Once the world’s vaccine factory, India faces an unruly scramble for the import of Covid-19 vaccines. As the second wave of the pandemic continues to create chaos, state governments, municipal corporations, private hospital chains, and corporate houses have all lined up to import foreign vaccines to fill the glaring gaps in the supply chain.

After having floated separate global tenders, they are all waiting to strike import deals. They may have to wait for a while as all the international manufacturers have got their hands full now.

The rush for imports follows India’s abrupt move to liberalise vaccine sourcing on April 13. Clearly departing from its ‘Made in India’ vaccine strategy, the government allowed all foreign vaccine makers that are approved by the World Health Organization (WHO) or regulators in the U.S., Europe, the U.K., or Japan—to sell their Covid-19 vaccines in the country on an emergency basis as the second wave of infections spread like wildfire. Import licences are readily available now for anyone who wants to import vaccines, on an immediate basis.

Pfizer Inc. is having the last laugh. Two months after the U.S.-based pharma giant said on February 5 that it failed to meet the Indian drug regulator's demand for a local safety and immunogenicity study and subsequently withdrew an application for emergency-use authorisation of its vaccine in the country, the government eased the import rules completely. In the new scenario, Pfizer said it would work towards bringing the mRNA-based vaccine, which it developed with Germany's BioNTech, to India, without specifying any timeframe.

Despite Serum, world’s largest vaccine maker by volume, and BBIL mass-producing vaccines, India has suddenly encountered a vaccine drought. The numbers put out by the government reveal that the demand-supply gap in the country has worsened after the government opened up the vaccination programme for the 18-44-year-group on May 1.

The sudden spike in demand in a market as huge as India is indeed happy news for the global manufacturers in an oligopolistic market.

On May 13, VK Paul, member (health), NITI Aayog, said in a media briefing that the External Affairs Ministry and the Department of Biotechnology were in touch with Pfizer, Moderna, Johnson & Johnson to make available their vaccines to Indian citizens. According to him, New Delhi had told the U.S.-based manufacturers that it could find partners and assist them if they indeed like to send doses to or manufacture in India. “They (Pfizer and Moderna) had informed us that they are working on their own and would talk of vaccine availability in the third quarter (July-September),” said Paul.

Of the three U.S.-based vaccine makers, only Johnson & Johnson has accepted the centre's offer, according to Paul. It is ready to produce vaccines under the Quadrilateral Security Dialogue (Quad, an informal strategic dialogue between the U.S., Japan, Australia and India). Subsequently, the U.S. Embassy in India said the Biden administration is considering joint production of the Johnson & Johnson vaccine in the country by tying up with the likes of Serum Institute.

The efforts to pull in the U.S. manufacturers to set up a base or enter into a tie-up in the country are unlikely to see a logical conclusion anytime soon as they are busy with their existing contracts. On the flipside, the next two-three months are extremely crucial for India.

Devi Shetty, chairperson of Narayana Health and a member of the Supreme Court-appointed national task force for devising a scientific mechanism for distributing medical oxygen, had recently said that India needs to vaccinate 510 million people in the next two-three months to protect the country from a likely third wave of infections. “Vaccination is by far the best and the cheapest solution for Covid-19,” he had said.

According to the government’s CoWin website, around 14.8 crore first doses and 4.1 crore second doses have been administered in India so far, as on May 22. Every day during the week preceding May 22, vaccination in the country barely touched 2 million doses a day, owing to the supply constraints. Sites conducting vaccinations have shrunk to 45,918, from over a lakh two months ago.

The two vaccines that are the mainstay of India’s inoculation programme are the indigenously-developed Covaxin by Bharat Biotech International (BBIL), and the Oxford-AstraZeneca vaccine that is produced and marketed in India as Covishield, by Serum Institute of India (SII).

As of now, the only foreign vaccine imported is Russia’s Sputnik V. Hyderabad-based Dr Reddy's Lab (DRL) has bought about 2.1 lakh doses from Russia. DRL, which markets the Sputnik V in India, has helped Russians to sweep the entire idle vaccine manufacturing capacity in the country to mass-produce their vaccine.

After New Delhi liberalised its vaccine strategy, over a dozen state governments including Maharashtra, Uttar Pradesh, Tamil Nadu, Andhra Pradesh, Telangana, and Kerala are desperately trying to source vaccines from abroad. Most of them are in the pre-bid stage and talking to potential bidders.

On May 8, Uttar Pradesh became the first state to float a global tender to procure 40 million doses within six months. As per the tender, at least 6 million doses are to be supplied each month directly to nine warehouses in the state.

The Tamil Nadu government has floated global tenders for procuring 3.5 crore doses of Covid vaccines to be delivered within 180 days progressively from the date of purchase order. Last date for submission of tender is June 5.

On May 19, Telangana government invited 10 million doses of Covid-19 vaccines from manufacturers or their agents through a global tender.

Several municipal corporations are joining the bandwagon too.

Among the municipal corporations, the cash-rich Municipal Corporation of Greater Mumbai (MCGM) has received proposals from three manufacturers (of Sputnik V) and is expecting more proposals to come in. It had floated global tenders a week ago to acquire 10 million doses to inoculate its citizens. Alarmed by the initial poor response, the municipal corporation has extended the timeline of the tenders by a week to May 25. The bid is open to all large international manufacturers such as Pfizer Inc, Moderna Inc, and Johnson & Johnson, apart from the two Indian majors—Serum and Bharat Biotech.

Following the footsteps of MCGM, the municipal corporations of Thane and Navi Mumbai have also floated global tenders to independently procure vaccines to speed up their inoculation drive. Thane Municipal Corporation intends to purchase five lakh vaccine doses, while the Navi Mumbai civic body wants to import at least four lakh doses.

Several banks and corporate houses that earlier announced free vaccines for their employees and immediate families were forced to take a step back as the country faced a severe shortage. This has made several of them to scout for imported vaccines.

Both the Tata group and Reliance Industries Ltd, two biggest conglomerates in the country, are exploring options to import vaccines directly. Tatas are likely to float a global tender to procure vaccines while RIL is also exploring tie-ups with global manufacturers to procure vaccines directly for its employees.

Among pharma majors, Lupin is exploring ways to import vaccines and has opened a dialogue with both Pfizer and Moderna. However, the company has not made any headway so far.

Among hospital groups, Apollo Hospitals and Fortis Healthcare, are open to exploring opportunities to import. These hospital chains have already launched an immunisation drive for the 18-44 age group at limited centres from May 1. Many others such as Max Healthcare and Aster Medcity may also explore import options if they find it difficult to source from local manufacturers.

The fact is that it is going to be a protracted struggle for India.

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