The Covid-19 pandemic has sparked focussed vaccine development efforts worldwide, whereby many vaccines based on novel technologies have been developed and deployed globally. India has established itself as a leading global vaccine manufacturer and is sufficiently well-placed in terms of infrastructural capacities. India’s accelerated response to Covid has been one of the landmark achievements of our nation.
India’s effective battle against Covid can be attributed to several key factors. These include proactive government support, a robust foundation of biomanufacturing capabilities within the private sector, and longstanding strategic investments in the biotech ecosystem. However, the pandemic has also revealed the need to strengthen health systems and supply chains for equitable access to medical countermeasures worldwide.
Current healthcare challenges are complex and require a concerted global response and Prime Minister Narendra Modi’s vision of ‘Healing, Harmony and Hope’ provides an opportunity to promote a more people-centric form of globalisation that, in turn, prioritises universal healthcare. The nation’s leadership at the G20 could be a defining moment in addressing critical issues for patients worldwide by establishing regional networks for research and development and manufacturing vaccines, therapeutics, and diagnostics to improve preparedness for future health emergencies.
The challenging Covid years witnessed a fatal economic downturn that had a more significant impact on low-income and emerging economies. Ad-hoc coordination mechanisms, such as the access to Covid tools, faced financing, access and trade challenges which constrained the ability to operate at the speed and scale required. In addition, more meaningful engagement of key actors, particularly low-income countries (LICs) and lower-middle-income countries (LMICs), was needed.
To address these issues, countries collaborating on R&D and manufacturing can ensure the accessibility and affordability of medical countermeasures for all, regardless of location or income level. These networks would bring together countries in a specific region to share resources, expertise and infrastructure, accelerating the development and manufacturing of medical countermeasures. By addressing the issue of vaccine inequity, regional networks can ensure fair distribution of vaccines, as highlighted during the pandemic.
The nation provides a favorable ecosystem for biotech and healthcare businesses, boasting a qualified talent pool, top-notch infrastructure, and business-friendly policies. The Department of Biotechnology (DBT) and Biotechnology Industry Research Assistance Council (BIRAC) under Government of India have worked significantly to strengthen healthcare infrastructure, improve disease surveillance, increase investment in R&D, increase public awareness, develop a robust supply chain, and last but not least foster collaborations with international organisations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) to share information and expertise on pandemic preparedness and response.
This includes DBT-BIRAC’s ‘Mission COVID Suraksha - The Indian COVID-19 Vaccine Development Mission’ that was launched under the Atmanirbhar Bharat 3.0 package, for the development of a safe, efficacious, and affordable vaccine for Covid. Four Covid vaccines supported under Mission COVID Suraksha received Emergency Use Authorisation that comprises world’s first and India’s indigenously developed DNA vaccine, ZyCoV-D.
Based on genomics and data analytics capacity, the department during Covid coordinated Indian SARS-CoV-2 Genomics Consortium (INSACOG) to sequence over two lakh SARS-CoV-2 genomes for strengthening Covid surveillance capabilities in the country.
The success of DBT’s Ind-Coalition for Epidemic Preparedness Innovations (CEPI) Mission, exemplifies the potential of regional networks in tackling global health challenges. Efforts like the Translational Health Science and Technology Institute (THSTI), an autonomous institute of DBT, recognised by CEPI as a global network of laboratories for centralised assessment of Covid vaccines, have significantly contributed to vaccine development. DBT’s The Partnerships for Accelerating Clinical Trials training programme for strengthening clinical trial capacities, was conducted under the aegis of Ind-CEPI, for 2000+ participants from 14 neighbouring countries.
The pandemic has underscored the importance of a decentralised model for manufacturing diagnostics, combining regional and global manufacturing to ensure equitable and sustainable access worldwide. With 78 per cent of the world’s top 50 pharmaceutical companies located in G20 countries, collaborative and cooperative approaches among G20 nations can complement the role of the World Health Assembly in expanding access to diagnostics and achieving universal health coverage.
A global platform that ensures inclusivity, efficiency, agility, accountability, speed and affordability, for coordinating medical countermeasures could also be a game-changer in global health preparedness by coordinating the development, manufacturing and distribution of medical countermeasures. The platform could bring together stakeholders from governments, academia and private sector to coordinate development, manufacturing, and distribution of medical countermeasures to ensure that all countries have access to life-saving treatments and vaccines.
By prioritising collaboration and coordination among stakeholders from different sectors, the platform could provide adequate funding for R&D and manufacturing, develop medical countermeasures for diseases with pandemic potential, and ensure sufficient stockpiles for rapid deployment during a crisis. In addition, such a platform could also help optimise for value for money as a crucial enabler of accessibility, particularly in LICs and LMICs and address the issue of vaccine nationalism, which has become a significant challenge during the pandemic.
The well-equipped DBT Autonomous Institutes and the robust start-up ecosystem fostered by BIRAC have created a conducive environment for low-cost indigenous vaccine development in the country. Other notable achievements in vaccine development by DBT-BIRAC include the low-cost indigenously developed Rotavirus vaccine (Rotavac) and more recently India’s first indigenously developed quadrivalent Human Papilloma Virus (qHPV) vaccine against cervical cancer.
It is for the first time with India’s G20 leadership in 2023 that the G20 troika will comprise exclusively members from LMICs together with Indonesia and Brazil. By prioritising global health preparedness and strengthening regional and global networks, we can ensure a more resilient and equitable world for all beyond the G20 countries.
The writer is Secretary at Department of Biotechnology in the Ministry of Science & Technology, and is Professor (on deputation) from IISER Pune. Views expressed are personal