India could play an important role in vaccine production

India could become the world’s second-largest Covid vaccine manufacturer in the world, and analysts say the country has the capacity to produce both for its own population and for other developing countries.

Most vaccines in the world have historically come from India. Even before Covid-19, the South Asian country produced up to 60% of the world’s vaccines, and can do so at a relatively low cost.

“India has been a center for vaccine manufacturing … even before the pandemic and should therefore be a strategic partner in global inoculation against COVID-19,” JPMorgan analysts wrote in a report last month.

Consulting firm Deloitte predicts India will be second only to the United States in terms of coronavirus vaccine production this year. PS Easwaran, partner of Deloitte India, said more than 3.5 billion Covid vaccines could be made in the country by 2021, compared to about 4 billion in the US

In addition, Indian companies are currently increasing production to meet demand.

“We are expanding our annualized capacity to supply 700 million doses of our intramuscular COVAXIN,” said Indian firm Bharat Biotech, which developed a Covid vaccine in conjunction with the Indian State Medical Research Council.

Covaxin has been approved for emergency use in India, but has been embroiled in controversy due to criticism over the lack of transparency in its approval, and also because it has not released enough efficacy data.

Another vaccine, known as Covishield in India and developed jointly by AstraZeneca and Oxford University, has also received emergency approval in India. It is produced locally by the Serum Institute of India (SII).

According to Reuters, SII makes about 50 million doses of Covishield each month and plans to increase production to 100 million doses a month by March.

Other Indian companies have agreed to produce vaccines for developers such as the Russian Direct Investment Fund and the American firm Johnson & Johnson. To be clear, these vaccinated candidates have not yet been approved for use.

“Even without successful vaccine development from its own pipelines, the available capacity provides the opportunity to partner as contract manufacturers with approved vaccine developers to meet supply needs, especially for the India and others [emerging markets]”, said the JPMorgan report.

India’s vaccines are likely to be more appropriate for developing countries, said K Srinath Reddy, president of the Public Health Foundation of India.

Some of the leading vaccines at the moment, such as those from Pfizer-BioNTech and Moderna, make use of messenger RNA (mRNA) technology that uses genetic material to trigger the body’s own process of fighting infections.

These vaccines require “strict cold chain requirements” that will be difficult, or even “out of scope,” for most health systems, Reddy said.

Vaccines made in India are easier to transport and cheaper, placing the country in a better position than the United States and Europe in meeting the demand of the developing world, he added.

India’s large production capacity also trusts analysts that the country can provide vaccines to other nations.

New Delhi has pledged to ship vaccines to its neighboring countries and has already supplied 15.6 million doses to 17 countries, according to Reuters.

“India’s manufacturing capabilities are sufficient to meet domestic demand,” said Nissy Solomon, an associate researcher at the Center for Public Policy Research (CPPR).

“With a proven track record on the scale at which vaccines are produced, India should be able to increase production to meet international demand as well,” he told CNBC.

Solomon added that the country controls domestic needs before making decisions about exports.

Bharat Biotech, for its part, said it is “fully prepared to meet India’s needs and global public health.”

However, there will be challenges as the country wants to meet the demand for vaccines in India and beyond.

Jefferies capital analyst Abhishek Sharma wrote in a note that the launch of vaccines in India has been slow. Even on the assumption that the speed of vaccinations will increase, Sharma estimates that only 22% of India’s population, with 1.380 billion people, can be vaccinated in a year.

This is roughly the number of people India wants to inoculate in July or August.

“Vaccine supply is not so much a problem as vaccine storage, distribution and uptake,” Solomon said of CPPR.

“India does not have the capacity to store and distribute to the masses on such a large scale as this,” he said, adding that the country should “strategically” choose vaccines that should not be stored in extreme temperatures.

Vaccines manufactured in India currently require normal refrigeration, but those produced by Pfizer-BioNTech must be kept at extremely cold temperatures of minus 70 degrees Celsius (minus 94 degrees Fahrenheit), while those of Moderna must be kept store at minus 20 degrees Celsius. (minus 4 degrees Fahrenheit).

The “real challenge” lies in the large number of people who need to be vaccinated, said Reddy of the Public Health Foundation of India.

“This is the first time an adult immunization program is being conducted on such an unprecedented scale,” he told CNBC.

He said vaccination programs typically focus on vaccinating children and mothers, and that the logistics network may not be prepared to handle vaccines for entire populations.

Reddy suggested that the existing cold chain for food could be used for vaccines, and hoped that this problem could be resolved.

“I would say [these challenges are] rather like speed switches that will slow down the program … instead of actual locks that require the program to stop, ”he said.