Suraj Profile picture
17 Apr, 19 tweets, 5 min read
Vaccine supply chain management is a careful balancing act everywhere right now. Here’s a sampling of news to offer context:

US: nbcnews.com/news/us-news/s…

1/
Shortages in California in late March: abc7.com/california-vac…

3/
UK supply disruptions late March: cnbc.com/2021/03/18/cov…

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Germany update late March : cbsnews.com/news/germany-c…

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Japan, which started this week after several delays - npr.org/2021/04/13/986…

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For context, India has multiple vaccines. It produces it all at home. One is entirely homegrown IP. The other we licensed because we have the demonstrated scale to make it at home.

7/
Multiple developed countries lack their own IP and manufacturing base. They are dependent on the vagaries of Pfizer supply choices made in another country: bloomberg.com/news/features/…

8/
The scale of Indian vaccine production is under appreciated:

ncbi.nlm.nih.gov/pmc/articles/P…

Table 4: of $155 billion in saved medical costs btwn 2001-20, SII’s vaccines alone contributed to $140 billion savings

9/
Here’s some additional data from WHO summarizing vaccine and generics suppliers (who.int/immunization/p…) . Page 5 and 6 are interesting.

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The current situation despite the existing manufacturing and development prowess is difficult - scale up production multiple times prior baseline, while simultaneously maintaining quality without any interruption. Distribute without any bottleneck anywhere.

11/
Most do not even have the luxury of having local supply, even if raw material is imported in some cases.

Ordering Pfizer in Sept 2020 hasn’t ensured EU reliable supplies as of April 2021. Pfizer is made in US, Belgium and Germany.

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The UK delayed second dose guidance to up to 12 weeks: england.nhs.uk/coronavirus/wp…

… and exploring giving different vaccines for 2 doses: bbc.com/news/health-55…

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It’s beneficial to understand the challenges in a clear and unemotional manner.

To educate on the complexities of vaccine IP, let a famed immunologist speak. To understand how complex supply chain works, let someone who has run complex intl supply chain speak.

14/
The Indian population counts amongst it some of the most accomplished individuals in every aspect related to how this process works.

The population values education and deserves to learn the details and nuances of the problem and appreciate the nature of the challenge.

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A continuous stream of mind-numbing sensationalism does not serve the needs of the modern Indian state. We have amongst ourselves some of the worlds best medical professionals, technocrats, logistics and operations experts .

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People need to be able to clearly learn what they have to say about the various challenges associated with an effort on this scale and complexity. The effort needs to be benchmarked against the problems others are also facing.

17/
The role of the press here is to connect the expert knowledge directly to the public in clear understandable language. It cannot by itself monopolize the conversation. It leads to embarrassing gaffes like someone not knowing that Remdesivir is a chemical.

18/
The press isn’t expect to be domain experts and should pretend to be one. It has a job to connect the experts to the public and to let the public quietly learn and understand the details of the medical, technological and operational challenges itself.

19/19

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More from @surajbrf

13 Apr
This thread discusses “vaccine shortage”. Data from news reports over last 6 months.

Tl;dr: Situation is not shortage as such. India has stockpile of ~140m doses end March. However there’s a tricky situation with supply vs consumption over short term.

1/
Situation: SII and BB accumulated significant stockpiles much before earliest approvals.
SII 40m by mid Nov: timesofindia.indiatimes.com/india/serum-in…
SII 270m doses produced end-March: sundayguardianlive.com/news/sii-seeks…
Covaxin 20m stockpile March: bbc.com/news/world-asi…

2/
Vaccine exports total 64.9 million : mea.gov.in/vaccine-supply… but dropped to almost 0 in April.

Total consumption is 173.1 million up to April 12: 108.2 m local vaccinations plus 64.9m exports .

3/
Read 18 tweets
7 Apr
The vaccination prioritization is set out in the official documentation posted on ICMR’s and MoHFW’s sites:
vaccine.icmr.org.in/covid-19-vacci…
mohfw.gov.in/pdf/Covid19Com…
Page 64 explicitly lists the priority groups.

It was published back in 2020.

1/n
The document offers detailed information on how to communicate a mass vaccination campaign, stating the roles of government, mainstream media, religious leaders, and more.

2/n
The Indian guidelines are essentially the same as the prioritization defined in other major economies:
USA: cdc.gov/coronavirus/20…
UK: gov.uk/government/pub…
Germany: thelocal.de/20210310/expla…

3/n
Read 14 tweets
18 Mar
This thread describes the progress of Indian electrification coverage. Two charts are presented, both sourcing data from EIA.

First chart:

1/
Observations:
1. By the start of the century China had already almost finished full electrification. India had 60% without electricity.
2. Big drop 2000-04, from 600m to 500m
3. Shallow drop 2004-14 from 500m to 350m
4. Big drop 2014-18 from 350m to 50m

2/
Note:
1. slope of electrification rate from 2000-04 and since 2014 exceeds peak rate of electrification in China
2. 2017 was start of Saubhagya mission.
3. By 2019, India achieves near complete electrification (next graph)

3/
Read 6 tweets
15 Feb
There's a lot of talk about India and climate change goals. Particularly, it is argued that the Indian government lacks commitment. This thread is intended to offer an overview of current status. It will be data focused.
The most recent epoch of data is the annual climate transparency report: climate-transparency.org/wp-content/upl…
All major nations are rated by their ongoing progress against Paris Agreement Nationally Determined Contributions (NDC 2015) towards their 2030 target goals.
Page 23 is of particular interest. All major nations listed with status:
USA: critically insufficient
China: highly insufficient
Japan: highly insufficient
EU: insufficient
Germany: insufficient
France: insufficient
Australia: insufficient
Canada: insufficient
Read 21 tweets

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