India may play an important role in vaccine production

India may become the world’s second-largest manufacturer of Covid vaccines, and analysts say the country has the capacity to produce 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 about 60% of the world’s vaccines – and can do so at relatively low cost.

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

Consulting firm Deloitte predicts that India will be second only to the United States in terms of producing a vaccine against coronavirus this year. PS Easwaran, a partner at Deloitte India, said that more than 3.5 billion Covid vaccines could be produced in the country in 2021, compared with about 4 billion in the US

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

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

Covaxin was approved for emergency use in India, but has been involved in controversy due to criticisms that there was a lack of transparency in its approval and also because it did not publish sufficiently effective data.

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

According to Reuters, the SII produces about 50 million doses of Covishield every month and plans to increase production to 100 million doses per 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 vaccine candidates have not yet been approved for use.

“Even without the development of successful vaccines from their own pipelines, the available capacity offers the opportunity to partner with contract manufacturers with approved vaccine developers to meet supply needs, especially for India and other countries. [emerging markets]”said the JPMorgan report.

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

Some of today’s leading vaccines, 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 infection control process.

These vaccines require “stringent cold chain requirements” that will be difficult, or even “outside the realm of possibilities,” for most health systems, Reddy said.

Vaccines made in India are easier to transport and cheaper, putting the country in a better position than the United States and Europe when it comes to meeting the demands of the developing world, he added.

India’s enormous production capacity also gives analysts the confidence that the country can supply vaccines to other nations.

New Delhi has committed to sending vaccines to neighboring countries and has already provided 15.6 million doses to 17 countries, according to Reuters.

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

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

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

Bharat Biotech, meanwhile, said it is “fully prepared to meet the needs of India and global public health”.

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

Jefferies stock analyst Abhishek Sharma wrote in a note that vaccine launches in India have been slow. Even assuming that the speed of vaccinations will increase, Sharma estimates that only 22% of India’s 1.38 billion population can be vaccinated in one year.

That is roughly the number of people that India wants to inoculate by July or August.

“The supply of vaccines is not so much of an issue as storage, distribution and absorption of the vaccine,” said Solomon of CPPR.

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

Vaccines that India currently manufactures require normal refrigeration, but those produced by Pfizer-BioNTech need to be kept at extremely low temperatures of minus 70 degrees Celsius (minus 94 degrees Fahrenheit), while Modern vaccines must be stored 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 that an adult immunization program is being carried out on an unprecedented scale,” he told CNBC.

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

Reddy suggested that the existing cold chain for food products could be used for vaccines and was hopeful that this problem could be resolved.

“I would say that [these challenges are] more like speed switches that will slow down the program, rather than actual road blocks that require the program to stop, “he said.