India Resumes Vaccine Exports as Domestic Stock Builds

Introduction

COVID-19 is a contagious disease caused by the severe acute respiratory syndrome (SARS-COV-2). In December 2019, the first known case was discovered in Wuhan, China. Since then, the disease has spread worldwide, causing a pandemic. As of November 2021, Worldmeters.info reported a total of 262.54 million global coronavirus cases with 5.22 million fatalities and 237.11 million recoveries. To end this pandemic, most of the world needs to be immune to the virus and the safest way to achieve this is with a vaccine. Humanity has often relied on vaccines in the past to bring down the death toll of infectious diseases.

When the pandemic started several research teams rose to the challenge and in less than 12 months developed vaccines that protected humans from the virus (SARS-COV-2) that caused COVID-19. These vaccines contain tiny fragments of the disease-causing organism or its blueprints. They also contain other ingredients including antigen, preservatives, stabilizers, surfactants, residuals, diluent and adjuvant to keep the vaccines safe and effective. Now the challenge is to make these vaccines available worldwide.

60% of the vaccine production in the world is done in India. As the pandemic hit, the Indian pharmaceutical industry rose to the occasion to manufacture and maintain a supply chain even during the lockdown period and exported medicines such as HCQ (Hydroxychloroquine) and paracetamol to more than 150 countries. Vaccine export from India across the world has been playing a vital role in the fight against COVID-19. Domestic pharmaceutical businesses collaborated with global companies to create billions of vaccine doses, including the world's largest vaccine maker, the Serum Institute of India, working with AstraZeneca, DrReddys with Sputnik and Biological E with Johnson & Johnson. The first shipment of Indian vaccines left India on January 21, 2021, and the top five countries receiving the most supply are Nepal, Bangladesh, Morocco, Brazil and the UK. However, due to an increase in domestic cases, India halted the vaccines exports after donating and selling 66 million doses to over 75 countries in April 2021. In October 2021, the Indian government decided to resume exports starting with Nepal, Bangladesh, Myanmar and Iran.  As of November 30, 2020, India has exported 72.34 million supplies to over 95 countries across the world.

 

Key Developments

The countrywide vaccination campaign began on January 16, 2021, with healthcare workers (HCWs) being vaccinated first, followed by front-line workers (FLWs) on February 2, 2021. The second phase of COVID-19 immunization began on March 1, 2021, for individuals over 60 years of age and those aged 45 and above with specific co-morbid conditions.  The third phase began on April 1, 2021, for all those over 45 years of age, regardless of co-morbidities. In a significant development, the Indian government later also announced that it will provide free COVID-19 vaccines to all adults from June 21, 2021.

According to the Union Health Ministry, India achieved the 1 billion mark with its COVID-19 vaccination drive on October 2021, with ~75% people over the age of 18 receiving the first dose and over 31% of the population receiving both doses.

According to the Ministry of Health and Family Welfare, as of November 30, 2021, there were 100,000+ active cases in India, with over 468,000 fatalities and 1.23 billion people have gotten at least one dose of the vaccine.

As of November 30, 2021, 7.99 billion people across the world have gotten at least one dose of the COVID-19 vaccine, accounting for 54.4% of the global population. The UAE (98%), Singapore (93%), Cuba (90%), Portugal (89%) and Chile (89%) are the top five countries with the highest percentage of people vaccinated, while South Africa (29%), Egypt (24%), Kenya (8%), Ethiopia (6%) and Nigeria (3%) have the lowest percentage of people vaccinated.

Trends and Drivers

Trends

Increasing number of collaborations between domestic and global pharmaceutical companies has been one of the major trends amid the COVID-19 pandemic. Some instances are listed below:

• In May 2020, Johnson & Johnson partnered with Telangana-based pharmaceutical company, Biological E Limited, to manufacture a COVID-19 vaccine named “Janssen COVID-19”, that is currently approved for use in the US, the EU and other countries including Thailand and South Africa
• In June 2020, the Serum Institute of India collaborated with AstraZeneca, to ensure fair and equitable distribution of one billion doses of the Oxford University vaccine to low and middle-income countries, including India
• In September 2020, Indian pharmaceutical company, DrReddys Laboratories, partnered with the Russian Direct Investment Fund (RDIF), for clinical trials and supply of Sputnik V COVID-19 vaccine

Drivers

• Increasing Investment: In FY2021, India received the highest ever FDI inflows, valued at US$82 billion, that aided India's enormous "Vaccine Maitri" program, taking India’s vaccine export to over 72.34 million doses to over 95 countries, as of November 2021
• International Vaccine Rule: In October 2021, the US government imposed a new vaccine requirement for most foreign air travel and lifted several travel restrictions on China, India and Europe. Under the new requirement, accepted vaccines for travel into the US include Pfizer Bio-NTech, Moderna, Janssen, AstraZeneca-Oxford, Covaxin and two other Chinese vaccines—Sinopharm and Sinovac. During the same period, India and Israel agreed on mutual recognition of their COVID-19 vaccination certificates to ease international travel and resume Free Trade Agreement (FTA)
• Domestic Policies: The Indian government has allowed 100% FDI in the sector under automatic route for greenfield pharmaceuticals. In addition, 100% FDI in the pharmaceutical sector is allowed in brownfield pharmaceuticals; wherein 74% is allowed under the automatic route and thereafter through the government approval route

Growth Opportunities

With FDI inflows firmly cementing India's credentials as a secure and key investment destination, India's pharmaceutical sector has received worldwide interest due to COVID-19. In the pharmaceutical industry, 100% FDI is currently permissible. Under the automatic route, FDI up to 100% in greenfield pharma projects is permitted, while FDI up to 74% in brownfield pharmaceutical projects is approved. Furthermore, foreign investors continue to find mergers and acquisitions in Indian brownfield pharma to be an appealing prospect. With many multinational corporations planning to relocate their operations from China, the Indian pharmaceutical industry is likely to grow rapidly in the next years. Between 2020 and 2030, the Indian pharmaceutical industry is expected to increase at a 12% CAGR, to reach US$130 billion by 2030 from the US$41.7 billion recorded in 2020.

Challenges
The pharmaceutical sector in India has significant potential to grow in the next few years on the back of vaccine exports. The resumption of India’s vaccine exports in October 2021, however, comes amid mounting concern about the Omicron Variant (B.1.1.529), a novel and potentially aggressive coronavirus strain discovered in South Africa.