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India’s double challenge: the world’s pharmacy needs




  Will there be enough doses?


On April 11, India recorded nearly 170,000 cases of Covid-19, a record for the country since the start of the pandemic. The day before, India crossed another type of milestone: the vaccination of 100 million people. It is this swing of desperation and hope that India is riding today, battling the epidemic with a health system on the brink of collapse even as its pharmaceutical industry tries to fill the global prescription of doses of vaccine.

India hit the 100 million vaccine mark in 85 days, faster than the United States and China, which took 89 and 102 days, respectively. But the task ahead is daunting: the government of Prime Minister Narendra Modi has set itself the goal of completely vaccinating 300 million people by July.

The arithmetic alone is daunting. India started with a stockpile of 100 million doses of the vaccine at the start of the year. Its two manufacturers – the Serum Institute of India and Bharat Biotech – are equipped to produce 66 million doses per month until June, or 396 million in total. But they also have the obligation to provide Unicef’s COVAX program and export agreements elsewhere up to 80 million doses. That leaves 416 million doses for local use: 184 million doses less than the 600 million needed to meet the July target.

Already, the Serum Institute in Pune – which manufactures the AstraZeneca blow, called Covishield in India – and Bharat Biotech, based in Hyderabad – which makes the locally developed Covaxin – are already at full capacity. New vaccines from new manufacturers are expected to hit the market.

The shortage comes at a crucial time in the global fight against Covid-19 – and in India’s impressive vaccine diplomacy so far. Shipments went from Asia to the Caribbean, Africa to Latin America in boxes labeled with the Sanskrit phrase Sarve bhavantu sukhinah, “May all be happy.” Bhutan has administered at least one dose to over 60% of its population using vaccines produced in India. New Delhi also supplied serum to Paraguay, which had been under pressure from Beijing to sever ties with Taiwan in order to obtain vaccines made in China.

But the generosity of diplomacy earned the internal anger of the Modi government. The Indian vaccine stock is distributed to all states that administer the health system. The just-in-time replenishment has led to stockouts in some cities, sparking criticism over the inequitable availability of vaccines as exports continue and local vaccinations are limited to people aged 45 and over.

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