What Britain can learn from India’s ‘Vaccine Prince’

Adar Poonawalla, Chief Executive Officer (CEO) of the Serum Institute of India poses for a picture inside a lab at the Serum Institute of India, Pune
Adar 'Vaccine Prince' Poonawalla, CEO of the Serum Institute of India - Francis Mascarenhas/Reuters

Two dozen precision cameras are locked onto the engine-like contraption as its cogs whirr and spin at speed, primed to spot any discrepancies as the machine methodically fills an endless line of vials.

Nearby, a group of PPE-clad workers supervise the automated process, ready to intervene in quality control should their robotic companions malfunction. At the factory’s peak, these machines fill 400 tiny glass bottles per minute – and there is no room for error.

From this sprawling campus of red-brick buildings, air-tight laboratories and super-chilled freezers in the Indian city of Pune, sealed vials will be shipped to health centres in every corner of the globe – from British town centres to Uganda’s central plateaus and Brazil’s Amazon rainforest.

This mammoth facility, operated by the Serum Institute of India (SII), has become a stalwart in the international vaccine supply chain since it opened in the 1960s. Last year alone, it produced more than 1.9 billion vaccines – delivering shots for deadly diseases including Ebola, malaria and measles to some 170 countries.

But it was the pandemic – when SII partnered with AstraZeneca to rapidly manufacture much-needed Covid-19 shots – that spotlighted just how critical the company had become.

A man walks past the logo of the Serum Institute of India, inside the facility in Pune, India
The facility operated by the Serum Institute of India has become a stalwart in the international vaccine supply chain - Francis Mascarenhas/REUTERS

“India has been known as the pharmacy of the world,” says Adar Poonawalla, the chief executive of the SII, from his office that fills an entire floor of one of the facility’s state-of-the-art buildings, filled with sculptures and an imposing desk.

“We lived up to that reputation… [and] demonstrated that we could make high-class, high-volume vaccines, distributed to 70 countries.”

Yet now, Mr Poonawalla is dismayed. India’s ‘Vaccine Prince’ – so-called because the pharmaceutical empire his father launched has turned his family into billionaires – hoped Covid-19 would be a catalyst for other nations to invest in similar facilities.

Instead, he looks at countries like the UK with despair.

“The political will, after Covid-19, has gone down completely on thinking like this, because there are other priorities,” he says. But unless countries act soon, “we’re going to be in exactly the same situation” next time, with a desperate scramble for limited vaccines.

Preparing for ‘disease X’

In Pune – a chaotic mashup of ear-splitting traffic, shanty towns and brand-new looming glass buildings around 100 miles east of Mumbai – these preparations are already well underway.

The SII was founded here by horse-breeder-turned-vaccine-entrepreneur Cyrus Poonawalla in 1966, with a single vision: to bring low-cost vaccinations to the developing world.

It has done just that, while becoming India’s most valuable unlisted company. The 79-year-old Poonawalla senior ranks 165th on the Forbes’ billionaires list, with an estimated net worth of $11.5bn, and his organisation has been credited with saving 30 million lives.

Now, under his son, SII is expanding to focus on the unknown: ‘Disease X’.

“The more you swear in peacetime, the less you bleed in wartime,” said Dr Umesh Shaligram, SII’s executive director of research and development.

“We’ll be the first one who can probably quickly react [to a new pandemic pathogen].”

Employees in personal protective equipment (PPE) work inside a lab where the HPV vaccine is produced at the Serum Institute of India, Pune
Lab researchers in PPE work on the development of the HPV vaccine - Francis Mascarenhas/REUTERS

The operation is unlike anything in Britain. Each of the pandemic preparedness building’s five floors span 70,000 square feet. In total, there’s 350,000 square feet of space dedicated to manufacture shots for any new emerging threat.

Dr Shaligram says the facility is part of the institute’s two-pronged approach to a pandemic threat: stage one involves stockpiling vaccines that can be rapidly adjusted to target new pathogens; stage two is about having the facilities ready and waiting to manufacture these newly designed shots.

In January, the Coalition for Epidemic Preparedness Innovations (Cepi) unveiled plans to invest up to $30 million to support SII’s work in this area.

The coalition was set up in 2017, but became a critical funder of vaccine development during the pandemic – and a leader of the Covax scheme, which aimed to distribute vaccines to low and middle income countries.

Now, it is championing a ‘100 Day mission’, a project its chief executive has compared to the race to reach the moon. The agency is busy laying the foundations for a new vaccine to be developed within three months of identifying a new pandemic threat – and creating a network of manufacturing facilities that remain “warm” is a central pillar of this plan.

“Living in an era of heightened epidemic and pandemic risk, evidenced by the increasing prevalence, speed, and spread of outbreaks of infectious disease, we must prepare to confront these threats head-on to avoid another Covid-like catastrophe in the future,” Dr Richard Hatchett, Cepi’s chief executive, said in January.

“As part of CEPI’s global manufacturing network, SII’s world-renowned manufacturing and rapid response capabilities are poised to play a critical role in enabling swift and equitable access to affordable outbreak vaccines.”

