Problems with Covax, global vaccine supplies and coordination

India has been requesting US for lifting Export restrictions on certain raw materials needed for vaccine production. Yesterday US State Deptt gave a scathing response regarding export restrictions - "US has special responsibility towards American people". These words are more than sufficient to gauge America's take on the situation. Recall that US has banned exports of raw materials after invoking defense production act in February. The goal was to mobilize all resources for American national vaccination program which now is going quite well. But this has created problems for India and globally. SII, Indian company which is the largest vaccine maker in the world is facing difficulty in ramping its vaccine production due to shortage of raw materials. SII is responsible for manufacturing vaccines for use in India as well as dozens of other countries. The vaccines are provided to foreign countries on commercial basis, humanitarian grants as well as Covax initiative. 

America also has a stockpile of millions of vaccines (i don't have exact numbers) which also includes 20 Million Astrazeneca doses which US most likely has no intention of using. I can understand that US will only grant vaccines from its stockpiles to its special allies , and would reserve its stockpile only for itself. But India is not asking for grant of readymade vaccines from US stockpiles, India asking for certain raw materials for making vaccines.

Recall that US was angry with China in early days of pandemic when China was hoarding medical supplies. I don't see why US has a problem with export of these raw materials. If US thinks that these vaccine raw materials are not in ample supplies, America if desires, can further ramp up the production of raw materials under defense production act and provide these raw materials to India. But US isn't interested in doing that. America used defense production act for its own self interest - that was its domestic vaccine plan. Invoking Defense production act was not easy as US Govt faced resistance from corporations (forces of free markets) who don't like to be forced by government to do things. But due to unprecedented pandemic emergency, US Govt took the steps needed for mass production of vaccines. Now US Govt doesn't like forcing its corporations to boost production when its meant for humanitarian needs abroad. After all, the domestic vaccination plan is going well on schedule and more than half of all adults in America are now vaccinated.  Vaccination in India, Brazil or some 3rd world country is not on priority list of America.

 

Angela Merkel in Germany also had some harsh words for Indian Govt. Merkel was expressing disappointment due to India's restrictions on export of vaccines. British Astrazeneca is marketing its vaccine in Europe. The vaccine is manufactured in several countries including in India at SII corporation. Due to massive 2nd wave in India, India is restricting export of vaccines to focus on domestic vaccination program. But Germany's criticism of India is unwarranted and actually hypocritical because of many reasons. Let me explain. First of all, the entire situation with scarcity of vaccines is due to the fact that we don't have global coordinated strategy of vaccination. In February last year, we were hoping that pandemic will be dealt with by fully sharing all knowledge & research on anti Covid drugs and vaccines among all countries. But now we see that vaccines & antiviral drugs are locked behind patent monopolies and industrial secrets of various corporations. India and dozens of developing countries have formally requested to suspend these patent monopolies for the duration of pandemic. Who is blocking this request? Its US, EU, Japan & Australia (basically free Democratic world). I have explained how vaccine shortage is artificial because only handful of companies & their joint channel partners have the monopoly to manufacture the vaccines. Open source vaccines, unrestricted transfer of R&D technology and industrial production know how of vaccines globally would've meant that any Pharma company in any part of the world having the capability would have been able to produce vaccines.

Also blaming India is hardly fair. The Astrazeneca vaccine is not just manufactured in India but UK & several other countries as well. UK has already vaccinated large part of its population and new cases have fallen to large degree. If EU wants Astrazeneca vaccine, it makes more sense in pursuing for the deliveries from UK factories which is producing vast majority of Astrazeneca vaccine. On top of that, America has suspended export of vaccine raw materials which has disrupted the SII supply chains. How can we expect SII to mass produce vaccines in these circumstances? Its also interesting to note that EU itself has placed restrictions on export of vaccines but expects India to come good on vaccine deliveries. The problems (read 1 & 2) between EU and Astrazeneca has little to do with India and EU nations should pursue their complaints with UK Govt and Astrazeneca.  US has a stockpile of 20 Million Astrazeneca vaccines which US has no use of. Germany & other European nations being NATO partners with US can ask Americans for these vaccines. And Astrazeneca vaccine is just one of the option for Europe. Europe also has access to pool of several vaccines including Pfizer & Moderna apart from Astrazeneca. India right now only has access to Astrazeneca (Covishield) & Covaxin & Astrazeneca comprises of 90% of our production & dispensation.

Given all the problems among countries about the vaccine supplies, wouldn't it make more sense to have a joint global vaccine action plan? OK, i know that this sounds too good to be true considering the present geopolitical tensions between nations. But at least we need some level of coordination and cooperation between countries to resolve barriers & bottlenecks in vaccine production and deliveries. Here i find it interesting that US Govt, supposedly the great world leader, has not yet appointed a special envoy on Global pandemic response. Someone who can coordinate between countries, try to address and resolve various barriers & bottlenecks on vaccine trade & production. I can understand that US doesn't have much influence over China & Russia, but at least US can help coordinate things among its own sphere of influence like NATO, QUAD countries & any other nations that want to work with US. Also we need someone who can formulate serious plan to help poor countries that have been left out in vaccine race. Isn't this something that should be on top priority for America in this pandemic?

Problems with Covax

I have mentioned about problems with Covax in earlier article.  Building up on that, the fundamental problem with Covax is that it has no timeline for delivery of vaccines. The program originated & inspired by Gavi & Bill Gates foundations pledges to provide vaccines to poor countries but there is no timeline & hard commitments for that. Covax has been failing due to several reasons. Firstly, the whole concept of it was flawed. The idea was that vaccines will given as charity (or discounted pricing) to poor countries while production, technology & patents of vaccines will remain in hands of few big corporations & their channel partners. There was no real commitments of delivery of vaccines to countries, only promises.  The US has very little to contribute in terms of actual vaccine delivery. US may contribute vaccine deliveries in future after its domestic vaccination program is complete and it has extra vaccine supply to send abroad. But poor countries need help now in the pandemic, not in the future. The assistance countries needed 3 months ago, COVAX will deliver it 6 months in future from now. US paid $2 Billion to Covax and pledged to pay $2 Billion more in future. At the same time, US has been denying vaccine raw materials to SII which is the largest contributor/manufacturer of Covax program right now.

 

In regard to India and QUAD partnership, US & Japan plan to fund J&J vaccine joint venture in India that will supposedly start vaccine production this year. This is a good initiative but India should safeguard its domestic interests by exercising first rights over vaccines which we require for domestic vaccination program. Western companies as well as western governments want to utilize (or shall i say exploit) the great potential of India's Pharmaceutical sector (we are the largest manufacturers of Generics in the world) to boost global vaccine supply. That is fine and we don't have a problem with that as long as we get our own share of vaccines for domestic needs. We know that India had been exporting vaccines abroad, all in good faith, since last 3 months. When new Covid wave hit India hard, we temporarily restricted exports, which draw criticism from EU. Astrazeneca has sent legal notice to SII citing delay in its international obligations.  Western Governments & companies want India to fight this pandemic with one hand tied to its back.  India is ready to fight this pandemic with its full potential if you untie its hands. That is temporarily suspending vaccine & antiviral IPs, unrestricted transfer of vaccine R&D and industrial knowledge to producing vaccines & drugs, providing raw materials for manufacturing vaccines and broadly speaking, removing all barriers & restrictions in vaccine development & mass production.

Update - By the time i have completed this article, i am reading that US will be sending assistance to India & provide raw materials to SII. Its yet to be seen if US is genuinely interested in helping India or if its just a token of PR gesture.