India is home to the world’s largest manufacturer of Covid vaccines. But it faces a major internal flaw
People aged 18 and over waiting to be vaccinated against Covid-19 at a vaccination center on the Radha Soami Satsang site operated by BLK Max Hospital on May 4, 2021 in New Delhi, India.
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With the devastating second wave of the coronavirus pandemic in India, questions are being asked how the country where the world’s largest vaccine maker is based got to this tragic point.
India continues to report massive numbers of new infections. Tuesday passed the grim milestone of having reported over 20 million Covid cases and at least 226,188 people have died from the virus, although the reported death toll is believed to be lower than the real death toll.
Meanwhile, India’s vaccine program is struggling to make an impact and supplies are problematic, despite the country halting vaccine exports in March to focus on domestic vaccination.
The sharp rise in infections in India since February is due to the permission of a major religious festival and election campaigns, as well as the spread of a more contagious variant of the virus. Prime Minister Narendra Modi and his ruling Bharatiya Janata party have been criticized for a lack of caution and willingness, and accused of placing politics and campaigning above public safety.
There was also a war of words over the government’s vaccination strategy. The ruling legislature has been criticized for allowing millions of cans to be exported earlier this year.
So far India has administered Around 160 million doses of a coronavirus vaccine (the predominant shots used are the AstraZeneca shot, made locally as Covishield, as well as a domestic vaccine developed by Bharat Biotech called Covaxin). The Russian vaccine Sputnik V was approved for use in April and the first dose batch arrived in early May, although it has not yet been used.
So far, only 30 million people in India have received full two doses of a Covid vaccine, government data shows. That is a small number (just over 2 %%) of India’s total population of 1.3 billion people – although around a quarter of that population is under the age of 15 and as such cannot yet receive a vaccine.
As of May 1, anyone aged 18 or over has been eligible for a Covid vaccine, although this expansion of the vaccination program has been hampered due to dose shortages reported by national media across the country.
People receive their Covid-19 vaccines from medical professionals at a vaccination center set up in the classroom of a state school in New Delhi, India on May 4, 2021.
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Dr. Chandrakant Lahariya, a New Delhi-based doctor who is also an expert on vaccines, public policy and health systems, told CNBC on Wednesday that India’s large adult population is making vaccination efforts difficult.
“Even if the proposed supply was available, India opened vaccination to a far larger population than any vaccine framework can possibly expect. This is essentially the result of limited supply and a vaccination policy that ignores supply becomes.” No forward planning could have ensured the kind of care that is needed now with the opening of vaccination for 940 million people in India, “he said.
It is “unlikely that vaccine supplies will change drastically,” Lahariya said. “India takes between 200 and 250 million doses per month to reach full capacity of the Covid-19 vaccine engines and it has around 70 to 80 million doses per month. It is clear that there is a long way to go to get these Kind of care to achieve. ” ,” he noticed.
The shortcomings in vaccine supply have inevitably led to a diversion of blame with vaccine manufacturers in the line of fire. Questions about vaccine prices, production capacity and destination have preoccupied the world’s largest vaccine manufacturer, Serum Institute of India, and Bharat Biotech, the Hyderabad-based pharmaceutical company that makes Covaxin.
Both had criticized their vaccine price structures (i.e. different prices for doses destined for central government, state governments and private hospitals), which prompted the CEO of the SII to lower prices later as part of a public backlash.
Adar Poonawalla, CEO of the SII, which makes the Covid vaccine developed by AstraZeneca and Oxford University, said Sunday the institute had been blamed for a vaccine shortage and scapegoated by politicians, but said it was due to capacity an initial did not increase sooner lack of orders.
“I have been a very unfair and unjustified victim,” he told the Financial Times on Monday, adding that he had not increased capacity earlier because “there were no orders, we didn’t think we were more than 1 billion Doses a year. “
Poonawalla noted that the Indian government ordered 21 million doses of Covishield from the Serum Institute in late February, but did not specify when or if it would buy more, and ordered an additional 110 million doses in March as infections began to rise.
People wearing protective face masks wait to receive a dose of Covishield, a coronavirus vaccine made by the Serum Institute of India, at a vaccination center in New Delhi, India on May 4, 2021.
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Poonawalla said Indian authorities did not expect to face a second wave of cases and, as such, were not prepared for the onslaught of new infections in late winter.
He said the shortage of vaccine doses in the country will continue until July, when production is expected to increase from around 60 to 70 million doses per month to 100 million.
For its part, the Indian government insists on ordering more vaccines to meet demand. On Monday, the government issued a statement rejecting media reports claiming it had not placed new orders for Covid vaccines since March, stating that “these media reports are completely false and not based on facts” . It said it had provided money to both SII and Bharat Biotech for vaccines, which are due to be delivered in May, June and July.
On Tuesday, Poonawalla issued a statement attempting to calm tensions between the government and SII. He stated that “the manufacture of vaccines is a specialized process and it is therefore not possible to ramp up production overnight”.
“We also need to understand that India’s population is huge and it is not an easy task to produce enough doses for all adults … We have been working with the Indian government since April last year. We have all kinds of support, be it scientific , regulatory and financial, “he said. Poonawalla said the SII had total orders over 260 million cans without disclosing buyers.
When asked if the government had misunderstood its approach to vaccine sourcing and production, Lahariya noted that the government had become complacent, even though it was difficult to predict the course of the pandemic.
“To be fair, I think there were two surprises. Unlike a year ago when the availability of Covid-19 vaccines was projected around mid-2021, the vaccine became available a little earlier. Second, the lull in Covid-19- Cases in India has ceased complacency at all levels, “he noted. Lahariya added that many months were spent prioritizing the target population for vaccination, then opening the program “too early” to all adults.
“It was an issue of hasty and arguably politically influenced planning, while it was essentially supposed to be a public health decision. So a written plan detailing various aspects, such as the forecast of care, could have made all the difference. “
How the vaccination strategy will affect Modi’s ratings over the long term remains to be seen. However, there are already indications that Modi’s ruling BJP will have to pay for the Covid crisis in the elections.
Modi’s party failed to win the key state of West Bengal in a regional election last weekend and failed to win in three further state elections in April, although it retained power in the state of Assam.
Dr. Manali Kumar of the Institute of Political Science at the University of St. Gallen in Switzerland noted, “This second wave is a disaster caused by the complacency of the Indian government, which is now preoccupied with controlling the narrative rather than addressing the problem. ” “”
“Perhaps the worst disaster currently unfolding in India could have been avoided if restrictions on public and private gatherings had remained in place,” she noted, adding that “decades of neglect of investment in health infrastructure and an electorate Those who did not do this are also to blame for prioritized public services. “
Prime Minister Modi defended the government’s vaccination strategy, telling ministers in April that “those who are in the habit of politics (playing) allow it … I have received various allegations. We cannot stop those who do this to do.” We really want to serve humanity, which we will continue to do, “he said, the Times of India reported.
He also noted that an earlier peak of infections had been controlled this past September at a time when vaccines were not available and cases and mass tests were being tracked and followed.