why-has-india-agreed-to-resume-vaccine-export

Context: Recently, the Union Health Ministry announced that India will resume the export of COVID-19 vaccines under its ‘Vaccine Maitri’ programme to fulfil the commitment towards COVAX (COVID-19 Vaccines Global Access).

Background: 

  • With close to 85 crore doses of COVID-19 vaccines dispensed in India so far, the Health Ministry disclosed plans to resume export of the India-made vaccine from October, under a programme called ‘Vaccine Maitri,’ to foreign countries as well as COVAX. 
  • The latest supply forecast for global vaccine-sharing platform, COVAX, is that it will have distributed 1.4 billion doses by the end of 2021, less than the 2 billion doses it had aimed for earlier this year. 
  • Only 280.5 million doses have been given out through COVAX as of September 15.

How many doses has India supplied abroad?

  • According to data from the Ministry of External Affairs, as of May 31, 6.6 crore doses of locally made vaccines have gone out of India either as grants, exports or supplies to COVAX. 
  • The last dispatch was on March 29. 
  • Close to 99% of the vaccines supplied were Covishield.

Why did India stop vaccine exports?

  • India’s vaccination drive began in January for healthcare workers and was gradually expanded to those aged over 60. 
  • Until February, the uptake was slow. 
  • The first two months were also marked by a declining trend (that commenced in September 2020) in daily fresh cases of infection. 
  • By February, the daily count had dipped to an all-time low of below 10,000 — something not witnessed since June 2020. 
  • Some government-backed epidemiological forecasts as well political messaging began giving out the impression that India had likely passed the worst of the pandemic. 
  • By mid-February however, several districts in Maharashtra started reporting a sharp spike, and by March the ascension was rapid enough for a growing public demand that vaccines be made freely available. 
  • India had not yet approved foreign-made vaccines, and though Bharat Biotech’s Covaxin was approved before the results of its ongoing phase-3 trials, there was too little of it available to the public. 
  • By March-end, India placed “restrictions” on the export of Covishield, and stopped it by mid-April.

What is Covishield’s role in COVAX?

  • The Pune-based Serum Institute of India (SII) was expected to be the mainstay for COVAX. 
  • Along with the unexpected spike in demand in India following the second wave, a fire at its facility in January meant it struggled to meet its stated production target of 100 million doses a month and was languishing at around 60 million doses. 
  • The speedy production of Covishield was aided by a $300-million investment in SII, in November 2020, by the Bill & Melinda Gates Foundation to offset the risk from producing billions of doses of vaccine and in case it was proven to be not effective. 
  • However, with the second surge and the export restrictions, COVAX and its member-partners have over the last few months expressed concerns that SII’s inability to manufacture has meant that COVAX’s commitment to supply two billion doses by the first quarter of 2022 would be impacted. 
  • African Union countries are expected to receive 470 million doses by the end of 2021, but the forecast is 25% lower than predicted in June 2021.

What has changed now?

  • Regarding the resumption of exports, India has stated that only “excess supplies” will be eligible for exports. 
  • Vaccine production has nearly doubled since April and could rise to over 30 crore doses by October, thus freeing up supplies. 
  • Several factors favour India. 
    • There is a steady decline in new cases, 
    • Over half the adults have got at least one dose and, despite reports of fully inoculated people catching the infection, there is no worrying rise in severe disease or mortality. 
  • However, Covishield continues to be India’s vaccine mainstay. 
  • The supply of Covaxin has increased, but it still accounts for only around 11% of India’s total vaccine output. 
  • Millions of doses of Sputnik V, Sputnik Light, Corbevax and ZyCoV-D are projected to be available in the next few months but so far none has started rolling off the shelves. 
  • With nearly 100 crore doses needed to fully vaccinate all adults, it is unlikely that all will be fully vaccinated by the year-end. 
  • For that, one crore doses need to be administered every day. 
  • India’s average daily pace now is about 70 lakh doses.

