One day in the early 2000s, a sales representative of Bharat Biotech called the company founder Dr Krishna Ella from Calcutta (as the city was then called). The salesman said he had tried his best to convince a doctor about how good the company’s new Hepatitis-B vaccine was, but the doctor told him categorically that he would prescribe only vaccines made by multinationals.
Back then, the little-known Bharat Biotech was an audacious start-up that had come up with a made-in-India vaccine, something that had never been done before. With the money he got selling his house in South Carolina, US, supplemented by capital sewn together from any start-up’s traditional source of funding — ‘family, friends and fools’ — Dr Ella had, in 1996, set up a small plant to discover and produce vaccines that would take on global pharma giants — that, too, in a city he was a stranger, Hyderabad. Though a Telugu, he had grown up in Chennai.
Apart from the deep-rooted mistrust for India-made drugs, doctors had another reason to reject them — commissions. MNC drugs were pricey and the commission was commensurately high. Would a doctor want to prescribe a cheap, Indian vaccine? For the 100-odd medical representatives of Bharat Biotech, it was an uphill task to sell the vaccines.
Ella told the salesman: “Tell the doctor that it was because of people like him (the doctor) that East India Company thrived, and get out of his clinic.” The salesman did just that.
Bharat Biotech has indeed come a long way to become one of the stars of the Indian industry, one that has made the world sit up and take notice, with its Covid-19 vaccine, Covaxin. The company today expects the US Food and Drug Administration to allow Covaxin to be sold in the US; when that happens, it will be the first drug developed and produced in India to be sold in the US. The Indian drugs that are sold there today are either generics,contract-manufactured products or molecules developed overseas that have gone off patent.
When Bharat Biotech’s Joint Managing Director, Suchitra Ella, told this writer about this, the pride in her voice was palpable, not in the least because her mention of Covaxin’s imminent US entry but also as she remembered the days in mid-1990s when she had urged her husband to return to India and the couple had to face one question from most friends: ‘Are you out of your mind?’
The answer to that question is perhaps best provided not in words, but in numbers. In the first half of 2021-22, the company’s income, ₹3,076 crore, was more than twice that of the previous two full years; the net profit for the half year was ₹829 crore — 27 per cent of the operating income. No doubt, the pandemic cemented the numbers, but the company is on a trajectory that will sustain even after the pandemic goes away. More about that later. Pertinent to note here that while the pandemic proved fortuitous, the company was doing quite well even earlier. In 2019-20, the operating income was ₹1,081 crore and the net profit ₹298 crore.
But those asking the Ellas if they were out of their mind had a point. The couple was taking a big risk. The story of the initial days was the same, archetypal story of risk-taking start-ups — no financial backers, 15-hour work days and an uncertain future. Suchitra Ella recalls how her husband would allow only one of them to take a paycheck. Somehow, they persevered, and it paid off. Today, they take pride less in the profits, but more in another number — the number vaccine doses administered to patients worldwide. Today, it’s a staggering 5 billion.
The roots of Krishna Ella’s perseverance lay in his confidence in science. The words, “As a scientist, I...” is never too far away from his lips in any conversation. Science to him is both work and recreation. Bharat Biotech’s office, tastefully built with red-brick-wall interiors, has rooms named alpha, beta, gamma, Curie, etc. Ella is affable and down to earth, a trait evident when we talked about his formative days in Hindu High School, Triplicane, Chennai, and his long lunches at the iconic Ratna Café. But when it comes to work, which is completely underpinned by science, you see him get aggressive — combative even — never pulling punches when he talks, say, about the mistrust the press displayed in Bharat Biotech during the early days of Covaxin.
With the Indian media, especially television, Ella has a bone to pick. At a time when Bharat Biotech would have liked some media support, it only received doubt. He rues the lack of faith in Indian companies’ ability to deliver the goods, a sentiment that global competitors benefitted from. Conversely, Ella — while insisting he is apolitical — is thankful to Prime Minister Narendra Modi for visiting the Bharat Biotech plant in Hyderabad during the pandemic, which he says was an “acknowledgement” of India’s capability to produce a vaccine.
