New Delhi: Ever since its inception in 1996, Bharat Biotech has been at the forefront of developing vaccines. In 1998, Bharat Biotech launched Revac-B+, the world’s first Cesium Chloride free Recombinant Hepatitis-B vaccine. In 2010, the company launched HNVAC – India’s first cell culture-based H1N1 (Human Inactivated Influenza A virus) Swine flu Vaccine. Later, in 2013, Bharat Biotech introduced Typbar TCV – the world’s first clinically proven conjugate Typhoid vaccine. In 2015, the ROTAVAC – rotavirus vaccine was launched by Prime Minister Narendra Modi. It became the first vaccine under the ‘Make-in-India’ initiative. In 2016, Bharat Biotech became the first company in the world to file a global patent for Zika vaccine. The company’s experience came in handy during the COVID-19 pandemic and it introduced India’s first indigenous COVID-19 vaccine, COVAXIN.
NDTV-Dettol Banega Swasth India interacted with Suchitra Ella, Co-founder and Managing Director of Bharat Biotech to understand the vaccine development process, challenges during the pandemic, and how to strengthen operations in the pharmaceutical sector for future epidemics.
Talking about the challenges faced by the country during the COVID-19 pandemic, Ms Ella elaborated on the three years of the fight against the Novel Coronavirus. Starting from issues with testing for COVID-19 to vaccine development and distribution. Ms Ella said,
When the pandemic hit us, we had issues with testing first because we did not have a sufficient network of labs around the country, though there are many, the test assays required for testing a particular virus were not there initially. And this was a global problem; not just India specific.
Considering the population size of India, our problems undergo a multiplier effect, said Ms Ella. But we sailed through it and managed to increase the testing and labs doing Covid tests specifically. And, then parallelly came the issue of hospital admissions for people who were severely infected with the virus and required care.
Ms Ella said,
The first wave caught us all off guard. Even large countries like the United States and the Western world had called out for help. They needed antivirals and all kinds of other medications, which India, again has been at the forefront because we have a huge bandwidth of pharmaceutical manufacturing organisations. We helped ourselves, but we could also help those who wanted medications and drugs urgently.
Once the countries got hold of the virus, they began the vaccine development process. As per Ms Ella, India is absolutely 100 per cent self-sufficient in vaccine manufacturing. She added,
All our vaccines in the Universal Immunization Program are manufactured by Indian manufacturers. The large volumes in terms of a normal birth cohort of the country is manageable, say 100 or 200 million doses of every vaccine has been done in the past and it continues to be done. But when the pandemic hit us, it was just mind-blowing because the entire population had to be addressed.
Ms Ella opines that the real challenges were with regard to scaling up vaccine manufacturing and distribution to be able to cover the large population that India has. Further elaborating on how Bharat Biotech worked on developing a COVID vaccine, Ms Ella said,
We reached out to quite a few research and development (R&D) institutions in the United States, but we realised that at Bharath we had a platform of almost six viral vaccines, which we have manufactured over the last 25 years. So that strength in ourselves inherently gave us this enormous courage and the risk-taking ability to say why not try out on a similar platform. So, we reached out to the National Institute of Virology (NIV) under the Indian Council of Medical Research (ICMR) and asked for virus strains. We brought the actual strains of the SARS-Cov-2 into our facilities, live and our bioprocess engineers and technologists started working with the virus. Our team multiplied the virus, inactivated it, and then formulated the vaccine in probably less than 45 days.
Vaccine development is one part of the process. Following this, companies have to prove that the vaccine is efficient, effective, and safe. Bharat Biotech first tried the Covid vaccine on animals and then on humans in three different phases to prove its immunogenicity.
Ms Ella said,
The efficacy trial was completed in a population of about 27,000 human volunteers across 25 hospitals and medical institutions across the country.
She further informed that in a normal scenario vaccine development takes 10 to 20 years. But during the pandemic, despite the challenges of Covid restrictions, the fear of catching the virus and the public health protocols in place, it was crucial for the company to ensure the safety of its employees working round the clock on vaccine development.
Further talking about the distribution and delivery of vaccines and lifesaving drugs across the country, Ms Ella said that there are two ways of distribution – public and private. Under the public distribution mechanism, the vaccines are given to the state governments and from there they go to district hospitals and primary health centers and mandal level. In the private market, there are private hospitals and private clinics and doctors, mostly pediatricians and general physicians, who procure most of the vaccines depending on their practice and area of expertise. They procure vaccines directly from the distributors. Ms Ella added,
There are absolutely pockets where it is very difficult. The ASHA worker or the last mile health worker is the only person who is going to be able to carry a vaccine on horseback or camelback or on their own backs on cycles. In some cases, drones were also deployed. This is probably the best example that a world could have witnessed delivering not a billion doses but two doses of the same vaccine that were to be given within a gap of 30 days.
The geographical conditions of an area won’t change. So, to improve connectivity to remote and rural corners of the country, Ms Ella suggests using modern technologies to reach people faster with medical essentials.
When asked about the role big pharmas can play in ensuring ‘health for all’, Ms Ella highlighted the need for funding. She said,
Increase funding and increase partnerships among ourselves. We collaborated with other vaccine players who could give us some aspects of the process so that we could reduce time in manufacturing. Both the pharma and biotech industries can look at partnering. The best way going forward would be a public-private partnership. I think that will solve the majority of the challenges that we face in the industry today.
You can listen to the full Banega Swasth India podcast discussion by hitting the play button on the Spotify player embedded above.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.