India could play an important role in vaccine production

India could become the world’s second largest producer of Covid vaccine in the world, and analysts say the country has the capacity to produce both for its own population and for other developing countries.

Most vaccines in the world come from India. Even before Covid-19, the South Asian country produced up to about 60% of the world’s vaccines – and can do so at a relatively low cost.

“India was a vaccine production center … just before the pandemic and therefore should be a strategic partner in global inoculation against COVID-19,” JPMorgan analysts wrote in a report last month.

The consulting firm Deloitte predicts that India will be in second place in the US in terms of coronavirus vaccine production this year. PS Easwaran, partner at Deloitte India, said more than 20 billion Covid vaccines could be made in the country in 2021, compared to about 4 billion in the US

Moreover, Indian companies are currently increasing production to meet demand.

“We are expanding our annual capacity to deliver 700 million doses of intramuscular COVAXIN,” said Indian company Bharat Biotech, which developed a Covid vaccine with the state-run Indian Medical Research Council.

Covaxin was approved for emergency use in India, but was surrounded by controversy due to criticism that there was a lack of transparency in its approval and also because it did not publish enough efficacy data.

Another vaccine – known as Covishield in India and co-developed by AstraZeneca and Oxford University – has also received emergency approval in India. It is produced locally by the Indian Serum Institute (SII).

According to Reuters, SII produces about 50 million doses of Covishield each month and plans to increase production to 100 million doses per month by March.

Other Indian companies have agreed to produce vaccines for developers such as the Russian Direct Investment Fund and the American company Johnson & Johnson. To be clear, these vaccine candidates have not yet been approved for use.

“Even without successful vaccine development in our pipelines, the available capacity offers the opportunity to partner as contract manufacturers with approved vaccine developers to meet supply needs, especially for India and other countries. [emerging markets]”, said the JPMorgan report.

Vaccines in India are likely to be more suitable for developing countries, said K Srinath Reddy, president of the Public Health Foundation of India.

Some of the most important vaccines at the moment, such as those from Pfizer-BioNTech and Moderna, use RNA messenger (mRNA) technology that uses genetic material to trigger their own process of fighting infections.

These vaccines require “strict cold chain requirements,” which will be difficult or even “out of the question,” for most health care systems, Reddy said.

Vaccines made in India are easier to transport and cheaper, putting the country in a better position than the US and Europe when it comes to meeting demand in the developing world, he added.

India’s huge production capacity also gives analysts confidence that the country can provide vaccines to other nations.

New Delhi has committed to sending vaccines to neighboring countries and has already delivered 15.6 million doses to 17 countries, according to Reuters.

“India’s production capacity is sufficient to meet domestic demand,” said Nissy Solomon, senior research associate at the Center for Public Policy Research (CPPR).

“With proven experience at the scale at which vaccines are produced, India should be able to increase production to meet international demand,” she told CNBC.

Solomon added that the country monitors domestic needs before making export decisions.

Bharat Biotech, for its part, said it was “fully prepared to meet India’s needs and global public health.”

However, there will be challenges as the country tries to meet the demand for vaccine in India and beyond.

Jefferies capital analyst Abhishek Sharma wrote in a note that the launch of vaccines in India has been slow. Even assuming that the speed of vaccinations will increase, Sharma estimates that only 22% of India’s population of 1.38 billion can be vaccinated in a year.

This is about the number of people India wants to inoculate by July or August.

“The supply of vaccines is not as big a problem as the storage, distribution and absorption of the vaccine,” said Solomon of CPPR.

“India does not have the capacity to store and distribute to the masses on a scale as large as this,” she said, adding that the country should “strategically” choose vaccines that should not be stored at extreme temperatures.

Vaccines that India currently manufactures require normal refrigeration, but those produced by Pfizer-BioNTech must be kept at extremely cold temperatures of minus 70 degrees Celsius (minus 94 degrees Fahrenheit), while those from Moderna must be kept at minus 20 degrees. grade Celsius (minus 4 degrees Fahrenheit).

The “real challenge” is the large number of people who need to be vaccinated, said Reddy of the Public Health Foundation of India.

“This is the first time an adult immunization program has been conducted on such an unprecedented scale,” he told CNBC.

He said immunization programs usually focus on vaccinating children and mothers, and the logistics network may not be ready to deal with vaccines for entire populations.

Reddy suggested that the existing cold chain for food could be used for vaccines and hoped that this problem could be solved.

“I would say that [these challenges are] more like speed switches that will slow down the program … rather than actual blockages that require stopping the program, “he said.