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India is the country of the world’s largest producer of Covid vaccines. But it faces a major internal shortage

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People aged 18 and over waiting to be vaccinated against Covid-19 at a vaccination center in Radha Soami Satsang field run by BLK-Max Hospital on May 4, 2021 in New Delhi, India.

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As India experiences a devastating second wave of the coronavirus pandemic, questions are being asked about how the country – which is home to the world’s largest vaccine maker – has come to this tragic point.

India continues to report massive numbers of new infections. On Tuesday, it passed the grim milestone of reporting more than 20 million cases of Covid and at least 226,188 people have died from the virus, although the reported death toll is believed to be lower than the actual death toll.

In the meantime, India’s vaccination program is struggling to make an impact and supplies are problematic, although the country halted vaccine exports in March in order to focus on domestic vaccinations.

The sharp rise in infections seen in India since February has been attributed to the authorization of a large religious festival and election rallies, as well as the spread of a more infectious variant of the virus. Prime Minister Narendra Modi and his ruling Bharatiya Janata party have been criticized for their lack of caution and preparation, and accused of placing politics and campaigning above public safety.

A war of words over the government’s vaccination strategy also ensued. Lawmakers in power have been criticized for allowing the export of millions of doses earlier in the year.

To date, India has administered around 160 million doses of a coronavirus vaccine (the predominant vaccines used are the AstraZeneca vaccine, produced locally under the name Covishield, as well as a native vaccine called Covaxin developed by Bharat Biotech). In April, it approved the use of the Russian vaccine Sputnik V, and the first batch of doses arrived in early May, although it has yet to be rolled out.

So far, only 30 million people have received the two full doses of a Covid vaccine in India, according to government data. This is a small number (just over 2 %%) of India’s total population, or 1.3 billion people – although about a quarter of that total is under the age of 15 and, as that such, is not yet eligible for a vaccine.

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As of May 1, anyone aged 18 or over is eligible for a Covid vaccine although this extension of the vaccination program has been hampered given the dose shortages that have been reported across the country by national media.

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People receive their Covid-19 vaccines from medical staff at a vaccination center set up in the classroom of a public school on May 4, 2021 in New Delhi, India.

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New Delhi-based doctor Dr Chandrakant Lahariya who is also an expert in vaccines, public policy and health systems, told UKTN on Wednesday that India’s large adult population makes the vaccination effort difficult.

“Even though the planned supply was available, India opened up vaccination to a much larger population than any setting could possibly expect the vaccines (to be covered) to be covered. This is essentially the result of limited supplies and a vaccination policy that does not take supplies into account. . No advanced planning could have ensured this kind of supply, which is needed now with the opening of vaccination for 940 million people in India, ”he said.

Vaccine supplies are unlikely to change drastically, ”Lahariya said. “India needs 200-250 million doses per month for Covid-19 vaccination campaigns to reach full capacity and it has around 70-80 million doses per month. Obviously there is a long way to go to get this type of supply., ”he noted.

Vaccine wars

Gaps in vaccine supplies inevitably led to a shift in responsibility from vaccine manufacturers into the firing line. Questions about vaccine prices, manufacturing capacity and the destination of supplies have plagued the world’s largest vaccine maker, the Serum Institute of India, and Bharat Biotech, the Hyderabad-based pharmaceutical company that makes Covaxin.

Both saw their vaccine pricing structures (i.e. different prices for doses destined for central government, state governments, and private hospitals) criticized, leading the CEO of IBS to cut back. later prices against a backdrop of public backlash.

Adar Poonawalla, CEO of IBS which produces the Covid vaccine developed by AstraZeneca and the University of Oxford, said on Sunday that the institute had been blamed for a vaccine shortage and a scapegoat by politicians, but said that it had not increased its capacity earlier due to an initial shortage of orders.

“I was victimized in a very unfair and wrong way,” he told the UKTN on Monday, adding that he had not increased capacity earlier because “there were no orders, we didn’t think we had to make over a billion doses a year. “

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Poonawalla noted that the Indian government ordered 21 million doses of Covishield from the Serum Institute at the end of February, but did not indicate when or if it would purchase more, and then ordered an additional 110 million doses. in March when infections started to increase. .

Poonawalla said authorities in India did not expect to face a second wave of cases and therefore did not prepare for the attack of new infections at the end of winter.

He said the country’s vaccine dose shortage will continue until July, when production is expected to rise from around 60 million to 70 million doses per month, to 100 million.

For its part, the Indian government insists it has ordered and continues to order more vaccines to meet demand. On Monday, the government issued a statement in which it refuted media reports alleging that it had not placed new orders for Covid vaccines since March, stating that “these media reports are completely incorrect and are not based on facts “. He said he had advanced funds to both SII and Bharat Biotech to have vaccines delivered in May, June and July.

On Tuesday, Poonawalla issued a statement in which he sought to calm tensions between the government and the SII, noting that “the manufacture of vaccines is a specialized process, so it is not possible to increase production overnight. “.

“We also have to understand that the Indian population is huge and producing enough doses for all adults is not an easy task … We have been working with the Indian government since April of last year. We have all kinds of support … be it scientific, regulatory and financial, “he said. Poonawalla said the SII had received total orders of more than 260 million doses, without specifying the buyers.

Asked whether the government had misunderstood its approach to vaccine procurement and production, Lahariya noted that the government had become complacent, although the trajectory of the pandemic had been difficult to predict.

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“To be honest, I believe there were two surprises. Unlike a year ago, when the availability of the Covid-19 vaccine was expected around mid-2021, the vaccine became available a bit earlier. Second, the lull in Covid-19 cases in India has kind of put complacency across the board, “he noted. Lahariya added that while many months had been spent prioritizing the target population for vaccination, the program was then opened to all adults “too early”.

“It was a matter of rushed planning and arguably politically influenced, when it should essentially be a public health decision. That is why a written plan with details on various aspects, such as supply forecasts, could have been make the difference.”

Modi’s future

It remains to be seen how the vaccination strategy will impact long-term Modi evaluations. But there is already evidence that Modi’s ruling BJP is being forced to pay for the Covid crisis at the polls.

Modi’s party failed to win the key state of West Bengal in a regional election last weekend, and failed to win in three more state elections in April, although that he retained power in the state of Assam.

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Dr Manali Kumar of the Institute of Political Science at the University of St. Gallen in Switzerland noted that “this second wave is a disaster created by the complacency of the Indian government, which is now busy controlling the narrative rather than to tackle the problem. “

“Perhaps the worst of the disaster currently unfolding in India could have been avoided if restrictions on public and private gatherings had been left in place,” she noted, adding that “decades of neglect investments in health infrastructure and an electorate that does not have it Priority public services are also to blame. “

Prime Minister Modi defended the government’s vaccination strategy, telling ministers in April that “those who are used to being in politics, let them be … I have been faced with various allegations. We cannot stop those who are determined to play politics, but we are determined to serve humanity, which we will continue, “he said, The UK Time News reported.

He also noted that a previous spike in infections, last September, had been brought under control at a time when vaccines were not available and case tracking and traceability and mass testing had been used.

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