Suraj Profile picture
4 May, 11 tweets, 4 min read
Great thread that takes apart WSJ's predictable opposition to the TRIPS waiver that would help expand COVID vaccine production. The @WSJ is stridently focused on avoiding any attempt to learn from history.

@prasannavishy @c_aashish @amargov @centerofright
The TRIPS waiver was first mooted in October 2020 by India and South Africa:

docs.wto.org/dol2fe/Pages/S…

1/
A wider document was circulated in January 2021 with the signatories list expanding dramatically:

docs.wto.org/dol2fe/Pages/F…

2/
The October and January efforts both failed. The meetings were closed door events:

lifesciencesipreview.com/news/wto-decli…

3/
The following WTO summary page has details on communications by different countries on this topic, from late Feb 2021:

wto.org/english/news_e…

4/
In the US, the pharma lobby pushed Biden to oppose the waiver in early March, using standard cut and paste arguments dating back decades:

jdsupra.com/legalnews/bio-…

5/
On March 11 , the WTO declined the TRIPS waiver a third time:

law360.com/articles/13634…

6/
The current effort is the fourth one. It has resulted in lobbying on both sides:

aipla.org/detail/news/20…
reuters.com/business/healt…

7/
It's unclear if it will pass. On the positive side, India has not one but potentially at least two unique vaccine IPs (Covaxin and the DNA-based Zycov-D in advanced trials).

8/
This is a departure in one more way: Covaxin is the only inactivated viral vaccine. Previous examples quoted have involved clean room re-engineering of western IP. Covaxin & Zycov-D are the first vaccines using their respective technologies in the world.

9/
However this does not mean India should not support the waiver any longer - there are simply too many people still a long way from accessing vaccines, even if India can independently devise and manufacture what it needs for itself.

10/10

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More from @surajbrf

5 May
Recently various sources have pitched the Pfizer vaccine for India. This parlays the recent western ‘branding’ effort differentiating Pfizer, but it is known that this vaccine has some unique technical requirements.

This thread analyzes the Pfizer logistics in depth.

1/
Storage
The vaccine must be stored at -60 to -80C, i.e. ultra low temp (ULT), much colder than normal freezer (-20C) or fridge (2 to 8C). Such storage systems are costly but cost depends on capacity. These have alarm systems to notify of failure or temperature fluctuations.

2/
The Pfizer transport box shows ~5000 doses = 10L tray volume. It is packed with dry ice and can be transported for no more than 10 days unopened, 15 if dry ice recharged. Each pallet has IoT comm to notify Pfizer of problems:
truckinginfo.com/10134508/vacci…
bbc.com/news/technolog…

3/
Read 24 tweets
28 Apr
@SerumInstIndia and @BharatBiotech recently released new Covid-19 vaccine prices. Enrolment for 18+ begins today.

Are they profiteering ?

This thread covers their production effort, scaling and some other factors. Starting with SII:

1/
SII started out with 50-60 million doses/mth capacity. Apr 1 it announced efforts to scale up to 100m by May using internal resources, and requested Rs.3000cr funding to scale up. The bulk order came thru mid April, enabling further scale up and deliveries through May/June.

2/
A common mistake made is to extrapolate latest prices to all future orders. Prices are tied to capital costs of scaling up and order size. Early SII orders were Rs.200/dose + GST. The higher initial price Is due to setup and initial investment SII made, described later.

3/
Read 34 tweets
22 Apr
This thread addresses Indian vaccine prices and orders.

Covishield sale price. Source: unicef.org/supply/covid-1…

1/
Observations:
1. SII-AZ signed the Covishield licence prodn deal to enable COVAX supply, so $3/dose is baseline
2. SII supplied 50m doses at that price, another 100m doses at 66% of that price to Indian govt.

2/
The second deal significantly stressed SII, supplying so far below cost. Same vaccine made in EU goes for $4-6 (Rs.300-450) per dose. SII pays ~Rs.75 per dose as royalty to AZ. At Rs.150/dose it makes only Rs.75.

3/
Read 18 tweets
21 Apr
This thread reports ongoing India vaccination data, explains 2nd dose crowding effect and May open eligibility projections.

First: Ongoing rate of vaccinations , with both first and second doses considered:

1/
Observations:
1. >60 group consistently ~1.1 to 1.3m per day since mid March
2. 45-60 group did 2.3/day in wk 1 of April, but dropped to 1.3m by wk 3

Unclear why 45-60 group less enthusiastic despite >60 group consistent wk to wk .

2/
Observations 2
1. Navratri since Apr 13
2. 2nd wave may be lowering turnout.

Since >60 is highest risk group, consistency in that group has highest impact on keeping mortality risk down.

3/
Read 18 tweets
17 Apr
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/
Read 19 tweets
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

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