On October 8, a day before government representatives met virtually with executives from about 20 syringe and needle manufacturers, an excel sheet was distributed by the office of the Drugs Controller General of India. The manufacturers had to fill in details around their annual production capacity, domestic supplies, exports over the past 18 months and whether the companies have additional capacity. The reason: the Union government is taking the first steps towards preparing for a mass covid-19 vaccination programme in 2021.
About 250 million Indians will be targeted for immunisation in the first phase, the manufacturers were told. Considering the vaccine chosen needs two doses per person, India would require half a billion syringes to begin with.
India is one of the largest syringe makers in the world with a current production capacity of over a billion a year when it comes to 0.5 ml syringes for intramuscular vaccination. By the middle of 2021, India could ramp up production to 1.4 billion, the manufacturers told Dr. V. G. Somani, India’s Drugs Controller General, and Shubhra Singh, chairperson of the National Pharmaceutical Pricing Authority, the two top government representatives who attended the meeting. About half this capacity, however, is planned for exports.
“They asked us on the issues manufacturers have in supplying to the government and in ramping up capacity,” Rajiv Nath, managing director of Hindustan Syringes & Medical Devices Ltd, one of the attendees, later told Mint. The syringe makers, he added, would be willing to invest in additional capacity for India’s vaccination needs but needed assurances around procurement and pricing. There are worries that the additional capacity invested in would remain idle once the pandemic passes.
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Convincing device makers is just one piece of a gigantic and complicated puzzle that the Indian government is beginning to solve. Rolling out an immunisation programme for over a billion Indians requires an unprecedented level of preparation and implementation.
The larger pieces of the puzzle include getting warehouses, cold chains, the supply-chain and reverse logistics of disposed syringes ready, mobilising human resources who will administer the vaccine, training them, and pressing the accelerator on mass awareness campaigns.
Even before any of these, India needs to pick a vaccine that is safe and effective besides ensuring there is money to finance it — India could require over $10 billion in the first year itself. That said, India has two advantages. The country is one of the largest contract manufacturers of vaccines in the world and it has the administrative experience of running vaccination campaigns. This has led to a sense of optimism.
“In the past, India has been very successful in running public health programmes for immunisation on a large scale like the pulse polio vaccination programme,” Dr. Sharvil Patel, managing director of Cadila Healthcare Ltd said. “There is no reason why we shouldn’t be able to do this again. We have time to gear up for this (covid vaccination) over the next few months and I believe that the government has already started working on a programme,” he added.
Cadila is developing a covid vaccine, ZyCoV-D, which is currently in Phase 2 of clinical trials. Globally, there are 42 vaccines in clinical evaluation, according to World Health Organisation. About 10 of them, all from foreign developers, are at an advanced stage. Because one doesn’t know which of them could ultimately win the race, there is uncertainty. Some vaccines would require one dose; others two doses and at varying intervals. Every vaccine has its unique temperature requirements. The unknowns make planning for the programme a tricky affair. Indeed, many experts prefer to tread cautiously rather than sound optimistic.
“There are a lot of areas we are not informed about. First, are we going to get a safe and effective vaccine? Assuming we do, the next question is whether the vaccine is going to be an India-developed vaccine or will it be a vaccine developed abroad for which we have been contracted to manufacture?” K. Srinath Reddy, president of Public Health Foundation of India (PHFI), a body that works on health research and advocacy, asked.
Source: Live Mint