Adar Poonawalla, Chief Executive Officer (CEO) of the Serum Institute of India, is seen in a reflection as he poses for a picture inside an office at the Serum Institute of India, Pune, India
Mr Poonawalla is dismayed at the lack of investment post-pandemic - Francis Mascarenhas/REUTERS

But elsewhere, efforts to enhance vaccine manufacturing capability pale in comparison, especially in the UK.

“When you look, scratch beneath the surface, it is nothing,” Clive Dix, the former head of the Covid vaccine taskforce, told the Telegraph. “In the whole environment for manufacturing, the UK is a bit of a hostile place for it to occur. So people have moved away.”

Like Mr Poonawalla, Dr Dix said a lack of political interest is a major barrier to the UK upping its manufacturing capabilities.

Experts have pointed to the Vaccine Manufacturing and Innovation Centre to highlight this issue.

It was launched during the pandemic as a not-for-profit company that would combine research and manufacturing under one roof. But in 2022, the £200m government-funded centre was sold to a private pharmaceutical company.

Dr Dix added that more incentives are needed to bring vaccine research and manufacturing to the UK, like the tax breaks recently introduced in Ireland. Otherwise, Britain will be left wholly reliant on other countries in the case of a new pandemic.

“We’ve actually lost a lot of our manufacturing [to other countries], partly because big companies look up the cost base for doing it,” he says. “A lot has gone to India and China … We’ve just let it slip through our fingers because of the cost base that we have.”

Across the Channel, Europe – which found itself in hot competition with the UK and US for supplies during the coronavirus pandemic – appears to be much more proactive. In June 2023, the European Union signed contracts with four vaccine producers to reserve manufacturing capacity in the case of future outbreaks.

At the cost of  €160 million per year, the deals with the US pharmaceutical giant Pfizer, Spanish vaccine makers HIPRA and CZ vaccines, and Dutch company Bilthoven Biologicals covers enough capacity for 325 million doses annually. It includes a range of vaccine types, including mRNA, viral vector and protein-based shots.

Dr Dix believes it is not too late to bring the ailing political will back and replicate Europe’s efforts.

“I think you could easily resurrect it with the right leadership and make it happen,” he says.

‘No one should be left behind’

Back in Pune, Mr Poonawalla stressed that investing in a diverse portfolio of manufacturers in different geographical regions will be critical if leaders worldwide want to avoid the supply-chain issues that plagued Covid-19 jabs.

“If you don’t have a ready-made facility available, we’re just going to be exactly in the same situation where we were dependent on four or five manufacturers in the world,” he says.

“Every country is going to scramble for it, you’re going to have all these bans and restrictions, raw material restrictions, regulatory restrictions that delayed and confused and created havoc during the pandemic.”

The SII was not immune to havoc. As India was engulfed by Covid-19 – which has killed at least 770,000 people in the vast country – the government banned vaccine exports.

At the time, SII had exported just 60 million of its doses, which were predominantly intended for low income countries unable to secure shots from elsewhere. AstraZeneca, which SSI struck a deal with to produce a billion doses of its shot, served a legal notice over delivery delays.

The delivery of vaccinations worldwide was splintered, with wealthy nations first in line to protect their people and poorer nations left behind.

Next time around, Mr Poonawalla said SII will be committed to guaranteeing the same thing doesn’t happen, and that costs will be kept low to ensure the most vulnerable get the shot.

“At SII, we firmly believe that no one should be left behind in the fight against global health emergencies,” he said.

“Our commitment to equity, coupled with our ongoing efforts to enhance manufacturing capabilities, forge strategic partnerships, and align with international initiatives, positions us to a timely and fair distribution of life-saving vaccines to those in need, both in India and around the world, during the next pandemic.”

SII’s has also faced opposition from the US drug lobby for its calls to reform intellectual property protections, while regulations have made it hard for the company to break through in wealthy markets.

More broadly, India’s pharmaceutical industry is facing major scrutiny. It has been plagued by scandals, including a deadly cough syrup that killed hundreds of children, though SII has stressed that it was not involved.

An employee in personal protective equipment (PPE) walks in a corridor outside a lab where HPV vaccines are produced at Serum Institute of India, Pune
India's pharmaceutical industry is facing intense scrutiny - Francis Mascarenhas/REUTERS

Instead, the company points to recent efforts to tackle deadly pathogens as markers it is ready to take a leading role in pandemic preparedness.

In 2022, the company rapidly produced 40,000 doses of Oxford University’s Ebola shot within 60 days of an Ebola outbreak in Uganda. The new shot, which targets both of the major strains of the virus, was distributed just 80 days after the World Health Organization declared an outbreak.

More recently, the institute began manufacturing Oxford’s R21/Matrix-M malaria shot at a price of $4 per dose. It is the second malaria jab to be developed, but is cheaper and easier to manufacture than GSK’s version.

“Wherever there was a supply gap because of affordability and general supply of vaccines, that’s the gap that Serum is filling,” said Mr Poonawalla. “It should be something that the whole world needs.”

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