As scientists approach the creation of a vaccine opposed to SARS-CoV-2 coronavirus, Indian pharmaceutical corporations are at the forefront of the race to provide the world with an effective product. their corporations will struggle to produce enough doses temporarily for their own epidemic. In the most sensible, it will be a massive logistical challenge to distribute the doses to other people in rural and remote areas.
Indian pharmaceutical corporations are the leading brands of vaccines distributed worldwide, especially those in low-income countries, supplying more than 60% of vaccines to emerging countries, so they are likely to have fast to any COVID-19 vaccine that works, says Sahil Deo, co-founder of CPC Analytics in India in Pune, which studies vaccine distribution in the country.
Several brands of Indian vaccines already have agreements to manufacture vaccines that oppose coronaviruses that are being developed through foreign pharmaceutical companies, or that work with their own vaccines. Country.
Without India, there may not be enough vaccines to save the world, Peter Piot, director of london’s School of Hygiene and Tropical Medicine, said at an online symposium on vaccines organized through the Indian government in July.
A vaccine will be used to combat the massive coronavirus outbreak in India. On 30 August, the country reported some 79,000 new cases, the largest one-day accumulation ever recorded in all countries. Next year, the epidemic is expected to be the largest. in the world.
To reduce the number of other people dying from COVID-19, researchers say, people at higher risk of exposure or serious infection will want to be vaccinated first, including lifeguards, others with other diseases and the elderly, who make up about 30% of the population, about 400 million people, says Gagande Kangep, a vacunologist at Christian Medical College in Vellore , India, but a lot of vaccine doses want to be manufactured and distributed, the researchers say.
The government has convened an organization to determine the most productive way to distribute vaccines, led by Vinod Paul, a member of the National Institution for the Transformation of India, a group of government experts, and includes representatives of state agencies and the central government. The government is also working with vaccine brands to accelerate clinical trials and regulatory approvals.
The world’s largest vaccine manufacturer, the Serum Institute of India in Pune, has reached an agreement to manufacture one billion doses of a coronavirus vaccine developed by scientists from the University of Oxford in the UK and the British pharmaceutical company AstraZeneca, if approved for use. . The vaccine is currently undergoing Phase III clinical trials in Brazil, the United Kingdom and the United States to verify its effectiveness.
If the vaccine works, the Serum Institute and the Indian government are committed to reserving some of the company’s stock to India and supplying a portion to low-income countries GAVI, a donor funding vaccination for low-income countries, says poonawalla. Managing Director of Serum.
So far, the company has invested 11 billion rupees ($200 million) to manufacture the vaccine and has produced about 2 million doses to be used in regulatory approvals and testing, even before trials are completed, Poonawalla said. have been redirected for this purpose, and the company can manufacture 60 to 70 million doses depending on the month at full capacity, Poonawalla said.
“The resolution [of buying the Oxford vaccine] was taken only to give manufacturing a special touch, to have enough doses if clinical trials are successful,” poonawalla says. If the vaccine does not work, Serum will divert its attention The company is also testing 4 other COVID-19 vaccines, two of which were developed as a component of internal projects and two in progress in collaboration with Novovax biotechnology corporations in Gaithersburg, Maryland, and Codagenix in Farmingdale, New York.
The pharmaceutical company Biologicals E, based in Hyderabad, India, has also partnered to manufacture a candidate vaccine, which is being developed through Janssen Pharmaceutica, in Beerse, Belgium, and is currently undergoing early protection trials. and Indian Immunologicals, also in Hyderabad, is working with Griffith University in Brisbane to verify and manufacture the university’s vaccine. Two other Indian corporations, Bharat Biotech, in Hyderabad and Zydus Cadila in Ahmedabad – are running Phase I and II vaccines.
Scientists congratulated the Indian government for allowing the country’s pharmaceutical corporations to export some of their vaccine stocks to other countries. millions of doses of coronavirus vaccines in development, sufficient to supply their respective populations several times.
But even with the manufacturer’s commitment to get some of their vaccines locally, scientists say it will take time to take the 400 million doses required for the maximum doses that are at risk of severe COVID-19 and, through this point, most of the epidemic, which lately is havocing in primary cities, will probably have moved to rural areas , where fitness is weaker, Deo said.
This means that the biggest impediment will be to get vaccines to others across India. “This is a major challenge,” says Randeep Guleria, director of the Indian Institute of Medical Sciences in New Delhi and a member of the government’s vaccine management group. “India is a huge country, we have a very large population and we have remote areas, such as the Northeast and Ladakh [in the Himalayas]. “
The vaccination program will probably take years, Kang says. One of the largest immunization campaigns in the country to date, the delivery of the measles and rubella vaccine to 405 million children, starting in 2017, lasted 3 years.
Guleria says cutting-edge approaches will be needed to distribute vaccines in rural and remote areas. He says national election campaigns can simply offer lessons. In 2019, 11 million election officials crossed India to set up polling stations, so other people don’t have to. More than 2 kilometers to vote. The network reached 900 million voters, adding up to those in the most remote areas, in just over 6 weeks. A similar network of fitness officers to administer vaccines can simply cover much of the country, Guleria says.
But it’s not as undeniable as putting the vaccine on other people,” Kang says. “The vaccine will have to stay cold, other people want to exercise. “It will also be expensive to buy syringes and needles, exercise others to vaccinate and buy the vaccine.
The Serum Institute has set the value of the Oxford vaccine at 225 rupees (US $ 3) according to the dose, which means that the charge to immunize 400 million other people will be at least $ 1. 2 billion. As a general rule, the government buys vaccines for less than the value of bottled water: Rs 60. “We never pay $ 3 for a vaccine,” says Kang.
The Indian government is unlikely to bear the full burden of vaccinating its population, says Deo, who will pay for vaccines from poorer citizens and ask everyone else to buy their own vaccines, he said.
Nature 585, 167-168 (2020)
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