India produces 60% of the vaccines distributed in the world and Europe depends 90% on Beijing for the supply of molecules and active ingredients. From off-shoring to bland Pacific regulations, all the (avoidable?) Causes of an addiction that’s not good for anyone.

The largest vaccine producer in the world is Indian. It would be hard to believe, given that for days there has been talk of nothing but vaccination warfare, citing the USA, Europe, China and Russia as the first protagonists of the new health colonialism. Forgetting, however, that the world’s pharmacy is in India. Suffice it to say that already in the pre-Covid era, 60% of the vaccines distributed in the world were produced on the Indian continent.


And especially from the Serum institute of India. Based in Pune, the company specializing in biotechnology and pharmaceutical production boasts a family management – it is led by Adar Poonawalla, son of the founder Cyrus Poonawalla – but also a considerable turnover (800 million dollars before the outbreak of the pandemic). And at the moment it would seem the only reality capable of sustaining an exponential increase in vaccine production without encountering major obstacles.


Among the vaccines produced by the Serum Institute there is also that against AstraZeneca’s Covid, which according to the company will be produced in even greater quantities as early as April, when it will go from the current 60-70 million doses to one hundred million.


Not only. Also according to what the company has declared, in the same period the production of Novavax will start (among the most promising vaccines in the approval phase) and by the end of the summer the British startup SpyBiotech will be added, again with the approval of the health authorities. But the foresight of the Serum Institute does not stop there, and is already aiming at the beginning of 2022 for the production of the single-dose nasal vaccine developed by Codagenix, another American biotechnology company. An ambitious program, but which Poonawalla apparently believes he can fulfill.


“I humbly ask you to be patient because the efforts of our institute are aimed at satisfying the gigantic needs of India and, at the same time, at finding a balance with the rest of the world”, Poonawalla wrote on Twitter less than a month ago. , veering in the same direction that everyone seems to have taken, or at least those who can access the vaccine without too much difficulty: first ours.


And this is the reason why for months we have been wondering (and it is indeed a mistake not to have done so before) how it was possible to relocate the production of life-saving products – in a non-metaphorical sense – such as that of drugs and vaccines so lightly. Because it is true that a vaccine produced in India certainly costs less, but it is equally true that in the event of a health emergency, such as the one we are experiencing, we would perhaps be willing to pay for it at any price.


But no. We waited for India to stop exporting a considerable amount of active ingredients – 26 to be precise, including the “banal” but fundamental and irreplaceable paracetamol – because the usual supply from China – cut short by Covid at the time – was struggling to arrive. In fact, Europe depends 90% on Beijing for the procurement of molecules and active ingredients, which according to the Medicine and Healthcare Products Regulatory Agency overall produces almost half of the planet’s active ingredients. Most of which, then, are exported to India to be processed and then distributed.


“There was a time – reads an ISPI report – when Italy was among the first countries in the world in the production of active ingredients with a market share of 12% in 2013”. Over the years, however, our country, like almost all Western countries, has progressively lost shares with respect to India and China which, thanks to less stringent regulations and important state subsidies, have managed to guarantee prices 30-40% below the global average.


Among other things, this autarchic war is slowly – but not too much – transforming into a dog that bites its tail, risking to affect even those who have the knife on the side of the handle. According to some Indian producers, Washington’s use of the defense production act is threatening the supply of vaccines (anti-Covid but not only) all over the world. Some of the materials necessary for the production of vaccines – such as bioreactors or plastic materials – would seem to come from the United States, but at the moment they limit or even exclude their export. A dog that bites its own tail, in fact.


Last Friday, meanwhile, WHO director general Tedros Adhanom Ghebreyesus, hoping to channel countries towards more effective collaboration, raised the alarm. Not only is there a risk of not being able to produce enough vaccines to stop Covid – he explained – but also of not being able to produce normal routine vaccines that fight diseases that have now disappeared in developed countries. “We are all interdependent,” said Ghebreyesus, recalling how it is impossible to think of getting out of the pandemic by vaccinating only one’s own citizens.


Reshoring is the way? Maybe yes. But as long as the countries are then able to pool skills and know-how for an end that is beneficial for all. To date, moreover, no one is able to produce everything in house and the only way forward seems to be that of collaboration. But the vaccine battle is still open, and a war is unlikely to end without losers and winners.


In the meantime, Italy seems to be on the right path. After the U-turn of the new government and thanks to the link between the Minister of Economic Development Giancarlo Giorgetti and the European Commissioner Thierry Breton, something has moved, showing a real will – both of Italy and Europe – to restore a productive autonomy in line with the needs of the country and the continent. Last week the government made the first agreement with Patheon Thermo Fisher to produce a vaccine (it is not yet known which one) on the national territory. A first big step, which hopefully – and imagine – will not be the last.

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