October 02, 2020

Submitted by Devendra Mishra, Executive Director, BSMA,  09022020

The General Assembly of the United Nations on September 11 reaffirmed that international cooperation, multilateralism and solidarity as the only way for the world to effectively respond to global crisis of COVID-19. It urged member states to enable all countries to have unhindered, timely access to quality, safe, efficacious and affordable diagnosis, therapeutics, medicines and vaccines, and essential health technologies and their components, as well as equipment, for the COVID-19 response.

Facing the grim reality, Adar Poonawalla, the chief executive of Serum Institute of India (SII), has warned there will not be enough vaccines against the coronavirus disease (Covid-19) for everyone in the world till the end of 2024. He has estimated that the world will need around 15 billion doses of the Covid-19 shot if it is a two-dose vaccine. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, has warned that a nationalist approach “will not help” and will slow down the world’s recovery. Yet vaccine nationalism looms large over the search for vaccines, with the US, the UK and the European Commission all signing various advance purchase agreements with manufacturers to secure privileged access to doses of the most promising candidates.

Countries around the world, as well as a new entity created by the vaccine-purchasing nonprofit Gavi and the Coalition for Epidemic Preparedness (CEPI) in conjunction with the World Health Organization, are working to procure doses of vaccines and fund the scale-up of manufacturing before any vaccine has been proven effective because of the desperate need to slow the Covid-19 pandemic.

The global marketplace for the vaccines being developed, other than the USA, are primarily in the regions of the Europe, China, India, Russia and Brazil. Here are the salient features of distribution in those regions of the world.

EUROPE: On the 17th of June 2020, the European Union proclaimed that it would do all in its power to ensure that all peoples of this world have access to a vaccine, irrespective of where they live. Pfizer and BioNTech will supply 200 million doses of their investigational vaccine candidate against to European Union (EU), with an option for an additional 100 million doses. Deliveries would be starting by the end of 2020, subject to clinical success and regulatory authorization. Vaccine doses for Europe would be produced in BioNTech’s German manufacturing sites, as well as in Pfizer’s manufacturing site in Belgium. Further, in June, AstraZeneca reached an agreement with Europe’s Inclusive Vaccines Alliance (IVA), spearheaded by Germany, France, Italy and the Netherlands, to supply up to 400 million doses of the University of Oxford’s potential COVID-19 vaccine, currently in clinical development. The European Commission and German biotech firm CureVac said on the 20th of August that they had concluded a first round of talks for the supply of at least 225 million doses of a potential COVID-19 vaccine to EU states.

CHINA: As the country where the coronavirus outbreak began, China was fast out of the gate in developing vaccines. CanSino is also poised to launch a phase III trial. But the Chinese government has already said that its vaccine can be used by the military — making CanSino the first company to have a vaccine for COVID-19 approved for limited use in people. Sinopharm, a state-owned pharmaceutical company in Beijing, is developing two vaccines made using particles of the coronavirus that have been inactivated so that they can no longer cause disease.

INDIA: With almost 18% of the world’s population, India has a strong demand for COVID-19 vaccines. India has the potential to play a key role in overcoming vaccine nationalism because it is the major supplier of medicines to the global market. Médecins Sans Frontières once dubbed the country the “pharmacy of the world”. Its role in manufacturing a vaccine could come in two different ways – mass-producing one developed elsewhere (likely) or developing a new vaccine as well as manufacturing it (less likely, though not impossible).

India’s Serum Institute has already started manufacturing the University of Oxford/AstraZeneca vaccine candidate before clinical trials have even been completed. Serum Institute, the largest vaccine manufacturer in the world, has a deal to supply 400 million doses by the end of 2020 (1 billion in total). It has also inked a deal for the manufacturing and commercialisation of American firm Novavax’s COVID-19 candidate.

Another Indian pharma company, Biological E (BE), has agreed to manufacture the vaccine candidate of Johnson & Johnson’s subsidiary, Janssen Pharmaceutica NV. In addition, Aurobindo Pharma, Bharat Biotech, BE, Indian Immunologicals, Mynvax, Panacea Biotech and Zydus Cadila are all attempting to develop their own vaccines. The Indian vaccine manufacturers, along with the Government, support the idea of allocating 50% of India’s production to the rest of the world.

RUSSIA: Russia became the first country to approve the public use of a Coronavirus vaccine in the world in August. Weeks after Russia approved the public use of Coronavirus vaccine Sputnik V, the first batch of the vaccine has been released for civil circulation, news agency ANI reported. The vaccine developed by the Russian state-led drug maker Gamaleya National Research Center of Epidemiology and Microbiology was approved for public use by the Russian regulatory bodies without the completion of the third and final phase of human trials.

BRAZIL: In Brazil which has a large coronavirus outbreak, the Butantan Institute plans to test Sinovac’s vaccine among health-care professionals because it is assumed they will face greater exposure to the virus than will non-health-care professional.

Global companies are planning their supply chain services to deliver vaccines from manufacturing facilities to centers of immunization. They are positioning themselves to match vaccine demand with supply in practical ways where collaboration will be a guiding principle.