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COVID-19 Vaccine Update: A Look at India's Vaccine Manufacturing Capacity

Editor, TRANSFIN.
Dec 15, 2020 9:43 AM 5 min read
Editorial

November was a good month for COVID-19 vaccine updates.

Pfizer, Moderna, AstraZeneca, Sputnik V, Sinopharm... There are now many vaccine candidates whose high efficacy has already been proven and are now preparing for mass rollouts across the world. Many other candidates are in late-stage clinical trials, with results expected soon. Virologists say the world will have a basket of options to choose from by early 2021.

Some vaccines - like Pfizer’s - have already acquired the requisite regulatory approval in some countries for public use. The UK was the first country to do this; Canada, UAE and Bahrain have followed suit. Others like the US and India may issue their own approvals in the coming weeks.

Of course, this doesn’t mean that the pandemic is at an end. This is just the beginning of the end. Now that the R&D stage is nearly done with, the next big challenge has to do with manufacturing and distribution.

Considering that (ideally) the entire world population would have to be vaccinated for COVID-19’s chain to be definitely broken, vaccine distribution is a challenge of monumental and historic proportions.

And it’s something that hinges on India’s ability to deliver.

India's Vaccine Manufacturing Capacity

India is regarded as the “pharmacy of the world”. Its $34.3bn pharmaceutical industry is the third largest in the world in terms of volume and has grown robustly in recent years.

The key stat to note is this: India manufactures over 60% of vaccines sold worldwide. The country’s pharma cos already supply large amounts of medicines and vaccines to global health programmes such as PEPFAR, the Global Fund to Fight AIDS and Gavi. They will invariably play a pivotal role in ensuring that a coronavirus vaccine reaches as many people in as little time as possible.

The world’s largest vaccine maker, Pune-based Serum Institute of India, has already stockpiled 50 million shots of the Oxford vaccine, and is awaiting the green signal of authorities in India and the UK.

Biological E has struck a deal with Johnson and Johnson to produce up to 500 million doses of the latter’s vaccine if it is successful. Hyderabad-based Bharat Biotech will manufacture 1 billion doses of Washington University’s intranasal vaccine. And Dr Reddy’s will produce 100 million doses of Russia’s Sputnik vaccine.

Moreover, there are also at least a dozen indigenous vaccines being developed within the country. These include ones by Bharat Biotech, Gennova Biopharmaceuticals and Biological E.

 

Pre-empting Demand

Many vaccine manufacturers are already amping up production capacities and infrastructure, expecting a surge in demand in the near-term. This goes for companies invested in other components in the vaccine chain as well. Especially cold storage (companies like Snowman Logistics and Hindustan Syringes & Medical Devices) and logistics (companies like DHL and FedEx).

Mumbai-based Schott Kaisha, which is in supply talks with around 10 vaccine makers at home and abroad, is increasing its annual manufacturing capacity by 300 million to 1.5 billion vials. Hindustan Syringes will increase capacity by 42% to 1 billion units by the first half of 2021.

Other major pharma firms are doing the same. SGD aims to add 100 million units to its current capacity of 350 million glass vials while Piramal Glass says it can double its specialised vial capacity at just a month’s notice “to meet any unforeseen demand”.

Many of these companies are investing heavily in facilities even before receiving adequate orders from governments. This is a calculated risk. Demand for their products is a given, so being prepared to meet that demand would be a wise decision to avoid last minute shortages. (Remember the face mask and hand sanitiser supply shortages that plagued many countries earlier this year?)

 

International Distribution

Being the world’s largest vaccine maker gives India a historic responsibility that is also a strategic advantage. Vaccine exports place the country at the very centre of the global supply chain.

As Australia’s ambassador to India, Barry O’Farrell, said recently, “There are many vaccines being produced in countries around the world but there’s only one nation that has the manufacturing capacity to produce sufficient quantities to satisfy the demands of citizens in every country, and that’s India.”

Foreign Secretary Harsh Vardhan Shringla recently briefed a group of diplomats and assured them that “India’s vaccine production and delivery capacity will be used to help all humanity in fighting this crisis. India will also help interested countries in enhancing their cold chain and storage capacities for the delivery of vaccines.”

Indian airports have duly begun preparing for the inevitable. For example, Mumbai Airport is the largest gateway for pharmaceutical exports. It has begun putting in place a variety of measures to ensure smooth and swift export of vaccines. These include a task force to handle vaccine shipments, a 24-hour customer service cell, and flexible slots available for ad hoc charter operations.

As far as supply is concerned, companies like Serum Institute have assured that about 50% of what they manufacture would be reserved for exporting, particularly to low and middle income countries. The remaining would be for domestic administration.

Speaking of which... 

 

Domestic Distribution

Vaccinating the world is one thing, vaccinating the country is a whole different ball game.

After all, India has the world’s second-largest COVID caseload and third-largest number of deaths. It is still reporting about 30,000 new cases on a daily basis - though this has come down from the near-100,000 peak in September. Besides the immense human toll, the pandemic has wrecked the country’s economy, which has entered a recession for the first time on record.

The Indian Government aims to initiate mass vaccination drives early next year and see 200-250 million vaccinations by July 2021. On priority to receive vaccinations would be healthcare workers and those particularly vulnerable to the virus, such as the elderly.

Now, while the pandemic is pushing the country’s public and private health systems to their limits, distributing vaccines across the country is something India has prior knowledge about. Indeed, it is something it excels in.

India’s Universal Immunisation Programme (UIP) is one the largest in the world, with over 700 refrigerator vans, 70,000 vaccinators and 28,000 functional cold chain points. Significantly, around 95% of these are located below the district level. The programme is used to administer the BCG, polio and hepatitis vaccines.

It is this UIP infrastructure that will be tapped to reach the last mile, from cities to the hinterland, when mass inoculations against COVID commence.

The fact remains, however, that what lies ahead for the country will be a battle like no other, regardless of the effectiveness of its earlier immunisation programmes. Besides, the UIP was designed primarily for babies and pregnant women. Vaccine distribution will have to prioritise frontline workers and the elderly.

Then there’s cost. Let’s set aside the Pfizer and Moderna vaccines - both are expensive and have advanced cold storage requirements. The vaccine candidate that is most promising for India - AstraZeneca-Oxford - is expected to cost about $5. Assuming 250 million Indians get vaccinated by July, that’s a hefty bill of $1.25bn. A lot of money for a country with an already overstretched fiscal deficit.

Moreover, much of the distribution will take place during summer - and Indian summers can be very hot. Vaccines need to be stored in cold temperatures throughout their journey from manufacturer to their destinations in hilltops, desert hamlets, jungles and faraway islands. And India’s cold storage infrastructure, as we discussed in an earlier E-O-D, is in dire need of an upgrade.

FIN.

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