India cuts vaccine exports as infections rise

NEW DELHI – With its own battle against the coronavirus taking a turn for the worse, India has dramatically reduced exports of Covid-19 vaccines, leading to setbacks in vaccination campaigns in many other countries.

The Indian government is now withholding nearly all of the 2.4 million doses that the Serum Institute of India, the private company that is one of the world’s largest producers of AstraZeneca vaccine, produces each day.

India is desperate for all the doses she can get. Infections are on the rise, topping 50,000 a day, more than doubling less than two weeks ago. And India’s vaccine campaign has been slow, with less than 4 percent of India’s nearly 1.4 billion people receiving an injection, well below rates in the United States, Britain, and most countries. Europeans.

Just a few weeks ago, India was a major exporter of the AstraZeneca vaccine, using it to exert influence in South Asia and around the world. More than 70 countries, from Djibouti to Great Britain, received vaccines made in India, totaling more than 60 million doses. From mid-January to March, no more than a few days passed between major vaccine shipments leaving India.

But the size of its shipments abroad has dropped considerably in the past two weeks, according to data from the Indian Ministry of Foreign Affairs. And Covax, the program set up by donor agencies to buy vaccines for poorer nations, said Thursday that it had told those countries that nearly 100 million doses expected in March and April would face delays due to “increased demand for Covid vaccines. -19 in India. “

The Indian government has not commented publicly on what is happening, and would not when contacted by The New York Times for this article. But health experts say the explanation is obvious: India is closing its doors when a second wave of infections hits home, clinging to a vaccine it did not develop but is being produced in large quantities on its soil.

The government of Prime Minister Narendra Modi, a heavy-handed nationalist, has regulatory control over how many doses of vaccine can be exported at any one time, and it appears that India is heading in the same direction as the European Union, which is moving to slow down. Exports.

Adar Poonawalla, CEO of the Serum Institute and an offshoot of the billionaire family that runs the company, finds himself in a very uncomfortable situation. The Serum Institute has a reputable interest in keeping its word to its foreign clients and AstraZeneca, and to honor the contracts it has signed.

But Poonawalla has been careful not to say anything negative about Modi or the pressure the Modi government is putting on him. Instead, he has asked for patience.

“The Serum Institute of India has been instructed to prioritize the enormous needs of India and, along with that, balance the needs of the rest of the world.” Poonawalla tweeted in late February.. “We are doing our best.”

The Serum Institute, based on a sprawling campus in the city of Pune, has agreed to provide vaccines to low- and middle-income countries, under an agreement it signed last year with AstraZeneca, the pharmaceutical giant that partnered with Oxford scientists. . who developed his vaccine.

Production issues at other AstraZeneca facilities in Belgium and the Netherlands have led wealthier nations such as Canada, Saudi Arabia, and Britain to rely on Serum Institute dosages as well, making the company even more critical to AstraZeneca’s global vaccine supply chain.

So far, India has still exported more doses of vaccines than it has given to its own people, unlike the United States, Britain and the member states of the European Union.

India, with a population of more than the entire African continent and hundreds of millions of people living below the poverty line, is completely dependent on its own vaccine supply, unlike many other countries that have obtained vaccines from different suppliers. of all the world. The country produces a second Covid-19 vaccine developed by Bharat Biotech, an Indian company, although the global demand for that vaccine is much lower than the demand for the AstraZeneca vaccine.

But given that many poorer countries are unlikely to have broad access to vaccines until 2023 or 2024, a prolonged suspension of India’s exports could further delay those dates, said Olivier Wouters, a professor of health policy at London. School of Economics that has been studying the global vaccine supply chain.

With the spread of new variants, he said, all countries are interested in working together to vaccinate the world.

“Many countries around the world, the poorest in particular, count on India,” Wouters said. “Vaccine nationalism hurts us all.”

Nepal, one of the poorest nations in Asia and a neighbor of India, has had to stop its vaccination campaign. It relied heavily on the AstraZeneca vaccine doses made at the Serum Institute, but with its national arsenal running low, Nepal stopped giving vaccines on March 17.

Dr. Jhalak Sharma, head of the immunization department of the Ministry of Health of Nepal, said that the country had received a donation of one million doses from the Indian government and had already paid 80 percent of the price of the next two million, but that didn’t seem to have made a difference.

“We couldn’t get the vaccine in time,” Dr. Sharma said.

India’s export restrictions, he added, “will affect us and the whole world.”

Britain is in a similar situation. He received five million doses from the Serum Institute several weeks ago, but has been waiting for five million more for weeks.

One of Prime Minister Boris Johnson’s top aides, Eddie Lister, used a trip to India this week to try to secure promised supplies to Britain, authorities said. Johnson is scheduled to visit India next month, and some diplomats here have referred to his trip as a high-profile mission to secure millions more doses.

At the same time, the Serum Institute has told Morocco, Brazil and Saudi Arabia to expect shipping delays, according to Reuters. Morocco is now struggling to secure more of the Sputnik V vaccine from Russia or obtain doses from other sources, Moroccan media reported.

The manufacturing capacity of the Serum Institute was always central to a plan to bring vaccines to the poor. An AstraZeneca spokesperson did not disclose exactly what percentage of the global supply of its vaccine Serum makes, but a recent statement from AstraZeneca called the contribution “substantial.” Serum has committed to producing about a third of the total 3 billion doses AstraZeneca said it will produce by the end of 2021, although it seems increasingly unlikely to meet that schedule.

The alliance between Serum, which started as a ranch that made serum from horse blood, and Oxford-AstraZeneca has resulted in the cheapest Covid-19 injection in the world – just $ 2. The vaccines developed by Pfizer and Moderna In comparison, they cost much more and require extreme cold storage, adding to the difficulty.

Serum is also playing a huge role in the Covax program for the poorest nations. Documents from the World Health Organization show that the Indian company was expected to contribute 240 million doses by the end of June.

But data from the Indian Foreign Ministry and Covax’s statement on Thursday indicate that vaccination campaigns around the world are likely to be further delayed.

The Serum Institute has supplied Covax with 28 million doses so far, according to the international schedule. India’s Foreign Ministry showed that 18 million doses had been shipped overseas under Covax, suggesting that around 10 million doses of India’s domestic vaccination also come from the program, which lists India as eligible for a share.

In contrast, around 34 million doses have been supplied in trade deals and around 8 million donated by the Indian government as part of its vaccine diplomacy.

On April 1, India will expand eligibility and allow anyone 45 and older to receive a jab.

“It’s a fluid situation,” said K. Srinath Reddy, a health policy expert at the non-profit Public Health Foundation of India. “But for the moment, given that the vaccine supply and the Covid situation is dynamic, I think it is appropriate for the government of India to pause and say, ‘Let’s keep the stocks.’

Benjamin Mueller contributed from London, Bhadra Sharma from Kathmandu, Nepal, and Aida Alami from Rabat, Morocco.

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