The vaccine race

Two Indian candidates for a vaccine targeting the novel coronavirus SARS-CoV2 have been granted permission for Phase I and II trials in India. One is being developed by Ahmedabad-based Cadila Healthcare, and the other by Hyderabad-based Bharat Biotech. The latter has now tied up with private health care labs for human trials, as well as some public hospitals; the All India Institute of Medical Sciences in New Delhi gave a 30-year-old man the first dose of the Bharat Biotech candidate, called Covaxin, last week. These two indigenously developed vaccines now join 23 other candidates from across the world in clinical trials. Of the 25 vaccine candidates that have moved from pre-clinical investigation to clinical trials, five are already in Phase III trials, which are large-scale population trials that include particularly at-risk segments such as the elderly or those with co-morbidities. One of those is AZD1222, commonly known as the “Oxford vaccine” because it has been developed at Oxford University’s Jenner Institute with support from the European pharmaceutical major, AstraZeneca. The developers of AZD1222 have signed agreements with Bill Gates’ Coalition for Epidemic Preparedness Innovations and the public-private alliance GAVI, which includes the Government of India and Pune-based vaccine producer Serum Institute of India. It is expected, therefore, that AZD1222 will also receive the nod for clinical trials in India. Elsewhere in the world, three Chinese vaccines are already in Phase III trials, one from Sinovac and two from Sinopharm; and much hope also attaches to the shortly-to-begin trials of a promising candidate from the American company Moderna.

It is now clear that the race to create a vaccine that is safe, effective, and accessible is truly on — and, also, that this is a global race. Unfortunately, this also means that there are economic and geo-political considerations that will begin to impinge upon the development of the vaccine. Who gets a successful vaccine first? How will it be rolled out across the world? Who will benefit, and who will profit? These are questions that now must be asked, including by policymakers in India. The malignant effects of international competition are already evident: Last week, Britain’s national cyber security agency warned that Russian hackers are targeting vaccine development institutions in Britain, the US, and Canada. Europeans, meanwhile, are still smarting from reports that President Donald Trump’s administration tried to buy the German company BioNTech, which, in cooperation with Pfizer, has one of the most promising Stage I/II vaccine candidates. After its reported attempt at an outright purchase failed, the US government signed a $2-billion agreement with BioNTech/Pfizer to provide up to 600 million doses, the latest of a series of such agreements that totals almost $4.5 billion.

It is important, therefore, for the Indian government to identify the most promising candidates and seal deals as early as possible for the licensing and production domestically of the finished vaccine, if it proves safe and effective. If one of the Indian candidates, or the Oxford vaccine, wins the race then it is the best-case scenario. But India must also prepare for attempts to try and monopolise the first few vaccines that appear to work. If the government keeps track of which organisations are doing well, it can ensure that it is among the first few countries to strike a deal.

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