Lessons from India's jab rollout

Lessons from India's jab rollout

In just 12 days after India launched its Covid-19 vaccination programme on Jan 16 -- touted as the world's largest coronavirus jab rollout -- more than 2.3 million healthcare workers have been inoculated against the virus. In Phase I of the drive, India plans to vaccinate some 30 million healthcare and frontline workers.

For India, such large-scale vaccinations are not new. Every year, 27 million infants are immunised against 12 diseases. The government's polio immunisation drive, which successfully eradicated the disease from India, has even set the global standard for such programmes.

Worth noting is the fact that the two Covid-19 vaccines authorised for emergency use in the country are domestically manufactured -- the AstraZeneca/Oxford-developed Covishield, which is produced by the Serum Institute of India; and Covaxin, developed indigenously by Bharat Biotech and the Indian Council for Medical Research.

India is one of the world's biggest vaccine producers, with a combined capacity to make 8.2 billion doses of vaccines for different diseases. In fact, India supplies some 1.5 billion doses annually to more than 150 countries, and the nation is the world's largest supplier of the DPT, BCG and measles vaccines. It is also a leader in vaccine research and development (R&D), with a well-developed ecosystem which links not only the public and private sectors but also the academia and other industry players, in a network which spurs innovation.

In addition to the two Covid-19 vaccines which are being administered across the country, there are five other candidates -- including three indigenously developed vaccines which are currently undergoing clinical trials. Among them is the DNA vaccine candidate called ZyCovV-D, made by Indian pharmaceutical company Zydus Cadila, which is in Phase II trials. Zydus Cadila has good credentials -- it launched a successful H1N1 vaccine after 10 months of R&D in 2010.

These capacities were developed assiduously over several decades. Back in the 1960s, vaccine production was done by state entities. With the entry of private companies in vaccine manufacturing, the sector has truly been transformed. From their initial role as producers of "standard" vaccines, Indian pharmaceutical companies have evolved to produce more complex jabs, for example, against meningitis, avian influenza and so on.

In India, government institutions and regulatory authorities are working together with the private sector to create a conducive regulatory environment which would support the development of vaccines.

As an example, the Immunoassay Laboratory of the Translational Health Science and Technology Institute (THSTI), an autonomous body under the Indian Department of Biotechnology is one of six designated global labs for the centralised assessment of Covid-19 vaccines. The lab, along with the National Immunogenicity & Biologics Evaluation Centre and supported by the National Biopharma Mission, played a key role in the evaluation of these Covid-19 vaccines.

Under Mission Covid Suraksha, the Indian government allocated than US$100 million (about 3 billion baht) to support vaccine development and conduct human trials. The National Biopharma Mission -- an industry-academia collaboration for accelerating vaccine development established in 2017 -- works with a funding of $250 million which was partially co-funded by the World Bank. This shows that not only does India have a conducive domestic ecosystem that enables public-private partnerships and spur innovation, but the nation is also actively engaging with other global partners.

In a large country like India, with its varied terrain and differing climate, the logistics of vaccine delivery can pose a challenge, so a complex network of 27,000 functional cold-chain storages -- 97% of which are located at a sub-district level -- exists to support the effort. The entire vaccine delivery process has also been digitised through an Electronic Vaccine Intelligence Network (Co-WIN), which is used for planning, monitoring and evaluation. A system of grassroots health workers going door-to-door to administer vaccines using insulated delivery kits is also in place.

The country's capacity to develop and deliver safe and low-cost vaccines rapidly has been praised by both global health bodies and civil society organisations. The global vaccine initiative, GAVI, as well as the World Health Organization and the Bill and Melinda Gates Foundation, regularly source vaccines in bulk from India -- most of which were intended for the global South.

At the Global Vaccine Summit last June, Indian Prime Minister Narendra Modi announced a contribution of $15 million to GAVI. India was in the forefront of launching the SAARC Covid-19 Emergency Response Fund in March 2020, and it is also contributing $1 million for the Asean Covid-19 Response Fund.

As the daily case rate in India decreases, the country's economy is showing signs of recovery. Since Jan 20, as part of its VaccineMaitri ("Vaccine Friendship") initiative, India has gifted more than five million doses of vaccines to neighbouring countries such as Bhutan, the Maldives, Myanmar, Nepal, Bangladesh, Sri Lanka as well as Mauritius and Seychelles. Commercial exports to Brazil and Morocco have also taken place. More are being rolled out for countries in Asia, Africa, as well as Central and North America.

Historically, our approach, both nationally and internationally, has been to make medicines -- including vaccines affordable and accessible. This is also in line with India's age-old belief of Vasudhaiva Kutumbakam (the world is one family).


Suchitra Durai is Ambassador of India to Thailand.

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