India could be at the centre of the global vaccination campaign against COVID-19, experts state.
Prime Minister Narendra Modi alluded to this recently. “Our scientists are very confident of succeeding in their endeavour of developing a vaccine against COVID-19,” he said. “There are names of vaccines from different countries doing the rounds in the market, but the world is keeping a watch on having the cheapest and safest vaccine. That is why, it is natural that the world is watching India.”
India is home to the Serum Institute of India (SII), the world’s largest manufacturer of vaccines, produced and sold to the tune of 1.5 billion doses. Beginning next year, the SII has said it intends to produce as many as ten crore doses of a COVID-19 vaccine, having manufactured five crore doses of the University of Oxford / AstraZeneca vaccine Covishield already. It has sought emergency use authorisation from the Centre for the vaccine – the second drugmaker to do so in India after Pfizer. The country is scheduled to manufacture eight vaccine candidates according to Union Health Minister Dr Harsh Vardhan.
“Because of the large volumes coming out of India and of course the affordable vaccines, there is no other country that will contribute more towards ending the pandemic than India,” said chief executive officer Adar Poonawalla.
However, India has a number of challenges to surmount. Vaccinating a population in excess of 1.3 billion represents a major logistical challenge. Modi is optimistic, stating “we have a vast and experienced vaccination network and the country will capitalise on these advantages.” He has announced a mass vaccination campaign against COVID-19 once scientists give the go-ahead and the Government has earmarked US$7 billion for the same. However, concerns over resources loom.
As reported by Amrit Dhillon in The Guardian, “India has 27,000 cold chain points (deep freezers and ice-lined refrigerators) to keep vaccines at the right temperature, 700 refrigerated trucks, around 50,000 cold chain technicians and about 2.5 million health workers to administer doses.
“But in many places the cold chain system is in a sad state of repair. Fridge temperature gauges don’t work, vaccines are not stored or monitored properly, and power cuts can last hours, leaving vaccines unfit for use.”
The report quotes Dr Satyajit Rath, a scientist at the National Institute of Immunology, who queried “Has anyone done an audit of what we need? We are not getting any specific figures. We’re told the existing immunisation set-up will be used but that is a drop in the ocean. The magnitude of the task is beyond the capacity of what we have, so what is the plan?”
India has had much success in past immunisation campaigns – the most notable past example being the campaign against polio that led to the disease’s eradication. But COVID-19 provides manifold challenges, from poor infrastructure to vaccine skepticism to the vast disparities between states and union territories in terms of the quality of their health systems.
A vaccine is good news. But it is only one component of the campaign against COVID-19. Without considering the additional needs of such a large-scale endeavour, India’s vaccination campaign may stall at the starting line.