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Adar Poonawalla, the CEO of the Serum Institute of India and president of the Vaccine Manufacturers’ Association of India, spoke to Sunetra Choudhury about the timelines for vaccine development, the plan to begin production of some of the candidates, the low rate of testing in India, and the need to end stigma around a region where cases spike. Edited excerpts:
Everyone is tracking vaccine development closely. Is it true that you plan to begin production of the candidates as early as next month?
Yes, we have to start manufacturing some of these candidates at risk because if the world wants hundreds of millions of doses, we need to start by August-September. We’ve planned that, and we are planning to start manufacturing when we apply for Phase 3 of clinical trial permissions, which should be in the first week of August. That’s the plan. Of course, there’s risk-taking in everything, and this is where we have chosen to put in a lot of our investment both in the opex (operating expenditure) and the capex (capital expenditure) — so that we have a dedicated facility, so that we can procure all the raw materials, and glass vials which we have already done.
There’s the risk that if it doesn’t work out, we’ve got to go on to the next candidate, and the next candidate, and so on. We’ve got five different partnerships at the moment, including two of our own candidates, so I’m sure something will eventually work. But we shouldn’t be in a rush, we should take our time and make sure that the vaccine that we launch is safe and effective.
ALSO WATCH | On The Record: ‘10 million tests till now is a joke,’ says Adar Poonawalla
Before we get to that bit of safety, can you explain the timeline a bit more about when vaccine will be ready for India’s billion-plus population?
As I said, rolling out the vaccine, reaching everyone in India, is probably going to take more than a year, even from December. So we are talking about a year-and-a-half at least. We are talking about reaching parts of the country that are very difficult to reach, and even if we assume that people are going to come from rural parts to cities to get vaccinated, I don’t know how that whole plan is going to pan out. So up to two years provided the vaccine trials succeed and work. That’s the main “if”.
After that, we can calculate how much time it will take, but the way the disease is spreading — 70-80% are asymptomatic, which means you are not really having very detrimental symptoms, severity of the disease is not so bad in most healthy individuals. A lot of people will get the disease way before the vaccine comes about, I think in the US, roughly 1% of people have got it. That’s visible because of the amount of testing they are doing, and I’ve said if you increase the testing in India, you’ll see something similar coming about where 2-3% of the population by the end of the year will have it. And in 3-4 years, maybe 20-30% of the population would have got the disease and have recovered.
The ICMR DG’s letter on a vaccine by August 15 created a storm. What did you make of the episode?
I think the letter was misconstrued. I think they were trying to expedite things that the government is expected to do — and they are doing a fabulous job about it. It got jumbled up, but nobody’s trying to cut corners. The whole vaccine industry is standing together to say we will conduct all Phase 1 and 2 and 3 trials, and even ICMR wants us to do that. They also want to adhere to global standards. What’s happened is a lesson that everybody’s learnt — let us all be patient and wait for trials of drugs and vaccines to happen. After that happens, then we can come to a conclusion and give recommendations of what can be given to the public.
We’ve just marked the milestone of 10 million tests in India. You’re not satisfied by that?
No, I think that’s a joke. I think it should be 100 million, because if you look at our population, and if you look at other countries and the amount of testing they have done, it is way more. I think as the labs are gearing up, we certainly have the technology and the capability in India to do it. I believe in Mumbai you no longer need a doctor’s certificate to get tested. In a workplace, say you have a couple of hundred employees, you should be able to test everyone so that you feel safe and they feel safe coming back to work.
We need to allow free testing, not in terms of price, but without doctor’s certificate or other such documents. The pricing of the test is very reasonable and affordable. We have picked up a lot, every week we are increasing and I think we are going in the right direction. Initially there were limitations to testing but now that’s no longer the case.
Are there apprehensions that some states are not testing enough because of what the numbers will say about their Covid-19 management?
Initially it was true, but very soon, whether it is at a country level or state level, where they compare with other states or countries to see the number of cases, I don’t think anybody’s going to care. Because there is going to be no shame in a state or a country that has got these cases, because this is something out of anyone’s control; you can’t stop it. You can mitigate it, you can take measures — everyone’s wearing masks, taking precautions, but you can’t hold it back beyond a point, so there’s no shame. As soon as countries realise that, and the individual states realise that, there is no competition, and no shame, politics doesn’t come in the way of the science. With testing, you can isolate areas, you can isolate people, you can actually prevent more damage by testing more.
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