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Explained | Why the latest aid from US doesn't include COVID-19 vaccines or ingredients

After more than a week of frantic diplomatic talks, the Biden administration has decided to provide crucial medical help for India. Even though the US has identified specific sources of raw materials required for Indian manufacturers of Covishield, it doesn’t say which is the raw material and how much will be available.

April 26, 2021 / 03:57 PM IST
US President Joe Biden (File image: AP Photo)

US President Joe Biden (File image: AP Photo)

Late on Sunday, the United States promised to soon dispatch excess rapid testing kits, Personal Protective Equipments (PPEs), ventilators and key drugs to India.

The mega bilateral aid package will land even as the Biden administration continues to rebuff India's request for critical vaccine doses which the US currently stockpiles and bans the export of key chemical components needed for vaccine manufacturing. The US has also not clarified whether it will be able to provide Remdesivir doses, the demand for which has shot up over the past two weeks in India.

In an official statement, the White House announced that US National Security Advisor Jake Sullivan had spoken to his Indian counterpart, National Security Advisor Ajit Doval, and that the “United States is working round-the-clock to deploy available resources and supplies” to India.

Ministry of External Affairs (MEA) officials say this is not expected to be the last development on the matter as the second wave gains pace in India and the need for faster vaccination strengthens and both governments will continue to negotiate on critical help.

What exactly has the US promised?

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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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Reports say that upwards of 300 oxygen concentrators have been loaded at New York’s John F. Kennedy International Airport. The cargo will also include ventilators, another item which India had sought on an urgent basis through diplomatic channels.

“However, while all help is deeply respected, especially during a crisis, India did not request the US for PPEs and face masks. We have enough domestic capacity," a senior MEA official said.

Apart from the shipment of critical supplies, the US Development Finance Corporation will also fund a substantial expansion of manufacturing capability for the vaccine being tested by Hyderabad-based Biological E. On April 24, the company got permission from the Indian drug regulator to begin Phase 3 trials across 15 sites for its new vaccine. The US funding will enable it to produce at least 1 billion doses of COVID-19 vaccines by the end of 2022, the White House said.

Additionally, the United States will deploy an expert team of public health advisors from the Center for Disease Control (CDC), America's health protection agency, and USAID, its premier international development agency. The team will work closely with the their Indian counterparts, the National Centre for Disease Control, and the India Epidemic Intelligence Service staff.

New Delhi had sought expert hands to help train personnel on the ground, sources say. The USAID will quickly help in identifying and mobilising emergency resources available to India through the Global Fund.

Why is India requesting the US for vaccines?

The US is reportedly maintaining 35-40 million doses of COVID-19 vaccines as a stockpile, according to Ashish Jha, the dean of the Brown University School of Public Health. While the US government had ordered tens of millions of doses of the vaccine, it still hasn't received authorisation from the CDC to be used in the country.

The country has already announced that 4 million doses that it is not using will be sent to Mexico and Canada. Also, it has ordered 600 million shots from Pfizer and Moderna, both of which are shipping 28 million doses per week to the country. Of this, 7 million doses are not being used.

Meanwhile, according to Bloomberg, more than 138.6 million people in the US have received at least one COVID-19 vaccine shot while the same is true for more than 80 percent of people above 60 years of age. With about 30 percent of the population fully vaccinated, vaccination rates have fallen from the 3 million daily average and the government extends to mop up the remaining population in the next three months.

What is stopping the US from releasing the excess doses at its disposal?

Despite being mindful of the geopolitical and public relations ramifications its decision has had, Washington DC is not expected to change its stance anytime soon, MEA officials say. This may be due to intense lobbying from pharmaceutical companies in Washington DC.

“As the second wave began in India, pharma companies, especially Pfizer, stepped up their efforts to convince American lawmakers that the vaccines they have ordered should not be given away. This is simply because the companies want to be able to sell the vaccines to India, the world's largest market at the moment,” a senior diplomatic source based in New Delhi said.

With government-led mass vaccination now coming to an end in the US, the country believes that making a large selection of vaccines in abundant quantities accessible to the populace is required. This will help to draw in a significant part of the population which has sworn not to be vaccinated owing to rumours.

Why has the Biden administration banned the export of raw materials for vaccines?

The Serum Institute of India has repeatedly requested the US to lift an embargo on essential raw materials needed to produce Covovax, the second vaccine it is getting ready to produce in India, in partnership with American vaccine developer Novavax.

Similarly, Bharat Biotech has also clarified that supplies of a chemical adjutant it wants to make Covaxin has stopped. Bharat Biotech was buying it earlier from Kansas-based company Virovax but now has announced plans to locally develop it.

The issue stems from the US government’s decision in February to invoke the Defence Production Act, which contains a sub-clause preventing the export of critical raw materials required for America's local vaccine manufacturers. As a result, supplies of 37 chemicals and compounds, many of them ingredients for vaccine manufacturing, have been cut off from India, the largest global vaccine producer.

“US policymakers fear that relaxing the law for sending shipments to India will open it to requests from other nations as well. At a time when the global vaccine manufacturing schedule has gone haywire, thanks to the repeated medical issues with already approved vaccines and multiple waves of outbreaks in the developing world, policymakers are placating their constituents with an America First approach,” a senior policy advisor to both governments said.

While a large number of American and Indian think-tanks, businesses and academics have called for an end to the law, the government does not expect the US to budge on the issue anytime soon. Also, sources say the raw materials are currently in short supply and the US may be trying to build up a stockpile for itself before it releases them.

However, the latest statement from the White House has made New Delhi hopeful. “The United States has identified sources of specific raw material urgently required for Indian manufacturers of Covishield that will immediately be made available for India," the statement read. But the US has declined to clearly state which is the raw material in question and how much of it will be made available.
Subhayan Chakraborty

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