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Tuesday, June 15, 2021

How good intentions but bad timing, not securing stocks, paved road to the shortage

India’s growing struggle to vaccinate people at home prompted a pause on exports. This has hit hard the Covax program aimed to benefit over 90 poorer countries. As things stand, the African Union could miss the target to vaccinate 30-35% of its population by the end of 2021.

Written by Jay Mazoomdaar
New Delhi | Updated: May 11, 2021 2:26:23 pm
Experts say that much more thought and planning should have gone in both timing and sustaining the exports.

From WHO chief Tedros Ghebreyesus and Caribbean cricketing star Chris Gayle to Antigua and Barbuda Prime Minister Gaston Browne, many praised India and Prime Minister Narendra Modi for demonstrating “perhaps the most significant of benevolence, kindness and certainly of empathy… compared to any act of any other leader globally”. President Jair Bolsonaro tweeted a depiction of Lord Hanuman delivering a mountain of vaccines, a lifesaver like the mythical Sanjeevani, from India to Brazil.

Until March. Then India’s growing struggle to vaccinate people at home prompted a pause on exports. This has hit hard the Covax program aimed to benefit over 90 poorer countries. As things stand, the African Union could miss the target to vaccinate 30-35% of its population by the end of 2021.

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That’s why, experts say, much more thought and planning should have gone in both timing and sustaining the exports. This, coupled with not placing advance purchase orders to build stock and not allowing liquidity for manufacturers to increase capacity, has now strained supplies.

“Of course, exporting vaccines to those who paid for it and need it was a commercial and moral obligation. But we should have planned this a lot better so that both domestic supply and exports could be sustained at an optimal level,” said virologist Shahid Jameel.

By December 2020, Serum Institute of India (SII) had offered 10 crore shots at a discounted rate for domestic use but the government dithered on pre-booking further stocks even after setting a national target to vaccinate a vulnerable population of 30 crore by July 2021.

This “strange reluctance”, explained a public health consultant privy to the negotiations since late-2020, to close advance purchase orders from SII denied the world’s largest vaccine manufacturer “enough liquidity to step up production” and build stock.

The delay, it is learnt, deferred SII’s plans to ramp up monthly vaccine production capacity from 5 crore in December to 10 crore by March. On paper, this made India’s vaccination goal a non-starter.

A table representing vaccine count. (Express Photo)

“Vaccinating 30 crore people would have required 65 crore shots, considering some wastage. Of this, a maximum of 15 crore shots would come from Bharat Biotech. But at a monthly production capacity of 5-7 crore, SII would anyway struggle to supply the remaining 50 crore doses by July. There was simply no room for export,” said the consultant.

Yet, until the end of March, India was vaccinating fewer people at home than the number of doses it was sending overseas. Consider these:

  • In the first two weeks of vaccination drive since January 16, India inoculated 39 lakh people. By January end, the country had already exported 1.6 crore doses.
  • In February, India administered another 1.1 crore shots while exporting 2.1 crore doses.
  • By April 1, when the country extended the vaccination drive to everyone above 45, India’s domestic vaccine delivery caught up with the export count at around 6.5 crore shots.

Less than three months from the July deadline, India has so far administered around 15.5 crore vaccine shots or 25% of the target. From over 35 lakh each day in the first week of April, vaccine shortage forced the daily inoculation count down to around 21 lakh in the last week of April. The daily average has further dropped to below 16 lakh in May.

A turnaround will take time. Bharat Biotech has enhanced monthly production of Covaxin from less than 50 lakh in January to 2 crore in April and expects to hit the 3.5-crore mark in June. SII, on the other hand, hopes to increase its production capacity to 10 crore shots a month by July.

While the government has also allowed vaccine import, the first entrant — Russia’s Sputnik V — may not be available until June. SII’s second vaccine candidate, Covavax, will not be available in India before September.

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