A week ago, the World Health Organisation flagged an oxygen emergency. The shortage of oxygen cylinders in low and middle income countries (LMIC) was affecting half a million Covid-19 patients everyday, the WHO said.

This week, WHO’s chief scientist Soumya Swaminathan pointed to the shortage of vials, glass, plastic and stoppers (vial caps), as well, according to foreign media reports. Adding his voice to the concern being raised about global shortages, Serum Institute of India Chief Adar Poonawalla told a World Bank panel that the US administration’s move to stop the export of materials such as bags, filters and so on from the US could create global shortages.

US President Biden’s administration was planning to use its Defense Production Act to boost local supplies needed to make Pfizer’s vaccines, he said, according to the report.

Serum Institute has an alliance with American company Novavax, and is undertaking clinical trials on this vaccine in India. This is in addition to an existing alliance with the AstraZeneca-Oxford University combine, whose vaccine is being rolled out in several countries including India.

‘Critical limiting factor’

“If we’re talking about building capacity all over the world, the sharing of these critical raw materials is going to become a critical limiting factor,” Poonawalla is quoted as saying.

“This is one thing that would need some discussion with the Biden administration to explain to them there’s enough to go around,” Poonawalla said. “We’re talking about having free global access to vaccines but if we can’t get the raw materials out of the US -- that’s going to be a serious limiting factor,” Poonawalla reportedly said.

Global shortages are emerging due to factors ranging from reduced production capacities to companies and countries resorting to last minute measures and bans. Italy has reportedly blocked the export of a shipment of AstraZeneca’s vaccine headed for Australia.

Swaminathan pointed out that global coordination was needed to ensure supplies and not “export bans.” The WHO is expected to have meetings with the International Federation of Pharmaceutical Manufacturers and Associations and the Developing Countries Vaccine Manufacturers Network next week to address these bottlenecks.

Auto-disable syringe maker Hindustan Syringes & Medical Devices Managing Director Rajiv Nath has had to re-work production-lines to meet last minute requirements for 0.3 ml syringes, to support the supply of Pfizer’s vaccines. HMD’s 0.5 ml syringes are WHO pre-qualified, but the changed requirements were for UN agencies supplying the Pfizer vaccine.

Vaccine nationalism

Global voices have been calling out “vaccine nationalism”, urging governments to ensure equitable delivery of Covid-19 treatments, including vaccines. For that reason the WHO-supported Covax had been set up. But the inconvenient truth is that developed countries had stockpiled a lion’s share of global vaccine supplies, forcing WHO to urge vaccine-makers to supply to Covax and not separately to countries.

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