Vaccine nationalism in countries including the U.S. and India is likely to derail efforts by the World Health Organization to deliver 2 billion doses to poorer and middle-income nations by the end of the year, according to the head of the world’s biggest vaccine maker.
Countries are holding tight to their supplies and restricting access to materials needed to make more, said Adar Poonawalla, chief executive officer of the Serum Institute of India Ltd. The company is responsible for providing more than half of the shots used so far in the WHO-backed COVAX program that aims to provide equitable vaccine access across the world.
Many manufacturers, including Serum, have already missed timelines and commitments, Poonawalla said in an interview with Bloomberg Live. It will take two to three months for shipments to COVAX to really pick up, and reaching the 2021 target of 2 billion doses will be challenging, he said, predicting it will “spill over by a few months.”
Poonawalla’s comments highlight the continuing challenge of vaccine inequality that threatens to prolong the pandemic after richer nations raced to stockpile supplies. Few African nations received a single shipment of shots before March, while more than 20% of the population in countries including Israel, the U.K., Bahrain and the U.S have received at least one shot.
As a manufacturing giant, India has sought to portray itself as a generous benefactor through targeted vaccine diplomacy, while seeking to outdo regional rival China. At the same time, New Delhi has tightly controlled the deployment of the doses it has, mostly supplied by Serum, which is making the shot developed by AstraZeneca Plc and Oxford University.
Indian officials have also requested more vaccines than initially expected from the company, said Poonawalla.
“We had to dedicate a lot of our capacity, which was not originally planned for India,” he said. “We’re trying to balance it out as much as possible, but again for the first few months we have been directed to prioritize supplies to India and certain other countries that have a high disease burden.”
COVAX has been slow to get off the ground, which WHO Director-General Tedros Adhanom Ghebreyesus has linked to companies and countries prioritizing bilateral deals ahead of the health body’s approval process.
Poonawalla reiterated his concerns over impending bottlenecks caused by “raw materials nationalism” after the U.S. invoked the Defense Production Act this month to safeguard supplies of items, such as bags and filters, for its own manufacturers.
“I’ve sent this message to all the decision makers in the U.S. — please do not put a ban on critical raw materials that other global vaccine manufacturers need,” Poonawalla said.
The Serum CEO earlier this month said the export ban could hit his plans to produce about a billion doses of Novavax Inc.’s COVID-19 vaccine this year. Despite those warnings, Poonawalla said he expects India’s regulators to grant approval for an August launch of the Novavax candidate, which Serum will begin stockpiling starting next month.
By then, Poonawalla hopes that a fully privatized vaccine market will have opened up across India. Currently private hospitals and clinics are allowed to charge 250 rupees ($3.45) a dose, but they have to purchase those vaccines directly from the government and can only inoculate people aged 60 and above or those 45 and older who are high risk.
Serum wants a liberalization of the rules to allow corporate clients to negotiate directly and potentially buy supplies at a higher cost, as its vaccines are now being provided through the government at “very low subsidized price.”
Though opening up the private market would help accelerate India’s vaccination effort — it has only administered about 32 million doses so far, behind the pace needed to reach a goal of 300 million people by August — there are concerns that doing so will lead to price gouging and unequal access across a country with enormous wealth divides.
A free market would allow corporations to immunize their workforces quickly and “speed up the opening of the economy,” said Poonawalla.
“This is an ongoing issue, which we’ve taken up with the highest levels of the government,” he said. “It’s a tough call for the government or anyone to make.”
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