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Explained: Punjab’s Covid-19 vaccine shortage, and why it wants to join Covax facility

Thus far, Covax has operated only at the level of nations — procuring vaccines for, and supplying to, national governments. Punjab’s plan to join the facility to procure doses appears to have little chance of succeeding

Workers carry Oxford-AstraZeneca vaccines made available through Covax and redeployed from the DR Congo, at Accra, Ghana, last week. (Reuters Photo: Francis Kokoroko)

On Friday, the Punjab government announced that, since it was facing a shortage of Covid-19 vaccines, it had decided to join the global Covax facility to procure supplies. Several other states, and the Brihanmumbai Municipal Corporation, have over the past few days expressed their intention to import vaccines from abroad.

As the situation currently stands, neither the attempt by states in buying vaccines directly from global manufacturers, nor Punjab’s decision to join Covax is likely to bear fruit. In Punjab’s case, it is not even clear whether it is eligible to join Covax, a World Health Organisation-led platform working to ensure equitable and affordable access to Covid-19 vaccines to countries around the world. Thus far, Covax has been operating only at the level of nations — procuring vaccines for, and supplying to, national governments.

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The shortage

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The declared attempts by states to procure vaccines on their own is a direct result of the current shortage of doses in India, which is slowing down vaccination efforts. About 22 lakh doses on average are being currently administered every day; this is much less than what India was able to do for some time last month — about 35 lakh doses on average — and far less than the demand. (See graph right)

Experts have been saying that India must administer at least 10 million (1 crore) doses a day in order to immunise the entire adult population by the end of the year.

India has deployed only two vaccines until now, the ones being produced by Serum Institute of India and Bharat Biotech. Several more are in the pipeline, including the Russian Sputnik V that was soft-launched on Friday. On Thursday, the government claimed that if everything went as per plan, 216 crore — more than 2 billion — doses of vaccines would become available in India between August and December. If that happens, it should be enough to vaccinate every adult in the country. But in the short-term at least, the shortage of vaccines is likely to persist.

Unfortunately for the state governments, doses are not available in the global market either. Fourteen vaccines are currently in use globally, and none of them are available immediately. Most manufacturers are struggling to fulfill their prior commitments to countries that had booked millions of doses in advance.

What Punjab seeks

While Punjab has announced that it would join Covax to access vaccines, it is probably not even eligible to get supplies through the facility. Also, Covax itself is struggling to get vaccines from manufacturers and donor countries.

The WHO-led Covax initiative was set up last year in partnership with GAVI (originally Global Alliance for Vaccines and Immunisation), and the Coalition for Epidemic Preparedness Innovations (CEPI) with the specific purpose of expediting the development and production of vaccines, and then making them available for all, especially to people in the poorer countries.

A handful of rich countries, the United States, United Kingdom, and those in the European Union had made bookings with vaccine developers last year, long before any of their vaccines had even been approved. The US spent over $10 billion in advance payments to six manufacturers, booking more than two doses for each of its citizens. Servicing these advance bookings would likely keep the manufacturers busy for several months even it they produce at peak capacity.

This situation would have left most of the developing and least-developed world without any access to vaccines for several months. It is here that the Covax facility was to be of help — not only to countries that do not have the resources to buy in the open market, but also to those who would have to wait indefinitely because they did not pre-book.

Covax does collective buying of available vaccines for all countries that are its members, and then allocates them in a manner that is intended to help each of these countries to vaccinate at least the most vulnerable sections of their populations.

Covax has so far provided 59 million vaccine doses to 122 countries. No sub-national entity has so far benefited from these supplies. And even this supply chain is strained, both because of lack of funds, and unavailability of vaccines.

Asked how Punjab hoped to get vaccines from Covax when only national governments were eligible to access it, the state chief secretary said the government was exploring all possibilities, and the suggestion to approach Covax had come up at a meeting of the state Cabinet on Thursday.

“We are exploring possibilities to get access to vaccines for our population. It was a good suggestion that was accepted by the Cabinet. We are exploring all possibilities,” Chief Secretary Vini Mahajan told The Indian Express.

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The road ahead

As of now, the roadmap unveiled by the central government seems to be the best case scenario for India. Several vaccines, both indigenously developed as well as from foreign companies, are expected to become available in the next few months. Some on the government’s list, like Sputnik V and Novavax, are certain to arrive, while others like those being developed by Zydus Cadila or Gennova are subject to regulatory approvals.

In the meanwhile, Serum Institute of India and Bharat Biotech are expected to ramp up production capacities. Together, they are expected to start producing at least 150 million doses every month by August.

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