To Help India, Biden Must Unclog the Vaccine Supply Chains

RUDRA CHAUDHURI

On 17 May 2021, U.S. President Joe Biden stated that the United States had “secured enough supply to vaccinate all adults and children above the age of twelve.” The next step, he made plain, was “to help fight the disease [COVID-19] around the world,” emphasizing that 80 million doses of American-made vaccines would be shared with the world. Giving his remarks a geopolitical twist, the president did not miss the opportunity to underline that this would be more than the 15 million doses that Russia and China have donated globally.

Biden’s announcement is great news for the world. Large-scale vaccination, according to almost all experts, is the only way out of this pandemic. For India, which has been ravaged by another deadly wave of COVID-19, the news of any excess supply of much-needed vaccines is a welcome development. How exactly the 80 million doses (60 million AstraZeneca vaccines and 20 million other U.S.-authorized vaccines) will be distributed is yet unclear. However, that countries are beginning to rally to meet global needs is encouraging. Accessing a sizable portion of the 80 million doses for India will be one of the key topics for discussion for External Affairs Minister S. Jaishankar during his visit to the United States between May 24 and 28.

OTHER COUNTRIES HAVE PITCHED IN SUPPLIES

Indeed, the United States, Russia, the United Kingdom, and many other countries around the world have rushed to India’s assistance in its time of need. Since the last week of April 2021, military and civilian aircrafts bearing relief have touched down on Indian airstrips almost every day. They have brought desperately needed oxygen concentrators, ventilators, cryogenic oxygen containers, BiPAPs (pressurized airway machines that help patients breathe more easily), rapid testing kits, and other emergency supplies.

On April 26, Indian Prime Minister Narendra Modi spoke with Biden. Importantly, Modi “underscored the importance of smooth and efficient supply chains of vaccine raw materials and medicines.” On the same day, Tim Manning, the White House’s COVID-19 Supply Coordinator, tweeted that the Biden administration had taken the decision to divert its “pending orders of vaccine filters to India’s vaccine manufacturing effort,” stressing that “this will help India make more vaccine.”

The White House move was significant. Under the U.S. Defense Production Act (DPA), certain raw materials had been prioritized for the U.S. domestic market. Essentially, this meant that U.S.-licensed contract manufacturers and those located in Europe—in the Netherlands and Germany, for example—were unable to prioritize orders from non-American vaccine makers. Now, as per Manning’s message, U.S.-based suppliers could reconsider pending orders from global manufacturers.

On the face of it, this was excellent news. In principle, it would ease the vaccine supply chain for manufacturers based in India. The considerable efforts of Indian ministers and officials, members of U.S. Congress, business leaders and conglomerates, the Indian American diaspora, and other civil society actors appeared to have been successful. Yet so far, the payoff has yet to be realized.

HOW TO EASE THE PROCUREMENT GRIDLOCK

Manufacturers in India continue to find it difficult, if not impossible, to access raw materials necessary for vaccine production. The main issue, they argue, has to do with the logjam in the manufacturing queue. American companies clog this queue with orders for the U.S. market. Biden has stated that by the end of June, the United States is expected to have enough vaccines “to protect everyone in the United States.” Yet, reportedly, the United States already has enough stocks of vaccines. So why wait till the end of June? The United States could step back now and let other countries move to the front of the line. To truly “lead the world,” to use Biden’s own words, it is imperative to prevail on American manufacturers—including their ancillary companies in Europe—to prioritize non-American orders and allow the largest vaccine manufacturers, such as those based in India, to jump the supply queue.

The Biden administration could also consider easing restrictive contractual clauses with American vaccine companies. This way, such companies no longer need to remain contractually obligated to produce vaccines for the U.S. domestic market, at least for a certain period of time. It would open the supply chain, instead, for global manufacturers.

At present, Indian manufacturers, Indian government officials, and others spend an inordinate amount of time trying to purchase key raw materials, which are in short supply. These materials are released on a case-by-case basis. As helpful and life-saving as the releases have been, this is a disorganized and impractical way of procuring supplies for the world’s second-largest vaccination program. All too often, manufacturers in India are left with a production timeline to access raw materials that sometimes comes down to a few days.

Further, crucial ingredients for the production of specific vaccine candidates co-developed with global technology companies continue to be listed as priority supplies under the DPA, reserved for the U.S. market. Manufacturers confirm that these ingredients continue to fall under the purview of the DPA. In short, the “DPA-driven restrictions,” as recent reports put it, continue to hamper Indian manufacturers’ ability to produce adequate doses of vaccines for India. As per a study published on May 4, the United States will be “sitting on 0.5 to 1 billion surplus” vaccine doses by the end of the year. It is surely time to once and for all remove all the restrictions under the DPA.

VACCINE SUPPLY CHAIN BOTTLENECKS ARE A GLOBAL PROBLEM

Delays and difficulties in accessing raw materials also make it harder, if not impossible, for manufacturers in India to produce vaccines for the rest of the globe, by way of their contractual arrangements with the World Health Organization–backed COVAX alliance and other international commitments. This includes supplying vaccines through the Quad (Australia, India, Japan, and the United States) vaccine initiative, which aims to deliver vaccines to countries in the Indo-Pacific. In sum, given the way vaccine manufacturing is organized globally, Indian manufacturers’ inability to access raw materials also has a direct, adverse impact on populations in Africa, the Indo-Pacific region, and other parts of the world.

The Biden administration’s instincts are clearly global—the enormous aid provided to India in the past three weeks attests to this. But, in many ways, delivering such assistance is easier than making the tough call to deprioritize a domestic vaccination drive for the benefit of other nations. Providing aid incurs, mostly, economic and logistical costs; whereas stepping aside to allow other countries to buy scarce vaccine components has an ideological cost—in this case, moving genuinely away from the America First dogma that appears to continue to shadow Biden’s advance. But it’s time to proactively remove the downstream barriers to accessing the vital ingredients required to fight a truly global war against future waves of this cruel pandemic.