India is restricting coronavirus vaccine exports, a move that will likely hit the world’s most disadvantaged nations hardest and exacerbate what the World Health Organization’s head this week called a “grotesque” supply chasm between rich and poor countries.
The world’s biggest vaccine exporter, the country is a key supplier to Covax, a program backed by WHO and partners to deploy shots to every corner of the globe. India’s decision to pare back shipments threatens the group’s plans to inoculate 2 billion people before the end of the year.
After the country shipped or donated more than 60 million doses of Covid vaccine, India’s exports have slowed to a trickle. Growing criticism of the speed of its own immunization campaign and a fivefold increase in new virus infections over the past month spurred the change, according to government officials familiar with the matter who asked not to be identified as the decision has not been publicly announced.
“Both these things are linked,” said Shahid Jameel, director of the Trivedi School of Biosciences at India’s Ashoka University. “At a time that a surge is happening in India, there is pressure on the government.”
– Dr. S. Jaishankar (@DrSJaishankar) March 25, 2021
Expansion of India’s immunization campaign to include everyone aged over 45 beginning April 1 also contributed to the curbs, though a schedule for exports remains in place until Sunday, the officials said.
India has burnished its global image through vaccine diplomacy, challenging China for political influence across the developing world. Subrahmanyam Jaishankar, India’s foreign minister, touted friendship and solidarity through “Made in India” vaccines arriving in countries from Bolivia to South Sudan to the Solomon Islands.
The about-face mirrors the European Union’s consideration of controversial restrictions in response to criticism of its chaotic, slow immunization campaign — though the EU has also exported more shots than it’s administered at home. Vaccine nationalism imperils equitable distribution of shots and risks bringing the world to the “brink of a catastrophic moral failure,” WHO Director General Tedros Adhanom Ghebreyesus said on Monday.
Covax is helping many poor countries access immunizations by providing doses funded by donors. Middle- and higher-income nations also use it to access doses that have been mainly snapped up by the U.S., the U.K., the EU and other wealthy buyers that have largely failed to share.
Gavi, the Vaccine Alliance, one of the WHO’s Covax partners, said Thursday that increased demand for Covid-19 vaccines from India was behind delays in authorizing further export licenses from its main supplier, the Serum Institute of India Ltd.
“Covax is in talks with the government of India with a view to ensuring deliveries as quickly as possible,” a Gavi representative said. India’s health ministry declined to comment through a spokesperson.
Almost 90% of shots administered in India were made by Serum, which has partnered with AstraZeneca Plc to churn out hundreds of millions of doses of the vaccine co-developed with the University of Oxford. The remainder come from Bharat Biotech International Ltd., which makes its own formulation.
A spokesperson for Serum declined to comment, though the company’s emergency license granted in early January doesn’t allow it to fulfill export orders without a nod from New Delhi. In an interview aired last week, Serum Chief Executive Officer Adar Poonawalla said India was asking for more doses than initially anticipated, and Covax’s goal to inoculate 2 billion people this year would likely be missed due to vaccine nationalism.
Since Ghana became the first country to take delivery of 600,000 Covax-supplied shots last month, the program has distributed more than 30 million doses to 50 countries. However, Bruce Aylward, a senior WHO official, said at a news conference on Monday that the facility was hampered by holdups from AstraZeneca and Serum.
“The problem we have quite frankly is we cannot get enough vaccine,” Aylward said. “Right now the manufacturers are unable to keep up with our orders.”
India’s move could further delay a Covax goal of reaching 140 countries in the near term, out of the 190 participating. The supply crunch has also hit India’s neighbor Pakistan, which is in line for 45 million doses through Covax. The first shipment, due in March, has now been indefinitely delayed, Asad Umar, the country’s planning minister, said Thursday.
Serum’s CEO also warned this month that materials needed to make vaccines, such as bioreactor bags and specialized filters, became pinched after the U.S. invoked the Defense Production Act to keep them for American producers. Even vaccine makers outside the U.S. that stocked those items will likely run into shortages soon, said Prashant Yadav, an expert on health-care supply chains at the Center for Global Development in Washington.
Even so, vaccine supplies from 13 producers could rise to 12 billion doses by the end of the year, according to a study from the Duke University’s Global Health Innovation Center. That would be enough to inoculate 70% of the world if distributed equally — an aim that the WHO is now struggling to achieve.
“There is such an urgent need for more balanced access to vaccines,” said Andrea Taylor, who leads Covid-19 research at Duke’s Global Health Institute. “We can’t allow a significant portion of the world to wait six months or a year or more to get vaccinated.”
“It just gives the virus more opportunities to evolve in ways that could greatly prolong the pandemic for everyone.”