On the fast track towards making 11 billion doses of vaccine

Never before has humanity tried to produce something so quickly for every living person on Earth.

With a handful of Covid-19 vaccine candidates lifting hopes that a viable one may soon be found, global attention is turning to where the precious commodity can be manufactured, and if sufficient amounts can be churned out quickly enough for everyone.

Leading vaccine candidates in the US include one being developed by Pfizer and BioNTech, and another by Moderna. China's vaccines - from Sinovac Biotech and Sinopharm - as well as Russia's Sputnik V are also thought to show promise. All of them require two doses per person.

Given a global population of 7.8 billion and with the World Health Organisation (WHO) putting the Covid-19 herd immunity threshold at around 70 per cent, 11 billion vaccine doses would be required if any of them should prove effective.

The figure has yet to factor in wastage from challenges in producing, transporting, storing and handling them. Production of other vaccines will also need to continue while the coronavirus ones are being manufactured. The world's vaccine factories have to rapidly ramp up capacity to cater to that.

The world's largest vaccine maker, the Serum Institute of India, has already warned that there will simply not be enough Covid-19 vaccines to go around until the end of 2024 at the earliest.

"It's going to take four to five years until everyone (in the world) gets the vaccine," its CEO Adar Poonawalla said in September.

The most recent estimate on global Covid-19 vaccine manufacturing capacity has British research firm Airfinity putting it at more than 16 billion by the end of 2021. Actual viable doses may fall by as much as two-thirds, though, after factoring in the probability of failure each step of the way, based on projections from European think-tank The Yellow House.

Furthermore, 9.5 billion doses of the Covid-19 vaccine have already been reserved by the world's richer nations, according to an analysis last week by the Duke Global Health Innovation Centre's Launch and Scale Speedometer initiative. Canada alone has secured enough to vaccinate its population five times over.

"It is sadly inevitable that demand for Covid-19 vaccines will vastly outstrip supply in the short term, leaving the majority of people unprotected," said Dr Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations (Cepi).

The agency aims to secure production of two billion doses of the Covid-19 vaccine by end-2021 for those who need them most.

A Cepi survey of 113 vaccine makers in May and June found that a third of them were based in the US while India and China together account for about a quarter of them.

Although the world's top five vaccine makers by revenue are all from the United States and Europe, it may be India and China, with their vast production capability and potential, that hold the key to creating enough of the coronavirus vaccine to supply the world.

India has long been rooted in the global supply chain, with its high-quality, low-cost drug exports. It supplies some 60 per cent of the world's vaccines.

Serum Institute's Mr Poonawalla, who aims to raise the company's Covid-19 vaccine-making capacity to one billion doses through 2021, has pledged that "50 per cent of whatever quantity we manufacture will be kept for India and the remaining will go to low-and middle-income countries".

China has until now mainly served its domestic market, with a fragmented industry of thousands of small vaccine makers riddled with safety scandals in recent years. Less than 5 per cent of Chinese-made vaccines are sold abroad.

But Beijing's confirmation last month that it would join the Covax initiative to ensure equitable distribution of Covid-19 vaccines around the world can help integrate it into the global supply chain as its manufacturers contribute vaccines prequalified by WHO to the rest of the world.

Covax, co-led by the WHO, Cepi and Gavi, the Vaccine Alliance, is backed by over 180 countries including Britain, Japan and Singapore. The US under President Donald Trump is not part of the effort, calling it too constraining.

It is hard to say exactly where the coronavirus vaccines will be made. Many countries are in the game, each with a vital role in piecing together the final products that can end the pandemic.

Among them, Britain's GlaxoSmithKline (GSK) and France's Sanofi - respectively the world's first and third-biggest vaccine makers by revenue - are together scaling up manufacturing of components of their vaccine candidate.

"One country cannot think of manufacturing a vaccine on its own," a GSK spokesman said.

Indonesia's sole vaccine maker Bio Farma has partnered Sinovac Biotech to manufacture the final product from active ingredients provided by the Chinese pharmaceutical giant.

Even tiny Singapore, in its role as a global biomedical hub, has built up additional capacity to provide vaccine developers with contamination-free fillings of drugs into vials and syringes.

As countries come together like never before to create a vaccine to solve the world's collective woe, everyone will do well to remember that there can be no faster, surer way to reach this shared objective, except through wholehearted cooperation and collaboration.