Nor is there any pulling of punches when talking about the science behind some of the quickly-cobbled-up vaccines in the market. For instance, he never flinches from expressing his displeasure over mRNA vaccines (of Pfizer, Moderna) for their short-lived immunity. Ella believes the current mRNA Covid-19 vaccines to be a catchpenny with evanescent benefits. In contrast, Bharat Biotech’s Covaxin is ‘adjuvanated’ (adjuvants are substances that enhance immune system’s response in the presence of a disease-causing antigen).
Ella’s zest for science comes to the fore when he explains why Covaxin gives long-term immunity. Bharat Biotech “licensed an adjuvant (IMDG) from a US firm, fixed it to aluminum hydroxide gel, so as to get it into the lymph nodes and thereby provoke a T-cell response.” That is also why Covaxin will work against most variants of SARS-CoV-2. For the man who got his Ph.D. (from University of Wisconsin-Madison) in ‘signaling pathways’ — series of chemical reactions in which a group of molecules in a cell work together to control a cell function — microbiology is home ground.
Spice of life
It was again science that led Ella into another business. Ella Foods, which produces spices, pickles, roasted nuts and even a probiotic upma, has science undergirding its products. Take spices, for instance. Grinding spices for mass production involves metal-to-metal contact, and therefore heat, which kills nutrients and flavour — unlike the traditional method of pounding, that uses wood. So, Ella Foods grinds spices in cryogenic conditions, preserving the native aroma. The company has an irradiation facility in Bengaluru, where pathogens in foods are killed using gamma rays.
Ella says Bharat Biotech is committed to doing things right, not just turn out a quick profit. One example is clinical trials. Typically, Indian companies test their drugs on a small group of volunteers, about a hundred, test another comparable incumbent drug on another set of volunteers, and compare the results. Bharat Biotech, during its 15-year-long development of rotavirus vaccine, tested it on 25,000 mothers.
Ella recalls that getting so many volunteers was a big problem, especially because ethics forbade the company from paying the volunteers. But instead of a fee, Bharat Biotech undertook all health-related expenses of the mother and child for three years, even if unrelated to the vaccine. That did the trick and the mothers signed up.
Today, the rotavirus vaccine has saved millions of children from diarrhea — the earlier vaccines could not be given to babies below two years, but Bharat Biotech’s vaccine was good for months-old babies too.
Drawing upon that experience, the company did extensive clinical trials for Covaxin. Its partner, National Institute of Virology, Pune, was a big help. NIV also helped with animal tests, something Bharat Biotech couldn’t have done by itself. “In India it is easier to get people than monkeys,” chuckles Ella. Some NGO will get a whiff of a trial on a monkey and raise hell.
And now, the company is all set to launch a nasal vaccine for Covid. Ella points out that the nasal vaccine is not Covaxin administered by nasal drops, but a new, adenovirus vector vaccine (like Astra-Zeneca’s Covishield). He says that a nasal vaccine protects the entire region from the nose to the lungs, whereas an intramuscular injection leaves the upper portions of the respiratory systems uncovered.
Will Covid-19 going away affect the fortunes of the company? Joint Managing Director Suchitra Ella, who looks after the business side, says no, because the company had actually had to backdown production of other vaccines — it has a portfolio of 20 products — to make room for Covaxin. So, after Covid-19, the capacities will go back to the other products. However, the company has now set its sights on Africa, thanks, at least partly, to former President of South Africa, Thabo Mbeki, who once rued to Ella that the world was only exploiting Africa’s problem, not trying to solve any.
Today, Bharat Biotech is a global name and its work is frequently mentioned in scientific papers. A quarter century ago, as a start-up, it unfurled its sails to cross an ocean that was anything but blue and has cut its way to the vanguard of the armada. More importantly, it has raised the world’s confidence in India to make and deliver vaccines. The situation today is vastly different than in its initial days. When its 400-odd salesmen go with their products to doctors, they go with the confidence that they will be heard and not shown the door.