{"id":31263,"date":"2021-05-11T08:09:06","date_gmt":"2021-05-11T04:09:06","guid":{"rendered":"http:\/\/www.mauritiustimes.com\/mt\/?p=31263"},"modified":"2021-05-11T08:09:06","modified_gmt":"2021-05-11T04:09:06","slug":"what-indias-second-wave-means-for-its-vaccine-coverage-and-the-rest-of-the-world","status":"publish","type":"post","link":"https:\/\/www.mauritiustimes.com\/mt\/what-indias-second-wave-means-for-its-vaccine-coverage-and-the-rest-of-the-world\/","title":{"rendered":"\u2022\tWhat India\u2019s second wave means for its vaccine coverage \u2013 and the rest of the world"},"content":{"rendered":"

\"\"<\/em><\/p>\n

 <\/p>\n

Increased demand and falling supplies in India risk leaving many countries empty handed<\/em><\/span><\/h4>\n

\"\"<\/span>Farooq Khan\/EPA-EFE<\/span><\/p>\n

With rich countries having bought up the majority of the world\u2019s Covid-19 vaccines, the rest of the world has relied on India \u2013 one of the world\u2019s largest vaccine producers and exporters \u2013 to increase access to doses.<\/span><\/p>\n

But now India\u2019s exports \u2013 which include supplies for Covax, the global vaccine-sharing programme, as well as bilateral donations and commercial agreements branded under its \u201cvaccine friendship\u201d programme \u2013 are being disrupted. India\u2019s devastating second wave has led it to redirect more of its vaccine production towards its domestic immunisation programme. With so many countries relying on India for supply, this is threatening vaccination progress globally.<\/span><\/p>\n

The UN secretary general, Ant\u00f3nio Guterres, has hailed India\u2019s vaccine production capacity as \u201cone of the best assets the world has today\u201d.<\/span><\/p>\n

India is a key supplier to Covax. At the beginning of the year, Covax was forecast to deliver 2.3 billion doses to low-income and middle-income countries in 2021, with more than 1 billion of these produced by the Serum Institute of India, the single largest vaccine manufacturer in the world.<\/span><\/p>\n

Of the 53.9 million doses shared around the world by Covax up to May 6, 19.8 million were exported from India, with a further 10 million Indian-made doses being supplied directly back to the country.<\/span><\/p>\n

Changing priorities<\/strong><\/span><\/p>\n

At the start of the year, the Serum Institute\u2019s CEO, Adar Poonawalla, declared that India had more vaccine stock than it could physically administer. But the second wave has seen India\u2019s position quickly deteriorate \u2013 and with it the prospect of the country meeting its commitments to Covax.<\/span><\/p>\n

By mid-March, the Serum Institute was dedicating much more of its capacity to India than originally planned.<\/span><\/p>\n

The Indian government has repeatedly stated that there\u2019s no export ban on Covid-19 vaccines, but consignments due to many countries \u2013 including the UK \u2013 have been delayed. Only 6 million vaccines have been exported since late March, compared to 60 million in the previous two months.<\/span><\/p>\n

At the same time, the number of Covid-19 vaccine doses administered monthly in India has increased from 3.7 million in January, to 10.1 million in February, 50.6 million in March and more than 90 million in April. By May 6, over 162 million doses had been administered \u2013 the third highest number in the world after the US and China.<\/span><\/p>\n

There has been a clear effort to increase vaccination as India\u2019s second wave has materialised. Indeed, India\u2019s vaccination programme was expanded at the beginning of May so all adults could register to receive a dose.<\/span><\/p>\n

The world\u2019s pharmacy is out of stock<\/strong><\/span><\/p>\n

The second wave is not the only reason exports have dried up. The escalating crisis has also revealed critical production shortages: increasing demand is being met with dwindling supply. The seven-day average of doses administered fell from 3.6 million per day in early April to 1.7 million a month later.<\/span><\/p>\n

This problem has been brewing since before the second wave. Back in February, Poonawalla warned that the Serum Institute wouldn\u2019t make 1 billion Covid-19 vaccine doses it was predicted to this year, but rather 400 million doses \u201cif we\u2019re lucky\u201d. He therefore cast doubt on Covax\u2019s ability to supply over 2 billion doses to countries around the world by the end of 2021, suggesting 18 months was a more likely timeline.<\/span><\/p>\n

Even if all of India\u2019s vaccine production capacity is dedicated to domestic supply in the coming months, capacity may still be insufficient. The Serum Institute has manufactured more than 90% of the vaccines administered in India so far, but its monthly production is estimated at only 60 million doses. The target of increasing this to 100 million doses has been frequently delayed \u2013 from March, to April, May, June and now July. India\u2019s only other supplier, Bharat Biotech, has an estimated monthly capacity of just 5 million doses.<\/span><\/p>\n

India\u2019s goal in January was to have ramped up production sufficiently to have fully vaccinated 300 million of its people by August. To achieve this now requires giving another 440 million doses, averaging over 3.5 million a day, over the next four months \u2013 a tall order.<\/span><\/p>\n

So what happens now?<\/strong><\/span><\/p>\n

According to Poonawalla, the absence of advance purchase agreements for the Serum Institute\u2019s vaccines slowed down its rate of production in 2020. However, such agreements have been more forthcoming in 2021. The biggest to date was announced on April 19, with advanced purchases of Rs 3,000 crore (US$406 million) to the Serum Institute and Rs 1,500 crore (US$203million) to Bharat Biotech. This money should enable them both to scale up production.<\/span><\/p>\n

Other vaccines are also expected to be available later in the year. Russia\u2019s Sputnik V received approval on April 13, becoming the third allowed for use in India, with the first batch imported on May 1 and partnerships in place with Indian companies for local production. Johnson & Johnson\u2019s vaccine may be imported from July, with a local production partnership also in place. But the Novovax vaccine, which Serum Institute is manufacturing, reportedly won\u2019t be available until September.<\/span><\/p>\n

With India struggling right now just to meet domestic demand, the immediate prospect of it making substantial vaccine exports looks bleak. Recognising India\u2019s domestic crisis, Mexico has waived an upcoming delivery of 870,000 doses. The Serum Institute is also issuing refunds to some governments, is reportedly being sued by others, and has received legal notification from AstraZeneca over delays.<\/span><\/p>\n

Insufficient and delayed supply from India \u2013 potentially for a number of months \u2013 will be a major setback for Covax.<\/span><\/p>\n

Recent donations of 500,000 and 1 million doses by France and Sweden respectively are drops in the ocean compared to the supply that had been expected from India. Moderna\u2019s new deal announced on May 3 to supply Covax with 500 million doses includes only 34 million in 2021.<\/span><\/p>\n

The need to scale up Covid-19 vaccine production has never been more evident. But while that happens, countries besides India urgently need to step up their Covax donations. Covid-19 vaccination can then continue elsewhere as India fights its domestic crisis \u2013 helping to prevent other countries experiencing such devastation.<\/span><\/p>\n

Rory Horner<\/strong>, <\/span>
\nSenior Lecturer, <\/span>
\nGlobal Development Institute, <\/span>
\nUniversity of Manchester<\/span><\/p>\n

\n

* Published in print edition on 11 May 2021<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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