Related Facts

COVAX Program

  • Led by: The vaccine alliance GAVI, the World Health Organisation (WHO) and the Coalition for Epidemic Preparedness Innovations (CEPI) in partnership with UNICEF, vaccine manufacturers and the World Bank. 
  • Objective: To ensure equitable distribution of COVID-19 vaccines globally, COVAX is being called the largest vaccine procurement and supply operation in history.
    • Under the program, over 2 billion doses of COVID-19 vaccines are expected to be delivered by the end of 2021.
  • The funding: The funding target for this program for 2021 is about US $6.8 billion, of which about US $4 billion has been raised. 
    • The funding is partly coming from high and middle-income countries that will also receive a share of the vaccines produced for COVAX. 
  • Eligible countries: The program will vaccinate roughly 20 percent of the population in the 92 Advance Market Commitment (AMC) countries, which include middle and lower-income nations that cannot afford to pay for COVID-19 vaccines. 
    • This means countries with a Gross National Income (GNI) per capita of less than US $4000 and some other countries are eligible under the World Bank International Development Association (IDA).

Challenges to Successful Vaccination 

  • Vaccine Hesitancy- it is the biggest challenge for any vaccination programme where people are not ready to take vaccines due to several reasons. 
  • Infrastructural issues- for eg.- technical glitches in the Co-WIN app that is used for registering for the Covid 19 vaccination.
  • Vaccine wastage- for instance each vial of covid vaccine contains 10 doses and they have to be used within 4 hours of opening. This leads to vaccine wastage.
  • Under Financing: It is unclear if merely the policy move of liberalizing vaccine supply will leave States in India with the finances and negotiating power to procure enough stocks of vaccines.
  • Shortage of Raw Material: The inability of getting the much-needed raw materials from the United States – bags, vials, cell culture media, single-use tubing, specialized chemicals, etc. that have now been banned for export has disrupted vaccine production in India.
  • Shortage/ Non- availability of Vaccines- The vaccine procurement policy followed till now required the states to individually procure vaccines for themselves that led to shortage or non-availability of vaccines in several states.
  • Digital Divide- It has emerged as a major challenge in the vaccination process especially among the lesser educated groups who are not digitally equipped and hence are unable to register for vaccinations through the CoWIN App.

Approach that is needed for a Successful Vaccination Campaign

  • Eliminating vaccine hesitancy: Communication is required in order to resolve the confusions and to eliminate the vaccine hesitancy. Engagement with the community-based organisations and spreading awareness by educating people about the vaccine.
  • Preventing vaccine wastage: organised appointment for vaccinations, ensuring once opened, the vaccine is surely utilised and not wasted.
  • Massive Multimedia Campaigns: If fresh lockdowns are to be avoided, we need to enforce mask wearing by investing in massive multimedia campaigns for information, education, and communication, like it was done for polio and HIV.
  • Supporting Domestic Production: It should also speed up approvals and financial packages for ramping up domestic production for expanding supply, expanding age bands.
  • Strengthening Vaccine Supply Chain: Enhancing Electronic Vaccine Intelligence Network (eVIN) system will enhance real-time information on vaccine stocks and storage temperatures across all country’s cold chain points.
  • Special focus to those who are not well digitally equipped so that they are not left out of the drive.
  • Continuing with the enforcement of the necessary protocols like masks, handwashing, etc.

Vaccine Diplomacy: It is the use of vaccines to increase a country’s diplomatic relationship with  other countries.

Vaccine Maitri

  • India has started the supply of COVID vaccines to its neighbouring and key partner countries. 
  • Bhutan and Maldives were the first to get the vaccines followed by Bangladesh, Nepal, Myanmar and Seychelles.  
  • Sri Lanka, Afghanistan and Mauritius also got doses.
  • Pakistan is not named in this initiative.  
  • Vaccines will be Supplied to the partner countries in a phased manner, keeping in mind the demand.

Read more about the COVID Diplomacy

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