiologists who were actually forecasting a second, but nobody was willing to accept it. All of us were under the impression that we had overcome it and I must admit even I thought this; this is what is happening, that there's something very, very unique about the Indian environment and the Indian DNA or whatever you might call it, that, you know, we are not seeing the kind of disease burden that other countries are seeing. But then, you know, this has actually taken us by storm.

And I think that is why I think we need to vaccinate at scale. I've been really, really making a big plea to the government saying vaccinate those who are really exposed and not just the elderly.

Q: Is it also because of the variant? The double mutant UK strain...

Kiran: Will you please understand that any virus undergoes mutations? For instance, you know, if you look at the influenza virus, it could just be a mutant of the Spanish one, which happened a century ago. So, it keeps continuing cogeneration also has now taken the world by storm, and this is a new virus, and I wouldn't be surprised if it keeps on mutating. And it'll become like another flu. You know, it has to go through many, many mutations.

So, mutations will happen. But we do need to find a way of basically dealing with this virus and I think the only way we can deal with this virus is through vaccination.

Q: Former PM Manmohan Singh has written to Prime Minister Modi, saying we should invoke the compulsory licensing regime here, just like what India has done in the past with AIDS and HIV programs. Do you agree?

Kiran: I don't agree with that at all. Because I think that right now, we are not dealing with vaccine production. Today, we have enough arrangements between Indian vaccine makers and overseas vaccine makers.

Q:  Is it also a funding issue? Last week, Adar Poonawalla said he needed Rs 3,000 crores to ramp up manufacturing. Some believe that allowing companies to give CSR funds for this could be a solution. The Govt did give a grant to Bharat Biotech but that's a small one.

Kiran: I certainly believe that the government has to understand that if they want to ramp up manufacturing in a big way, then it's not about 65 crores, it is going to require a few 1,000 crores each. So you will need a few billion dollars to support the vaccine manufacturers. But I think more than anything else, given better pricing to the vaccine makers for the private market.

Q: Finally, in terms of the next steps, on the treatment protocol side, you said some of these drugs should be available in the coming weeks. But from a vaccine perspective, where do you see this going?

Kiran: It is difficult to answer that question because we just don't know what the COVID task force is thinking about. I mean, are they going to allow us to import vaccines, like the mRNA vaccine? Because those are available for a much higher price.

If we have Sputnik approved, how are we going to deploy it because they are refusing to consider Rs 150 as a price? So you know, they really shot themselves in the foot. So. I really want to know, how are we going to ramp up vaccination, and of course, all the vaccine makers are trying to ramp up in a big way.  And I personally believe that vaccine deployment ought to be decentralized. I think state govt must be given some kind of flexibility to decide how they want to prioritize.
Chandra R Srikanth is Editor- Tech, Startups, and New Economy

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