The approaches to Covid vaccines in India and the US. A thread … (Source: The Ken)

(1) May 2020, the US government made a plan - to support 7vaccine candidates simultaneously to speed up trials and the approval process and to promote ways to manufacture them at scale (Operation Warp Speed) - conceived as a partnership between the US govt and private companies.

(2) The rationale was that a vaccine would emerge faster was if pharma companies were given lots of money to fund their research. How much money? ~ over $11 billion. Given out to eight of the biggest pharmaceutical companies in the world.

(3) India was a different story altogether. SII, bereft of any Govt funding, had to approach private investors - raised $150 million from the Bill and Melinda Gates Foundation and even invested $100 million of its own money. How much money received from Govt? Zilch.

(4) In July 2020, the US government went one step further. It paid nearly $2 billion and placed an order with Pfizer for 100 million doses of the vaccine - and it did this EVEN before it knew whether the vaccine was going to be a success or not.

(5) Then, it went ahead and signed another $1.5 billion contract with Moderna for another 100 million doses. And then, It also signed contracts with Johnson & Johnson, Novavax, and AstraZeneca for >500 million vaccine doses

(6) Meanwhile, in India, the Govt had promised to purchase the first 100 million vaccines @ Rs. 200 ($2.66) each - one of the lowest prices in the world. The reason that SII agreed to this was the fact that it could sell subsequent doses on the private market at a higher price.

(7) Further, SII had already received purchase orders from several countries—including Saudi Arabia, Brazil and Morocco—for millions of doses. All of this would help fund SII and enable it to scale up.

(8) But there was a problem: the Indian government HADN'T SIGNED ANY purchase orders with SII. In January 2021, India’s largest vaccine manufacturer had no idea how many vaccines the Indian government would need and by when.

(9) Further, although SII was manufacturing close to 60 million doses a month, tHe actual production needed to be much higher to have any hope of meeting India’s requirement.

(10) India had an entire year to scale up manufacturing capabilities across the nation, all to produce the vaccine at a war footing when it was ready.

But it didn’t.

(11) on 11th January 2021, the Indian govt finally placed its first purchase order.

It ordered 11 million doses.

2 weeks later, the US Govt exercised its second option with Pfizer and Moderna.

It ordered 300 million doses, bringing the total order to 600 million doses.

(12) As Covid cases rose, India quickly suspended exports on all vaccines.

Countries that had booked vaccines with SII much earlier than everyone else were told to wait. India’s needs had to come first.

Incl. Brazil, where 3,000 people die from the coronavirus every day.

(13) Two days back, SII received a legal notice from AstraZeneca, the developer of the vaccine, over delays – we can understand what this means to the credibility and reputation of India’s (and probably the world's) largest vaccine manufacturer.

(14) Earlier this week, SII asked for financial help from the Indian government to the tune of Rs 3,000 crore (~$400 million). As of this morning, there has been no official response from the government to SII’s request.