Covid-19 is the deadliest curse of our times. The last comparable pandemic was the “Spanish Flu,” which occurred in 1918-20, more than 100 years ago. So far, Covid-19 has killed more than 690,000 people worldwide and infected more than 18 million. In India, over 38,000 people have succumbed to SARS-CoV-2, as the virus that causes Covid-19 is known, and more than 1.8 million people have been infected by it. And their numbers are rising fast, putting a severe strain on public healthcare facilities. With no proven cure for the illness, people are anxiously waiting for a vaccine that would provide them protection against the virus.
Covid-19 first broke-out in the Chinese city of Wuhan in early December 2019, in the form of a mysterious pneumonia which could kill those infected by it in days. It did not respond to standard treatments. By the end of that month, the situation became serious enough to warrant informing the World Health Organisation (WHO) officially that 41 patients had contracted a new illness. Some doctors treating the patients in Wuhan had also privately raised an alarm about the disease. Still, the illness did not get the attention it deserved from the Chinese government.
By the time Chinese President Xi Jinping announced the new illness to the world on January 20, 2020, valuable time had been lost. Thousands of people in China, and many in other countries, had contracted the illness. A lockdown was imposed on Wuhan on Jan. 23, and all flights to and from Wuhan were cancelled. A few days later, all domestic flights in China were cancelled. However, a similar ban on flights from China to other countries was not imposed, resulting in the spread of Covid-19 to all parts of the world. By that time, it had become clear that the world was facing a highly infectious new virus which caused a life-threatening illness, which the WHO named Covid-19.
Today, more than seven months after the outbreak of the disease in Wuhan, there is still no cure for it. And the numbers of those infected by it are still rising steeply in many countries, including India. A vaccine to prevent it from infecting more people is therefore urgently needed. Many researchers and pharmaceutical companies, around the world, are currently engaged in developing a vaccine to prevent Covid-19, which has caused widespread death and destruction of livelihoods. The human and economic toll of Covid-19 has been enormous.
In the normal course, a new vaccine requires several years to develop and obtain the necessary safety and efficacy approvals from the regulatory authorities concerned. But time is not a luxury available in the case of Covid-19. Therefore, research is being speeded up. The stakes involved are very high, not only in terms of preventing infections and deaths, but also in financial terms. Billions of dollars would be involved in the sale of the vaccine to various countries; some of them have already placed orders and paid money for them, in advance of their approval and production. There is a race going on, with huge financial bonanzas for those who deliver the goods speedily.
There are usually four stages in the approval of a candidate vaccine: (1) Pre-Clinical Trial, during which the vaccine is tried-out on animals such as mice and monkeys; (2) Phase I, during which it is administered to a small number of human volunteers, in the range of a few dozen, for a few weeks or a few months; (3) Phase II, in which the vaccine is tested on a few hundred people; and (4) Phase III, in which it is tested on several thousand volunteers. This phase can take several months.
As of now, more than 150 candidate vaccines for SARS-CoV-2 are being developed around the world. According to the latest information from the WHO, 25 candidate vaccines are in one of the three stages of human trials. These include two being developed by Indian companies Zydus-Cadila and Bharat Biotech, which began Phase I trials in early July 2020.
Five candidate vaccines are in Stage-III trials. The front-runners among them are a vaccine being developed by Oxford University and the pharmaceutical company AstraZeneca; another is being developed by the US National Institutes of Health and a biotechnology company Moderna Therapeutics, and a third one is being developed by the American company Pfizer in collaboration with the German biotech firm BioNTech. All of them are testing their candidates on around 30,000 volunteers. Preliminary results are expected by October this year.
Vaccine for India
The Serum Institute of India (SII), a private limited company based in Pune, has signed an agreement with Oxford/AstraZeneca to produce around a billion doses of the vaccine for low and middle-income countries by early next year. The SII, which is the largest producer of vaccines in the world, will also conduct part of the Phase-III trial in India. Around 1600 people will participate in the trials in over 20 cities spread across India. The company has committed to supply 400 million doses of the vaccine—if the trials are successful—to India by the end of 2020.
The three companies mentioned above plan to start production of their vaccines even before the preliminary results of their Phase-III testing are available, so that they may begin distributing their vaccines as soon as the results are out. Such is the desperation for the vaccines that some rich countries have paid billions of dollars to all the three companies, to “reserve” their vaccines.
For India, the most optimistic scenario is getting 400 million doses of the vaccine by end-2020. The Government of India will then prioritise their use, starting with healthcare workers. People living in high-population and high-density areas could hope to get the vaccine by March 2021.
(The author is a former Ambassador of India )