As the second wave of COVID infections start to dwindle, India is still coping with the devastation it has left. But the biggest question in the minds of the people remains, ‘What's next?’. The fear of another deadly wave and a lack of treatments for the disease leaves only one solution to prevent the third wave from shattering the country- Vaccinations. In a country where Right to Life guarantees a right to health surely the task of inoculation falls solely on the Government’s shoulders, right? That is certainly not the case.
The top 2 contenders in the race
Indian’s are majorly receiving 2 vaccines- Covaxin and Covishield. Contrary to popular belief, these vaccines are currently being manufactured only by private sector holdings, who are bounded by India’s Vaccine Policy.
Covaxin, a truly ‘Made in India’ vaccine by Bharat Biotech. It was independently developed along with National Institute of Virology, and the government has recently allowed 3 public facilities to manufacture it.
Covishield, the local name for the Oxford-AstraZeneca vaccine, is being manufactured by the Serum Institute of India, the world's largest vaccine manufacturer. Serum holds the sole rights for its production in India.
Right to Health: for a price
India’s vaccination programme started out with free vaccinations for all healthcare and frontline workers in January 2021. These vaccinations were given only at government-run health facilities. The second and third phase allowed private health facilities to give vaccinations at the price of Rs 250—350.
The final phase, announced in the middle of the peak of the second wave, saw vaccination for all adults, but also a deregulation in prices. The liberalized policy mandated vaccine manufacturers to give 50 percent of their supply to the central government. They were allowed to sell the remaining to states and private players.
Since 1 May, vaccinations continued to be given for free in the public sector but prices went as high as Rs 2,000 per dose in the private sector, among the highest in the world.
The new COVID vaccination strategy, has allowed the Serum Institute of India (SII), to dominate the vaccine pricing and policy and earn super profits. Even with regulated pricing, companies more than made up for cost of production. The ability to fix prices for private contenders will undeniably skyrocket these profits.
Vaccine Politics
Founded in 1966, Serum Institute of India (SII) is an Indian biotechnology and biopharmaceuticals company. It is the world's largest vaccine manufacturer, and has been a much needed resource for vaccine provision with over 90% share in total 13 crore plus shots administered so far. What makes Covishield standout? Unlike its competitor Bharat Biotech, the creators of Covaxin, SII only procured manufacturing rights for the Oxford- Astrazeneca Vaccine, locally known as Covishield. These rights have come with global obligations as well.
Who plays ringmaster?
Serum institute is binded in a contract with foundations such as the Bill and Melinda Gates amongst others. These organizations are collectively operating under the Covax program co-convened by CEPI, Gavi, WHO– working in partnership with UNICEF to ensure COVID-19 vaccines are available worldwide to both higher-income and lower-income countries.
According to the agreement SII is contracted to provide COVAX with the SII-licensed and manufactured AstraZeneca (AZ)-Oxford vaccine (known as COVISHIELD) to 64 lower-income economies participating in the Gavi COVAX AMC (including India)
It is obligated to deliver 237 million doses of the AstraZeneca-Oxford vaccine by May and up to 400 million doses through 2021. According to the information shared by the ministry of external affairs, SII has till date only delivered 17.2 million doses to the COVAX facility.
One of the major implications of the COVAX agreement is it’s direct hinderance to the number of vaccines Indian market receives. SII cannot legally divert all production to the Indian market, amidst a significant surge in cases in the country.
This introduces us to the second bearer of the whip- The Government of India. SII being an Indian organization it’s trade and export are bound by the Centre’s rules. Manufacturers of the vaccine in India are obligated to sell 50% of their production to the Centre as per the latest vaccine policy. Couple that with India’s stellar performance in having the single largest daily COVID cases, and you have a grim picture.
India had slowed all major exports last month to sate the home demand. With the decrease in age limit for vaccinations and the liberalized policy, State’s are fighting tooth and nail to acquire doses.
“India is saying that first it will take care of its needs and for this, there may be some decrease in the doses to the COVAX facility for a short while." - Govt. Official
Serum is the only facility in India with the licence to manufacture Covishield. In a country where only 1.97% of the population has been fully vaccinated, the vaccine requirements are beyond comprehension. The added hounding of the COVAX program, has left Serum- with the production capacity of 65 million doses per month- in a sorry state.
The government has taken a decision to allocate Rs 3,000 crore to financially support Serum’s expansion plans. Serum expects to make 100 million doses per month by May-June.
A clamp on exports has delayed vaccine supply for the countries operating under the COVAX programme. SII faces severe hinderances in acquiring export licences as the Indian Government moves to firstly meet internal demands. COVAX has notified all affected economies of potential delays. SII has pledged that, alongside supplying India, it will prioritize the COVAX multilateral solution for equitable distribution.
Conclusion
With Serum Institute being bound on both sides, the vaccine drive in India and the COVAX countries will face severe regression. The license for manufacturing came with stipulated demands that the institute has failed to meet. With international demands taking forefront, India needs alternate options if it hopes to ward off further infectious bouts. The recent imports of Sputnik, Novavax starting production in India and increased public production of Covaxin, all play a crucial role but the question remains- Will they be enough to fill in Serum’s shoes?
Sources -Economic Times, Reuters, WHO, GAVI, Serum Institute of India
~ Devangi Sharma
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