Jab shortages threaten India's place as global vaccine hub

Faced with an acute shortage of Covid-19 vaccines, the Indian government has contracted three state-owned vaccine makers to boost production of Covaxin, one of the two approved Covid-19 vaccines in the country.

Vaccine policy experts said the decision was long overdue and the government must marshal more such manufacturers to ensure vaccine and health security beyond the second wave of the pandemic.

The government's April 17 decision came amid soaring infections and inadequate vaccine production by the two main manufacturers, both private companies - Serum Institute of India, which makes AstraZeneca's vaccine; and Bharat Biotech, which makes Covaxin.

India recorded more than 363,000 infections and 4,100 deaths in the past 24 hours. It needs to vaccinate 70 per cent of its population of 945 million people to achieve herd immunity. But 117 days after its Covid-19 vaccination programme began, less than 10 per cent of the population has received the jabs.

Government data shows vaccination rates crashed by half late last month as supplies of vaccines dried up. Prime Minister Narendra Modi's government blames the supply crunch on rising infections and an unexpected uptick in demand for vaccines, but experts say poor planning contributed to the crisis.

"We are facing an acute vaccine shortage because the government's vaccine policy depended excessively on only two manufacturers, and these two companies exaggerated their supply capabilities," said Ms Malini Aisola, co-convenor of the All India Drug Action Network, a movement that campaigns for affordable healthcare.

Serum Institute can currently produce 70 million doses a month of the AstraZeneca vaccine, known locally as Covishield, and Bharat Biotech can make 10 million doses of Covaxin. Together, they had promised to make 200 million doses a month by this month.

On March 17, the Health Ministry set up a six-member inter-governmental panel to explore how to ramp up vaccine production.

A month later, it permitted three state-owned companies - the Hyderabad-based Indian Immunologicals; Bharat Immunologicals and Biologicals in Bulandshahr city in Uttar Pradesh; and the Mumbai-based Haffkine Institute - to scale up the manufacturing of Covaxin. It will also invest in installation of the facilities required.

The Indian government co-owns Covaxin, and two public institutes were involved in developing it.

The new units will reportedly double the manufacturing of Covaxin to 20 million doses a month by next month. By August, the companies are projected to make 60 million to 70 million doses a month, and about 100 million doses by September.

Dr K.V. Balasubramaniam, a life sciences consultant and former managing director of Indian Immunologicals, welcomed the "long-overdue decision" to include existing state-owned units in vaccine production, but noted that the timelines might be impractical, given the lack of equipment and trained manpower.

Only Indian Immunologicals has the highly secure Biosafety Level 3 production facilities for making Covaxin, which involves the cultivation of large batches of the highly infectious coronavirus before inactivating them.

Furthermore, Covaxin accounts for only one-tenth of the jabs given in India. The rest are Covishield shots. AstraZeneca owns the rights to Covishield, making it complicated for the Indian government to sub-contract vaccine makers for it.

"For ensuring long-term, sustainable, affordable supply of vaccines, India needs to use its large, experienced public-sector vaccine manufacturers. This will ensure stable supply and minimal prices because it's under government control and will not have market uncertainties like private companies do," said Dr Y. Madhavi, a senior principal scientist at the National Institute of Science, Technology and Development Studies in Delhi who has researched India's vaccine policy for decades.

There are other vaccines in the pipeline. India has allowed the import of foreign-made shots from Pfizer, Moderna and Johnson & Johnson. The Hyderabad-based Biological E has its own vaccine candidate, and is also contracted to make Johnson & Johnson's single-dose vaccine in India.

India's drug regulator recently approved the Russian vaccine Sputnik V for emergency use. Russia had entered into advance agreements last year with five Indian manufacturers to make Sputnik V for Indian and foreign use.

Correction note: The article was edited to reflect the correct name of Dr KV Balasubramaniam. We are sorry for the error.