Though Minister for Health and Population Hridayesh Tripathi has been assuring the public that additional anti-COVID vaccines will be brought from India soon, the southern neighbor has indefinitely halted its vaccine export as it struggles to inoculate its citizens amid rapid surge in infection rate.
As many as one million doses of Covishield vaccine had arrived in Nepal from India two months ago. Nepal has yet to receive one million doses of the vaccine from India, as per the purchase agreement between the two countries.
A Cabinet meeting held on February 16 had decided to buy two million doses of Covishield vaccines from the Serum Institute of India (SII). Nepal then received one million doses on February 21 from India.
Following perennial delay in receiving the vaccines, Foreign Minister Pradip Kumar Gyawali had discussed the issue with the Indian External Affairs Minister, S Jayashankar, on April 9 in a telephone conversation.
At that time, Jaishankar had pledged timely export of the remaining doses to Nepal.
After gifting and selling tens of millions of COVID-19 vaccine doses abroad, India suddenly finds itself short of shots as new infections surge in the world’s second-most populous country.
India breached 200,000 daily infections for the first time on Thursday, and is trying to inoculate more of its population using domestically produced shots.
Facing soaring cases and overflowing hospitals after lockdown restrictions were eased, it also abruptly changed the rules to allow it to fast-track vaccine imports, having earlier rebuffed foreign drugmakers like Pfizer.
It will import Russia’s Sputnik V vaccine starting this month to cover as many as 125 million people.
The reversal in fortunes could hamper not only India’s battle to contain the pandemic, but also vaccination campaigns in more than 60 poorer countries, mainly in Africa, for months.
The COVAX programme, backed by the World Health Organization and Gavi vaccine alliance, aims at equitable vaccine access around the world, and is relying heavily on supplies from India, Asia’s pharmaceutical powerhouse.
But so far this month India has only exported around 1.2 million vaccine doses. That compares with 64 million doses shipped abroad between late January and March, according to data from the foreign ministry.
Reuters quoted four sources involved in discussions on vaccine supplies and procurement as saying that factors including delays by India and COVAX in placing firm orders, a lack of investment in production, raw material shortages and underestimating the coronavirus surge at home had contributed to vaccine shortages.
The SII, the world’s biggest vaccine manufacturer, had vowed to deliver at least two billion COVID-19 shots to low and middle-income countries, with nearly half of that by the end of 2021.
But it has also come under pressure to meet the needs of other governments, including Britain, Canada and Saudi Arabia, amid AstraZeneca’s global production problems.
The United States, meanwhile, ring-fenced the supply of key equipment and raw materials for its own vaccine makers, limiting SII’s operations and delaying by months its goal of raising monthly output to 100 million from up to 70 million now, said one of the sources.
A further initial hurdle to SII’s supply ambitions was India’s hesitation in placing firm orders, two sources said.
That could have allowed it to boost output of the AstraZeneca vaccine early, even though regulators had yet to approve it.
India spent months discussing the final price per dose, and inked an initial purchase order roughly two weeks after India’s drug regulator approved the AstraZeneca shot, according to the sources.
At one point, SII ran out of space to store produced doses.
“That is why I chose not to pack more than 50 million doses, because I knew if I packed more than that, I would have to store it in my house,” SII Chief Executive Adar Poonawalla told Reuters in January.
COVAX CONUNDRUM AND ITS IMPACT IN NEPAL
COVAX has a deal to buy 1 billion-plus doses from the SII. But it has received less than a fifth of the 100 million or so doses of the SII-made AstraZeneca vaccine it had expected by May.
SII is also supposed to make millions of doses of the Novavax shot for COVAX.
Gavi had hoped SII would fully resume vaccine deliveries to COVAX in May, but on Wednesday it said India’s COVID-19 crisis could affect that.
Though Nepal is supposed to receive a total of 2,256,000 doses of the Covishield vaccine under COVAX, the country received only 348,000 doses in its first batch on March 7.
The crisis in India is most likely to further delay vaccine supply under COVAX to Nepal.