Virendra Pandit
New Delhi: Until early March, India was the world’s top vaccine exporter for the Covid-19 pandemic, providing jabs to about 65 countries; then it stopped exports and became an importer instead to meet its own urgent needs because of a devastating second wave of the pandemic.
Now the World Health Organization (WHO) has reminded the Serum Institute of India (SII) of its commitments to export vaccines. But the exports cannot resume before October 2021.
Battling a fierce second wave, India’s Covid-19 death toll on Tuesday climbed to 278,719 with a record 4,329 fresh fatalities, while the single-day rise in cases stood at 2.63 lakh, the lowest in 28 days, according to the Union Health Ministry data.
New Delhi is unlikely to resume major exports of Covid-19 vaccines until at least October as it diverts shots for domestic use. It may worsen supply shortages from the global COVAX initiative to other countries, sources said.
The exact timing for resuming exports could change depending on how soon India is able to control the second wave of cases that has overwhelmed the health system.
As the world’s biggest jump in coronavirus infections unfolded, India halted vaccine exports in early April after donating or selling more than 66 million doses. The move has left countries including Bangladesh, Nepal, Sri Lanka and many in Africa scrambling for alternate supplies.
WHO Director-General Tedros Adhanom Ghebreyesus said on Monday that once the second wave recedes in India, the SII will need to get back on track and catch up on its delivery commitments to COVAX, the global initiative to supply coronavirus vaccines to nations around the world.
The surge in pandemic cases in many countries has compromised the global vaccine supply and there is already a shortfall of 190 million doses to COVAX by the end of June, he said.
US President Joe Biden said on Monday his country would export at least 20 million doses of the Pfizer/BioNTech, Moderna and Johnson & Johnson shots, on top of 60 million AstraZeneca doses he had already planned to give to other countries.
His move came as WHO chief Ghebreyesus warned that the world has reached a situation of “vaccine apartheid”, calling on wealthier nations and vaccine producers to increase vaccine sharing.
COVAX, the global vaccine equity scheme, has so far delivered 65 million doses to 124 countries and economies but it is dependent on countries and manufacturers honouring their commitments.
Meanwhile, UNICEF said the devastating surge in coronavirus cases in India has adversely impacted vaccine supplies to the COVAX facility. Because of the soaring domestic demand, 140 million doses intended for distribution to low- and middle-income countries through the end of May cannot be accessed by COVAX. On Monday, UNICEF asked G-7 countries to donate supplies to COVAX as an emergency measure to address a severe shortfall caused by disruptions to Indian vaccine exports.
Another 50 million doses are likely to be missed in June, UNICEF Executive Director Henrietta Fore said in a statement, media reported.
The shortfall numbers are based on delays related to shipment numbers from the SII only. Other delays related to the original COVAX delivery schedule are expected to be made up by the end of June.
UNICEF said the COVAX facility will deliver its 65 millionth dose in the coming days when it should have been at least 170 millionths.
By the time G-7 leaders gather in the UK next month, amid a deadly second wave of Covid-19 currently sweeping across India and its South Asian neighbours, the shortfall will be near 190 million doses.
Fore said, besides vaccine nationalism, limited production capacity and lack of funding is the reason why the roll-out of Covid vaccines is so behind schedule.
“We are concerned that the deadly spike in India is a precursor to what will happen if those warnings remain unheeded. While the situation in India is tragic, it is not unique.”
Cases are exploding and health systems are struggling in countries nearby like Nepal, Sri Lanka and the Maldives and far, like Argentina and Brazil, Fore said, warning that the cost for children and families will be incalculable.
The longer the virus continues to spread unchecked, the higher the risk of more deadly or contagious variants emerging, she said, adding that the clearest pathway out of this pandemic is a global, equitable distribution of vaccines, diagnostics and therapeutics.
Early in May, SII CEO Adar Poonawalla said it was not possible to ramp up production overnight since vaccine manufacturing is a specialised process. The SII has received total orders of over 260 million doses from the Government of India, of which more than 150 million doses have been supplied. In a tweet last week, Poonawalla said that the SII is doing its best to ramp up production and launch new vaccines on priority for India.
Fore cited new data analysis provided by life sciences research facility Airfinity that indicates that G-7 nations and Team Europe’ group of European Union member states could donate around 153 million vaccine doses if they shared just 20 per cent of their available supply over June, July and August.
COVAX had inked a deal with the SII to deliver 1.1 billion doses of either the AstraZeneca or Novavax shots. UNICEF, which is helping supply Covid-19 vaccines through COVAX, estimates the supply shortfall at about 190 million by the end of June.
The WHO chief said Pfizer has committed to providing 40 million doses of vaccines with COVAX this year, but mostly in the second half of 2021. Moderna also will also supply 500 million doses with COVAX, mostly in 2022.
As per the pact which included funding to support manufacturing increase, the SII is contracted to provide COVAX with the SII-licensed and manufactured AstraZeneca-Oxford vaccine (known as Covishield) to 64 lower-income economies participating in the Gavi COVAX AMC (including India), alongside its commitments to the Government of India.
Last year, it was announced that the collaboration among SII, Gavi and the Gates Foundation would accelerate manufacturing and delivery of up to an additional 100 million doses of future vaccines for low- and middle-income countries in 2021.
On Monday, the WHO, which co-leads COVAX, called on vaccine makers outside India to advance supplies to the programme given the shortfall from the South Asian country.
“As India confronts a truly dreadful wave of the pandemic, Indian vaccine production, including the 140 million vaccine doses initially destined for COVAX, have been committed to protecting its own citizens,” a GAVI spokeswoman was quoted as saying in a media report.