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India could have stockpiled the Covid-19 vaccines in adequate quantity to effectively arrest the second wave, but grew complacent and inattentive, failing to proactively vaccinate its population at the earliest. Indian Government’s lack of focus and foresight plunged the world into a deeper crisis created by an avoidable vaccine shortage.

Highlights

  • With the second wave slamming hard, India quickly went from a leading exporter to a massive importer of Covid-19 vaccines.
  • It was only in April 2021 that additional manufacturers were roped in to scale up the production of Covaxin.
  • With the increased demand for COVID-19 vaccines in India the delivery of doses from the SII to the Covax scheme has been delayed.
  • The Covax scheme is now facing a shortfall of tens of millions of doses, leaving millions worldwide, who banked upon the timely supply of doses from the SII, in serious peril. 

The Indian government admitted to the Supreme Court that “no governmental aid, assistance or grant” was extended for Covid-19 vaccines, Covishield and Covaxin, at any stage except for conducting clinical trials and the advance payment for the vaccine supplies. Covishield has been developed by Oxford-AstraZeneca and is being manufactured in India by the SII under license. Covaxin has been indigenously developed by Bharat Biotech in collaboration with the Indian Council of Medical Research (ICMR) and National Institute of Virology (NIV). 

The NIV is a part of the ICMR, which is funded by the Government of India through the Department of Health Research, Ministry of Health and Family Welfare. Yet it was only in April 2021 that additional manufacturers were roped in to scale up the production of Covaxin, and the rules to make “advance payment” to Covid-19 vaccine manufacturers were relaxed to speed up vaccine procurement. But even this little, this late charge doesn’t seem to have panned out. Delhi Chief Minister Arvind Kejriwal is still requesting the Prime Minister to end the “duopoly”. According to a report published on May 16, 2021, the government is still only readying the state-run manufacturers to produce Covaxin with Bharat Biotech sharing the formula. This indicates a complete lack of foresight and preparedness.    

The government has been so lax in its pandemic response that until very recently, there were no advance purchase orders placed with the manufacturers, which created a liquidity shortage, delaying ramping up vaccine production. SII’s plan to increase production went from stocking 50 million doses in December 2020 to 100 million in March 2021. To inoculate 300 million Indians, around 650 million doses were required. Out of this, 150 million were coming from Bharat Biotech (Covaxin) and the rest from the SII (Covishield). So out of the 650 million required doses, India had around 250 million coming in from both the manufacturers by March 2021. This left the country far too short, meaning there was no room for exporting the vaccines at all. And yet India exported more than it kept for domestic use. “We have supplied more vaccines globally than having vaccinated our own people,” India told the UN on March 26, 2021. That was true.

The SII had said in December 2020 that 50% of their Covid-19 vaccine produce would go to India and Covax. This means half of the total output was to supply the needs of both Covax and India. This means that even if the SII could have doubled its manufacturing capabilities, the number would’ve been still way short of the 650 million doses needed.   

As per the data available with the Ministry of External Affairs, as of May 16, 2021, India has exported 66.36 million doses to 95 countries, out of which 10.7 million were by way of grant, 19.8 million under the Covax program, and 35.7 million were sold (commercial). Hence, India sold more than it gave away in grant and supplied under the Covax arrangement combined. All vaccine exports are on pause since April 16, 2021, with the last sale on March 29, 2021, to Palestine, the last supply under Covax on April 16, 2021, to Syria, and the last grant on April 16, 2021, to Albania.

How India worsened the Global Crisis 

The Serum Institute of India (SII) had received funding to ramp up its manufacturing capacity under agreements with Gavi and the Bill & Melinda Gates Foundation signed in August and September 2020. Under the agreement, the SII was contracted to supply up to 200 million doses of Covishield vaccine to 64 Low and Middle-Income Countries (LMICs) as part of the Gavi COVAX AMC mechanism within the Covax Facility

Infographic: Vaccine Exports From India Slow | Statista You will find more infographics at Statista

The Indian government knew that in addition to domestic commitments, the SII also had international commitments to supply a large number of doses, and it was in the process of scaling up its manufacturing capacities. So it did not have the standing capacity to meet all demands, and things could go wrong and there could be unforeseeable eventualities hindering the supply. But the government did not think of having Covaxin manufactured in larger quantities to ensure an ample, unhindered supply of vaccine doses required to fast-track nationwide vaccination in order to counter an imminent second wave. The vaccination, even in phases, could have progressed much faster and could have saved a large number of lives lost to the second wave.

Under the Covax scheme, the 64 countries to receive the vaccine are those that have no access to the vaccine except through the Covax facility. This list includes Algeria, Malawi, and Uganda in Africa; Iran and Iraq in the Middle East; and Barbados, El Salvador, and Nicaragua in the Americas. The vaccine with the greatest worldwide reach is the Oxford-AstraZeneca vaccine (Covishield), of which the SII is a major supplier. But due to the sudden surge in Covid-19 cases in India and “the increased demand for COVID-19 vaccines in India”, the delivery of doses from the SII has been delayed. Additionally, the Covax scheme is now facing a shortfall of tens of millions of doses on that account, leaving millions worldwide, who banked upon the timely supply of doses from the SII, in serious peril. 

Infographic: Progress of COVAX Deliveries to the Top Beneficiaries | Statista You will find more infographics at Statista

With the second wave slamming hard, India quickly went from a leading exporter to a massive importer of Covid-19 vaccines. Let alone hauling the world out of the pandemic, it could not even pull its own weight due to a complete lack of preparedness and foresight. India did not have to depend solely upon Covishield, for it had Covaxin and also manufacturers who could scale up the production. With Covaxin pitching in to share the load, the SII could have supplied Covishield in adequate quantities to both India and the world. But the government was obviously attending to some other, more urgent business, for the lack of focus couldn’t be starker. In a situation where an idle blink could cost lives, the Government was found napping at the wheel. 

The post India’s Vaccine Mismanagement Compromises Global Pandemic Response appeared first on DKODING.

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