'New vistas in vaccinology emerging post-Covid' (IANS Interview)

New Delhi, July 23 (IANS) Vaccinology could undergo a paradigm shift with new vistas emerging to aid the immune system in fighting "new bombs ticking to erupt" and guarding against infections for which fully effective measures do not exist, says a noted public health expert, noting that the concerted efforts of the government and industry have made India the world's epicentre for vaccine manufacturing and meeting 62 per cent of the global demand.

"With advancement in vaccine development platforms and nimbler and innovative technologies, new areas for use of vaccines for disease prevention and treatment are opening up. Two such new arenas are therapeutic vaccines and bridge vaccines," Sajjan Singh Yadav, an IAS officer who has a doctorate in public health from the London School of Hygiene and Tropical Medicine and is currently an Additional Secretary in the Finance Ministry, told IANS in an interview of his book "India's Vaccine Growth Story" (SAGE/Select).

"Therapeutic vaccines are used for treatment of an existing disease rather than as immunisation for protection against future diseases. They utilise a patient's own immune system to fight the disease. In 2010, the US FDA had approved the first therapeutic vaccine, Provenge, for treatment of prostate cancer."

"Vaccines to reverse vascular dysfunction of the heart, treatment of the wounds of diabetic patients, allergies, nicotine and drug addiction, and treatment of multiple sclerosis and other autoimmune diseases are being actively researched. It has been reported that the use of mRNA for gene therapy and to cure genetic diseases such as haemophilia and sickle-cell anaemia has also shown encouraging results," Yadav added.

"Bridge vaccines are another class of emerging vaccines which will come in handy to decrease the rate of infection and transmission of infectious diseases till an effective vaccine is developed. These vaccines will stimulate body cells to generate nonspecific immune responses against a variety of pathogens. This will aid the immune system in fighting against infections for which a fully effective vaccine does not exist," Yadav said.

"After conquering many dreaded diseases, vaccines had taken a backseat in public discourse. Covid-19 pandemic had, once again, demonstrated the critical role of vaccines. It pushed advancements in new vaccine platforms and delivery mechanisms. This will prove critical as the last century saw more than 300 new infectious diseases. So, many new bombs are ticking to erupt (and which need to be controlled)," he added.

The book, which is sub-titled "From Cowpox to Vaccine Maitri," notes that the concerted efforts of the government and industry have made India the world's epicentre for vaccine manufacturing.

"India now meets 62 per cent of the worldwide demand for vaccines. It is the only developing country among the top 10 vaccine exporters and has the largest global manufacturing capacity for the WHO's prequalified vaccine production. About 77 per cent of the vaccines produced in the country are exported to more than 170 countries. India meets 90 per cent of the WHO's demand for measles and 40-70 per cent for the DPT and BCG vaccines," Yadav writes.

According to the Ministry of Commerce and Industries, the value of vaccines exported from India has increased from Rs 394.8 million in 1996-97 to Rs 64.916 billion in 2020-21.

India has the largest number of US FDA-approved manufacturing plants in the world outside the US. Indian industry meets about 60 per cent of UNICEF's vaccine demand. In the case of the WHO, it meets 65 per cent of its demand for the DPT and BCG vaccines, and 80-90 per cent of the demand for the measles vaccine, the book says.

"Indian vaccines' unique selling proposition (USP) has so far been high volume combined with low costs," Yadav writes, quoting Adar Poonawalla of the Serum Institute of India (SII) as saying: "There is a very large reliance on Indian pharmaceutical drugs and vaccines because of our good quality and affordable prices."

The Indian industry is now giving tough competition to foreign multinationals in the development and marketing of complex vaccines too, Yadav writes, adding that many Indian vaccine-manufacturing companies have also partnered with international agencies to develop new vaccines for diseases prevalent in developing and least developed countries. International partnerships have opened doors for new technology.

"To enhance their presence and meet global demand, Indian companies have started taking over vaccine production units in industrialised countries. They have also entered into joint ventures with international players for the manufacture and marketing of vaccines," Yadav says.

For example, the SII collaborated with AstraZeneca to produce one billion doses of the Oxford University vaccine and export it to low and middle-income countries. Johnson & Johnson partnered with Biological E. Limited to manufacture the Janssen Covid-19 vaccine. Dr. Reddy's Laboratories collaborated with Russia's Direct Investment Fund on clinical trials and supply of the Sputnik vaccine.

"With its strong vaccine-manufacturing capability and capacity, India is likely to play a critical role in meeting the global demand for Covid-19 vaccines. The Indian vaccine market was projected to grow by a compound annual growth rate of 12.5 per cent from 2020 and touch $108.02 billion by 2027," Yadav added.

"With a strong and supportive government, committed academia, innovative entrepreneurs and a growing economy, India's vaccine growth story is definitely poised to add many new chapters in the times to come," Yadav concludes.