In the “far from normal” last two and half years, when humanity came the closest to living in a science fiction, India and Indians under the untiring leadership of Prime Minister Narendra Modi can collectively claim to have learnt crucial lessons. We demonstrated resilience, determination and strength that has earned respect the world over. This is an accomplishment unto itself.
Such a claim can be made for the vaccine space too. Be it the vaccine manufacturing prowess of India; be it innovations trials in R&D; be it unleashing the potential of public-private partnerships; be it digitalisation of the vaccination drive; be it how government departments come together on a mission mode; how under the leadership of the PM efforts taken to communicate and convince a billion people to take life-saving jabs, we can claim to have put together lessons of decades into two years to succeed on many fronts. That’s no small achievement, particularly amid rapidly shifting realities and constantly evolving science, and given social discord and vaccine hesitancy in so many different countries.
The development of safe, effective vaccines for a novel virus like SarsCoV2 in less than a year will go down as one of the most impressive feats in the history of modern science. The role of India’s vaccine ecosystem will get etched in that history. Despite myriad local challenges such as accidents and global difficulties such as acute shortage of raw-materials, the Serum Institute of India, the world’s largest vaccine manufacturer by doses, and other Indian vaccine-makers churned out well over two billion doses, sufficient to cover almost a third of humanity — if one dose offered immunity to an individual. That scale of manufacturing is a mere indicator of what India has to offer to the world as vaccines grow more high-tech and offer life-course protection against several other diseases across ages.
The country also excelled in providing health tech solutions best showcased by CoWin, the digital backbone of the vaccination drive. The speed with which India adapted e-Vin, its smart vaccine supply chain management system used in the universal vaccination programme meant for children and expecting women, into CoWin has been exemplary. India had started issuing digital vaccine certificates right from the start, at a time when many developed countries were struggling to do so. CoWin remains that valuable platform that can prove handy if other universal or age-specific vaccines are to be administered, either responding to an emergency or in a well-planned programme. It’s an asset that can also be adapted for other public health programmes.
Three areas where the country took a leap in attempting novel experiments and reaped rich learnings are vaccine R&D, the drug regulatory system, and deep engagement of the government across departments with private players to shape the Covid-19 response.
First, fully aware of how uncertain the path of vaccine discovery could turn out to be, the government chalked out a well-thought out strategy. That made sense as one didn’t know at the time which one would click, and even if multiple vaccine candidates succeeded, which one would emerge the safest, most efficacious and most convenient to use. In vaccine-making, science is so complex, that the first is not necessarily the best. Betting on a pipeline that was numerically rich, and technology-wise diverse, meant that the scientific community and innovation ecosystem packed a decade of learning into a year. It also showed us what was possible in vaccine development if companies, policymakers, and scientists came together.
Our drug-regulatory system, traditionally badgered as slow-moving, learnt to put in place accelerated pathways to approve vaccines, like many global regulators in mature markets. Keeping patient safety as the top priority, these lessons of agility and efficiency should seep into the work-flow of the regulatory system if the war against other diseases, equally or more dreaded than Covid-19, has to be waged effectively and forcefully.
What also helped in shaping the pandemic response was the way the government turned into one “whole”. Under the guidance of the prime minister, a number of inter-disciplinarian inter-departmental empowered groups broke the culture of working in silos and practiced what is now hailed as a “whole of government” approach in taking swift decisions. Industry too was involved as a stakeholder in many areas. All stakeholders including media, local influencers, civil societies and international as well as national partners played supportive roles. Continuing this approach well into the future has the potential to strengthen our country’s response to other public health challenges.
Finally, one of the most fundamental but valuable lessons we have learnt is to communicate transparently and engage effectively with the community in public health contexts and exhort them to place their faith in science in a language they understand best. From cutting-edge technologies like drones, to deeply traditional auspicious symbols such as turmeric, from 24×7 public health and risk related messages disseminated across the county, a range of innovative communication strategies were employed to invite people for vaccination or reach the last mile with vaccines.
At a time when many developed countries struggled with the anti-vaxxers movement, Indians participated in large numbers in the vaccination drive that it’s a country where scientific temper trumps hesitancy hands down — 96.7 per cent of the eligible population have been vaccinated with the first dose, 89.2 per cent have taken both doses, and over 18.7 crore precaution doses have been administered. It is a clear testament to the vaccination’s grand success. Special campaigns are being conducted across the country to encourage eligible beneficiaries to take up their due doses.
In 2021 alone, Covid-19 vaccination programmes averted nearly 20 million deaths globally, according to an estimate cited in Human Development Report 2022. Despite all the challenges, India, under the leadership of Prime Minister Narendra Modi has truly turned the response to the pandemic into a jan andolan (people’s movement).
The writer is Chief Executive Officer, Serum Institute of India