How India's Crisis Worsens Global Vaccine Inequalities

How India’s Crisis Worsens Global Vaccine Inequalities

About a third of the world’s population in the world’s poorest countries have placed their hopes on India to deliver their Covid-19 vaccines. Then the virus overwhelmed India itself.

The epidemic has caused widespread misery for the country’s population of 1.3 billion. Hospitals are overwhelmed, oxygen is scarce and the death toll of 200,000 is considered a huge undercount.

But it also reverberates well beyond the borders of India.

This vaccine production powerhouse now prioritizes domestic supplies over exports and no longer sends millions of scheduled doses to low- and middle-income countries in Africa, Asia and Latin America.

Experts say this has already exacerbated global vaccine inequalities, leaving poorer countries to wait even longer while the United States and others soar. This could prolong the pandemic for everyone, with mutating virus variants that could be more infectious and elude Western vaccines.

“This is the worst fear of anything that worried us last year,” said Achal Prabhala, an Indian vaccine supply expert with the AccessIBSA project, which advocates for global access to medicines. “Deciding to rely solely on not just one country – but a business in that country – was a ridiculous decision,” said Prabhala, who is based in Bangalore.

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Experts say there is a lot of criticism to be made.

With the United States and other wealthy countries buying most of the Pfizer-BioNTech and Moderna vaccine supplies – both expensive and delicate injections – poorer countries have turned to India.

The Serum Institute of India is the world’s largest vaccine producer by volume and has entered into a licensing agreement to manufacture the inexpensive and robust Oxford University-AstraZeneca vaccine.

Funeral pyres in New Delhi this week.Anindito Mukherjee / Getty Images

Last year, the IIS signed a huge supply contract with COVAX, a global vaccine sharing program co-managed by the World Health Organization, which plans to deliver 1.8 billion vaccines to 92 countries. low- and middle-income earners this year.

Experts have always said it was optimistic because COVAX assumed the Serum Institute would be able to provide him with an unrealistic number of doses. Now that India has limited this supply, it has dug a yawning hole in the vaccine supply to the developing world.

“What happened was not just highly predictable – it was predicted,” said Andrea Taylor, deputy director of programs at the Duke Global Health Innovation Center, an authority on Covid-19 vaccine supply data. .

“We have put so many eggs in one basket with vaccine manufacturing in India,” she said. “Unfortunately, it was a huge strategic mistake to expect a country to produce vaccines for so much of the world.”

The Indian government has not directly admitted to restricting exports, but it is clear that is what is happening, according to supply chain experts and data from the Indian Ministry of Foreign Affairs.

Covid-19 patients inside a banquet hall temporarily converted to a health center in New Delhi on Thursday.Tauseef Mustafa / AFP via Getty Images

NBC News contacted India’s Ministry of Health by email and phone on Friday with no response. The Serum Institute of India declined to comment.

Experts say export restrictions were a big factor in COVAX delivering less than 50 million vaccines globally – just a quarter of what it planned to distribute by the end of the month. may.

Supply has dried up for countries across Africa, as well as parts of Asia and Latin America. Many countries have not yet reached 1 percent in terms of people vaccinated. Others – such as Chad and Burkina Faso – have not yet received doses of COVAX.

Some experts say India can hardly be blamed. Keeping doses at home to fight a raging national epidemic is what the United States and others have been doing all along.

Prabhala disagrees.

“India is now taking vaccines that have been legally contracted out to other parties,” he said. “It’s not the same as the United States, which had always planned to earn a lot of it for itself – we didn’t do the same until much later and with other vaccines. people.”

A man performs last rites for a relative at a New Delhi crematorium last week.Anindito Mukherjee / Getty Images

Others believe that COVAX made a big mistake in relying so much on a drug maker and a vaccine. Experts have told NBC News for months that they feared it would come back to bite the project.

A spokesperson for Gavi, one of COVAX’s partners, said in an emailed statement to NBC News that he understands that “India’s vaccine production – for next month at least – will commit to protecting its own citizens “as the” country faces a veritable terrible wave of the pandemic. “

In the meantime, COVAX would try to diversify its vaccine portfolio and offer support to countries left waiting for doses, “ensuring that the second dose is delivered on time.”

In the short term, rich countries could do a lot more to share doses with poorer countries rather than immunizing healthy young people in their homes, many experts say.

But the only long-term solution is to simply make more vaccines in more projects around the world, according to Rasmus Bech Hansen, CEO of Airfinity, a London-based pharmaceutical analysis company.

“Historically, vaccine production has not been a very good deal,” he said. “In the past, there was simply no demand and companies could not justify the investment.”

He added that “one of the lessons in all of this is that this is something that has to happen.”