Like many developing countries, Bangladesh has only been able to make a small dent in its COVID-19 vaccination ambitions. But the country’s drug makers say they hold the key to ending the pandemic in a matter of months, rather than years.
The country has only been able to vaccinate just over 4 million people and is not expected to hit its target of 130 million until the middle of 2023.
All of its doses are being manufactured in neighbouring India.
But the country’s drug makers say they could produce hundreds of millions of doses in a quick timeframe, if only they could secure a vaccine blueprint.
“I think the world cannot wait so long to be vaccinated,” the chairman of Incepta Pharmaceuticals, Abdul Muktadir, said.
“If we make these vaccines readily available, in [plentiful] numbers, then automatically this problem is going to be solved.”
Incepta Pharmaceuticals lies on the outskirts of the Bangladesh capital Dhaka, in an industrial neighbourhood.
Fitted out with the latest technology from Germany, the company already produces vaccines to fight a wide array of diseases such as hepatitis b, typhoid, the flu, tetanus, measles, meningococcal and rabies.
Mr Muktadir said the company had plenty of capacity to produce more drugs and could manufacture between 600 to 800 million doses of COVID-19 vaccines annually.
“If we get the ready-to-fill material or antigen, instead of waiting until 2023, we can make this vaccine available to our entire nation population within two to three months’ time,” he said.
Why an idea for free vaccine licences was rejected
Currently, pharmaceutical companies that invent the vaccines have control over who is issued a licence to produce it.
India and South Africa, supported by developing countries and international aid groups, unsuccessfully led a charge to have a temporary waiver on intellectual property rights, so a third party could distribute licences to produce COVID-19 vaccines.
A similar waiver was made two decades ago to help produce generic drugs during the HIV/AIDS epidemic.
Advocates say the move would help ensure low-income countries do not experience surges as they endure long waits for vaccines, like that being witnessed in Papua New Guinea.
But the move failed after wealthy countries, including Australia, blocked the proposal in the World Trade Organisation.
Harsh Pant, the director of strategic studies at the Observer Research Foundation in Delhi, said pharmaceutical companies want to ensure they can secure a profit, after spending large sums of money and resources into developing the vaccine.
Proponents of the current system argue it is needed to fuel innovation.
“You pour a huge amount of money and research and you reap the benefits,” Mr Pant said.
Pharmaceutical companies also want to ensure the final product meets their stringent standards and that the unique recipe is protected from being leaked onto the black market.
But Mr Pant said the tight controls on COVID-19 vaccine licences, which have created a supply shortage, were not justified considering the damage the pandemic had caused.
“It’s a do or die situation,” Mr Pant said.
“It’s life and death. So, I think the position by India and South Africa is an important one and it goes to the heart of global governance where equity is a concern.”
He also criticised wealthy nations for using their purchasing power to buy up most of the vaccines, forcing developing nations to scramble for a limited supply.
“Almost 80 per cent of vaccines are going to 10 or 12 countries,” he said.
“It has been about vaccine nationalism, hoarding a vaccine. You’d expect them to be a bit more generous.”
Why current measures might not be enough
The so-called ‘Quad nations’ of India, Australia, Japan and the United States announced an extra billion vaccines would be distributed throughout the Indo Pacific region before the end of 2023.
The deal would utilise India’s massive vaccine making capabilities, with Hyderbad pharmaceutical company Biological E to produce the doses, including one vaccine developed by Johnson & Johnson.
Public health expert Rajib Dasgupta from Delhi’s Jawaharlal Nehru University said the extra vaccines were not “a very remarkably big chunk”, but would help recipient countries better target at-risk communities or respond to local surges.
“It will boil down to which segment of the population a country will prioritise to protect,” he said.
“It’s not a one-time decision, it’s an evolving decision.”
India is aiming to inoculate 300 million people by August. Its program is aimed at supporting those most at risk — like the elderly or healthcare workers — and not about achieving herd immunity.
Yet the country is already behind schedule and at least two states, Kerala and Rajasthan, have complained about a shortage of vaccine supply, something India’s government has denied.
The Serum Institute, which has licences to produce the Oxford-AstraZeneca vaccine and Novavax, has already flagged a shortage of some items for vaccine production after five million doses were delayed for the UK.
Biological E has also flagged potential delays.
India has domestic laws that allow it to compulsorily acquire intellectual property rights for the manufacturing and distribution of drugs.
Dr Dasgupta said if this was invoked, India could not only rapidly ramp up vaccine supplies to better vaccinate its country, but allow more pharmacies to distribute the vaccine.
“This is going to be an extremely crucial tool,” he said.
The World Health Organisation’s COVAX program is also hoping this year to distribute 2 billion doses of vaccine to at least 92 low-income countries.
But that, according to its own estimates, would only reach about a fifth of the target populations.
The Quad, which is not a military alliance, is widely seen as a response to an increasingly assertive China, which is also producing large quantities of vaccines for the region.
Abhijnan Rej, the security & defence editor at The Diplomat, said the Quad deal was not about pushing Chinese vaccines out of the Indo-Pacific, but rather giving countries an “alternative” or choice.
“China is not the only game in town,” he said.
“I think that is really the larger geopolitical message.”