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The Modi government has approved two vaccine candidates and plans to inoculate 300 million people by July. It has launched a massive training programme for health workers and conducted drills to ensure the success of what will be the world’s largest vaccination programme.
As India gets ready to roll out the world’s largest Covid-19 vaccination programme over the next few weeks, hope floats alongside an equal measure of anxiety.
The country’s drug regulator, the Drugs Controller General of India (DCGI), has approved the emergency use of two coronavirus vaccines – Covishield, which has been developed by AstraZeneca and Oxford University, and Covaxin, developed by domestic pharmaceutical major Bharat Biotech. The former is being manufactured in India under license by the Serum Institute of India (SII), the world’s largest vaccine maker.
“The world’s biggest Covid-19 vaccination programme is set to begin in India,” Prime Minister Narendra Modi told a meeting organised by the Council for Scientific and Industrial Research recently. “For this, the country is proud of its scientists and technicians.”
He has also committed to provide vaccines to India’s neighbours and other less developed countries. Following visits to three vaccine making facilities in the country on November 28 last year, Modi had said: “India considers vaccines as not only vital to good health but also a global good. It is India’s duty to assist other countries, including in our neighbourhood, in the collective fight against the virus.”
However, the first priority remains the immunisation of the Indian people. For this reason, the government has banned the exports of Covid-19 vaccines. The numbers clearly validate the rationale behind this decision.
India has recorded the second-highest number of coronavirus cases in the world after the US. More than 10.3 million confirmed cases have been reported and about 150,000 people have died.
However, relative to the size of its population, it has fared much better than many developed countries. The proactive measures taken by the Modi government, which included imposing the world’s most stringent total lockdown, has helped to control the pandemic and bring it under control relatively quickly.
At present, despite the high absolute numbers, India has only about 225 active cases per million people, compared to 21,612 in the US and 3,513 in Russia, according to data on the Government of India’s Ministry of Health website. Then, India’s recovery rate of 94 per cent is significantly higher than the world average of about 70 per cent and its fatality rate of less than 1.5 per cent is almost a full percentage point better than the comparable global figure of 2.4 per cent.
On the back of this enviable track record of dealing with the pandemic, the Modi government has now set an ambitious target of vaccinating 300 million people. These will include healthcare and other front-line workers and people most at risk.
It’s going to be humungous effort and will test every arm of the government and society that is involved in it. So, the government is going about its task with military-like precision.
Last week, it held a pan-India drill to train 90,000 healthcare workers to administer the vaccine, initially to the targeted 300 million people and then to the country’s entire 1.3 billion population.
One big advantage India has over other countries in this field is that it already runs the world’s largest infant and children immunisation programme, which inoculates more than 55 million individuals every year. Thus, India can leverage this pre-existing network to roll out its Covid vaccination drive.
Then, unlike two other vaccines developed in the West by Pfizer and Moderna, Covishield and Covaxin do not need ultra-cold storage and special handling facilities. These two vaccines being rolled out in India can be stored at 2 degrees Celsius to 8 degrees Celsius, making them suitable for storage in any refrigerator.
However, an unseemly controversy with strong political commercial overtones has broken out on the eve of the mother of all vaccine rollouts.
Some experts have questioned the fast-track clearance granted by the Indian drug regulator to the domestically-developed Covaxin on the ground that data from its Phase 3 trials are not available for a transparent evaluation of its side effects.
Prominent Congress leader Shashi Tharoor tweeted that the green signal for Covaxin was “premature and could be dangerous” and that “its use should be avoided till full trials are over. India can start with the AstraZeneca vaccine in the meantime”.
Dr Randeep Guleria, Director of the All India Institute of Medical Sciences and a member of the National Task Force on Covid-19 Management, seemed to concur.
“I would say that we should in the first phase focus predominantly on the Serum Institute of India – the Astra Zeneca – vaccine, and (use the) Bharat Biotech (vaccine) only as a standby or a backup in case there is a surge in the number of cases,” he told the media.
Several international media agencies have also tried to play up this point in their despatches from India.
However, it must be noted that the Astra Zeneca-Oxford vaccine also has its share of sceptics. Even as the UK begins rolling out this vaccine, the European Medicines Agency (EMA), which advises the European Commission on whether medicines can be authorised for marketing, has issued a statement saying it does not have sufficient data to approve its rollout for public use.
It added that it will need additional scientific information “related to quality, safety and efficacy of the vaccine… to support the rigour required for a conditional marketing authorisation… The available data must indicate that the medicine’s benefits outweigh its risks”.
Thus, the same questions that plague the Bharat Biotech vaccine also dog the one developed by Astra Zeneca-Oxford.
But given the global health emergency, the Indian Council of Medical Research (ICMR), which has partnered with Bharat Biotech to develop the Indian vaccine, and the Drug Controller General of India (DCGI), have followed the examples of other global regulators in permitting emergency rollout of these vaccines.
Modi has called the proposed rollout of the vaccines “a decisive turning point”. Billions of people around the world, who are waiting to see how this inoculation drive pans out, will be hoping it is.