As the “world’s leading manufacturer of vaccines”, India’s private sector has a “very important role” in the global battle against Covid-19, Dr Anthony S Fauci, one of the world’s leading experts on infectious diseases, said on Thursday evening.
Dr Fauci was speaking at an online symposium organised by the Indian Council of Medical Research (ICMR), which was also attended by several other internationally acclaimed epidemiologists and vaccinologists.
“India’s private sector also has a very important role to play as the world’s leading manufacturer of vaccines and, as effective Covid-19 vaccines emerge from our research efforts, this manufacturing capability is going to be very, very important,” Dr Fauci said. “Moving forward, we and other (US National Institutes of Health) institutes will continue to work with Indian counterparts and colleagues to assure Indian scientists and Indian impressive research and development capacity are integrated in the global efforts to address the Covid-19 vaccine.”
Dr Fauci is the director of the National Institute of Allergy and Infectious Diseases (NIAID), which is part of the National Institutes of Health (NIH), the top medical research agency of the US government. Dr Fauci has been in his post since 1984, and has been adviser to six US Presidents since Ronald Reagan.
Dr Fauci listed three key aspects that would reduce the lag between trials and manufacture of vaccines: regulatory standards and review, harmonised data monitoring to foster comparability, and the financing of advanced vaccine production.
Giving his opinion on one of the ongoing debates in the medical community, Dr Fauci said he was against human challenge trials, in which participants are purposely exposed to the virus. The high incidence of Covid-19 makes such risks unnecessary, and the lack of highly effective therapies makes it unethical.
Several others in the symposium, however, disagreed. Prof Adrian Hill of Oxford University, who is part of the team of researchers who partnered with India’s Serum Institute to develop a vaccine candidate, said therapies such as remedesivir and convalescent plasma should allow researchers to consider both human challenge and randomised control trials to allow for “quicker and less expensive” pathways, given the unpredictability of the virus spread.
Others such as Nir Eyal, director of Rutger’s Center for Population-Level Bioethics, and Marc Lipsitch, professor of epidemiology at Harvard T H Chan School of Public Health, also disagreed with Dr Fauci, while microbiologist Peter Piot, director of the London School of Hygiene and Tropical Medicine, agreed.
Participants also discussed how to equitably distribute the future vaccine in view of rising “vaccine nationalism”, as Prof Piot described it. Officer on Special Duty, Ministry of Health, Rajesh Bhushan asked the panelists if the aim should be to reduce cases by distributing across populations, or to reduce the number of deaths by focusing on the elderly, those with comorbidities, or the poor. “Within the (Health) Ministry, we are engaged with this question… Outside the government, there is an emerging consensus that at least frontline health workers have the best claim over who should get the vaccine first… Would there be a priority list,” Bhushan asked.
Prof Eyal responded that essential workers, not just health workers, should be prioritised. Prof Lipsitch said country distribution should be measured by per capita.
NITI Aayog member Dr Vinod Paul, chairperson of India’s national Covid-19 task force, stressed the country’s commitment to vaccine access. “We cannot accept a situation where the rich have the vaccine and not the poor… The vaccine is not just for India and Indians but for the world and humanity,” Dr Paul said.
Other speakers included Principal Scientific Adviser Prof K VijayRaghavan, Drugs Controller General of India Dr V G Somani, WHO South East Asia Regional Director Dr Poonam Khetrapal Singh, and ICMR Director General Dr Balram Bhargava.