India resumes Covid vaccine exports to hamstrung Covax

India restarted shipments of Covid-19 vaccines to the Covax initiative, a much needed boost for the beleaguered global sharing body that has struggled to inoculate the world’s poorest nations and now faces a potentially more virulent strain of the coronavirus.

The Serum Institute of India Ltd., the world’s largest vaccine manufacturer, said an unnumbered amount of doses of its locally made AstraZeneca Plc shot were shipped for export to Covax on Friday. Serum expects to increase doses “substantially” into the first quarter of next year and to include Novavax Inc.’s inoculation at an unspecified time.

The decision by India after abruptly halting shipments in April follows growing confidence with the ramped-up pace of its once ponderous domestic inoculation drive. According to Bloomberg’s vaccine tracker, more than half of India’s 1.4 billion people have had at least one dose and infection rates have plateaued to relative lows last seen in early 2021, before the country’s severe second-wave took hold.

“It’s a huge moment to begin exports again,” Serum’s Chief Executive Officer Adar Poonawalla said in a statement. “The world has largely depended on the low-cost, high-quality pharmaceuticals and vaccines that India has traditionally exported.”

Variant Fears

The resumption of Indian exports to Covax comes amid concerns over a new and potentially highly virulent coronavirus strain identified in South Africa known as B.1.1.529. With more than 30 spike protein mutations, scientists fear it could fuel massive outbreaks across borders and break down barriers built up by the existing set of vaccines currently in use.

Since the start of the pandemic, Covax had looked to India’s massive vaccine manufacturing capabilities to help it procure cheap shots for low-income nations that would struggle to finance their own inoculation drives. But those plans fell through after Prime Minister Narendra Modi’s government prioritized its own citizens as a highly lethal wave of infections driven by the delta variant hit earlier this year.

While Covax had moved to diversify the inoculations it used after the Indian ban, Seth Berkley, the head of the vaccine alliance Gavi—one of the main bodies behind Covax—said Serum’s AstraZeneca doses remain “an important product which has the potential to help us protect hundreds of millions of people in the months ahead.”

The Indian government allowed Serum to export 5 million of the AstraZeneca vaccines via Covax to Nepal, Tajikistan and Mozambique, and 20 million doses of the vaccine produced jointly with Novavax to Indonesia, Bloomberg News reported Wednesday.

India had already tentatively resumed a small number of bilateral vaccine exports to neighboring countries in October. However, dispatches to Covax weren’t restarted until after the WHO granted emergency authorization in early November to Covaxin, an Indian Covid shot co-developed by the country’s state-funded medical research agency and local vaccine maker Bharat Biotech International Ltd.

Vaccine Inequality 

Modi’s ruling Bharatiya Janata Party has heavily promoted Covaxin, of which more than 130 million doses have been administered across India. The WHO’s independent technical panel took months to scrutinize data from the vaccine’s clinical trials, repeatedly asking Bharat Biotech for further data and delaying its eventual green light.

The World Health Organization has set a target to vaccinate at least 40% of people in every country by the end of the year with the help of Covax, after falling short of previous goals. Director-General Tedros Adhanom Ghebreyesus has called the immunization chasm between rich and poor countries morally “grotesque.” 

Many wealthier countries are already deploying booster shots and have used three quarters of all the Covid vaccines produced, the WHO said in October. Ghebreyesus has repeatedly urged highly-vaccinated nations to step up their support to low income ones to help hasten the end of the pandemic.