Wanted to save lives; also wanted to make our country proud

AS WE WAS As the main body initially guiding the nation during the pandemic, I had a sense of responsibility as well as fear, as I had never faced such a major disaster. I had to anticipate and act quickly, and my training as a doctor as well as a cardiologist helped me immensely. More than 30 years in a public sector hospital have allowed me to stay in touch with the reality and the suffering of many of our people.

I have been fortunate enough to treat almost a quarter of a million patients in my lifetime. During my medical career, being able to bring a smile to the faces of patients or their loved ones has always helped me cope with challenges. This new experience was a much bigger problem with no immediate smiles. However, the satisfaction of innovating, improvising, reusing and calibrating responses with results lifted my spirits.

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Every October, in the state of Nagaland, northeastern India, members of the Bomrr ethnic clan of the Yimchunger tribe carry out a special harvest which they have practiced for over seven generations.

Climbing up a cliff, the Bomrr stack firewood at cave openings and light a fire to produce large plumes of smoke. Their targets are the thousands of bats that live in these caves. Bats fall dead indoors or are hit with sticks when they take flight. They are cooked as a delicacy or dried and stored for future use.

Since bats are known to be reservoirs for a number of deadly pathogens, including coronaviruses and filoviruses, an international team of Indian researchers conducted a study on the Bomrr tribe in 2018. The researchers collected blood samples from bat hunters, which are exposed to the saliva, blood and droppings of the bat species Rousettus leschenaultii and Eonycteris spelaea. Bat samples were also collected. The study presented the first evidence of a disease transmitted from wildlife to humans, namely filoviruses from bats infecting humans.

ICMR has been conducting research on bat behavior and ecology since 2001, a relatively new area of ​​study in India. The NIV’s bat monitoring team, the only one of its kind in the country, carried out a mapping exercise across India to get a clearer picture of the distribution and abundance, as well as the proximity of humans to bat species that are also carriers. from various potentially dangerous viruses.

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Unlike other vaccines, including Covaxin, which are given in two doses several weeks apart, the Johnson & Johnson vaccine works in a single injection.

It was a conscious decision not to rely on Moderna, Pfizer or Johnson & Johnson because, first of all, they were limited in their production. Second, these vaccines required a very high cold chain of minus 70 degrees Celsius, which was a problem for India’s infrastructure. Covaxin can be stored at normal refrigerator temperatures. Scientists are also studying vaccines that could be stored at room temperature.

Developing a COVID-19 vaccine on our own was also extremely attractive as it would reduce both import costs and dependence on foreign suppliers or governments. While India was already known as the “pharmacy of the world” for its exports of cheap generic drugs and vaccines, it did not have many entirely local products. It was an opportunity to show the world India’s ability to offer a cutting-edge product developed with exclusively national expertise and resources. We wanted to save lives. We also wanted to make our country proud. Despite all the constraints, a few things worked in our favor. Luckily, Bharat Biotech had set up a high-quality manufacturing platform in Hyderabad to make injectable polio vaccines just before the COVID-19 pandemic struck. The company had also set up a BSL-3 laboratory for the spread of the virus at minimum risk. His staff quickly reassigned these facilities to help with the indigenous vaccine project.

The ICMR-Bharat Biotech partnership was destined to be an iconic Indian achievement: a successful arranged marriage! The company had collaborated with the ICMR several years previously on the development of JENVAC, an inactivated virus vaccine against Japanese encephalitis.

Bharat Biotech has a proven track record in the manufacture of vaccines. So, we decided to share the virus with the company and to characterize the vaccine of the company by associating ourselves with the Indian company. A memorandum of understanding has been put in place regarding the sharing of intellectual property (IP) rights. It was decided that five percent of sales revenue would go to ICMR. I think it was one of the first such agreements where intellectual property rights and sales revenues were shared in the manufacture of a vaccine.

We have been constantly updating the deal, for example when we provided Bharat Biotech with the variants, whether it is Delta variant or Delta plus, so that they can modify the vaccine accordingly to meet the challenge. new variants.

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Although we are the world’s pharmacy, in most cases we are primarily manufacturers of generics. We are not making new molecules. We are the pharmacy of the world because we are able to make expensive, cheaper products. And we are able to give them to the rest of the world, for example, we have provided the HIV drugs to all of Africa. With Covaxin, we have proven that we can make vaccines from A to Z, with the virus that was isolated by an Indian scientist. The virus was isolated in an Indian laboratory and the vaccine was made in an Indian laboratory. It was characterized in an Indian laboratory by an Indian scientist. It has been studied in India on small and then large animals. Phase I, II and III clinical trials were performed in India by Indian scientists. Almost all of the ingredients were from India, as far as the vaccine is concerned.

Covaxin is an outright homegrown product. In today’s interconnected world, you can source some components all over the world. But to be able to innovate, to be able to own the Product of Investigation (IP) and to be able to manufacture it oneself is an achievement, and we have done it with Covaxin.

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We have achieved an extraordinary feat. After the stress, the drama, the hard work, the long nights, the constant fear of illness and death, the brainstorming, the travel, the tests, the fatigue, the adrenaline rush … what to marvel.

Last year we had a lab that could do COVID-19 testing. Today we have several thousand.

Last year a deadly disease came to our country and started killing people, and it was a terrifying mystery. Today we know exactly what the “pretty virus” is and how to beat it. The lives lost and the lives still at stake are an untold loss, but now we know what to do.

Last year the whole world stopped. This year India has an Indian vaccine that will save millions of lives around the world and help the world come to life.

Last year we were known as a reliable vaccine manufacturer. This year, we are a recognized vaccine pioneer.

Today, I am filled with a sense of urgency to vaccinate India and prevent a repeat of the tragic second wave. We have to be very careful.

Ironically, the best way forward for us is to emulate our enemy: we must mutate and evolve to outsmart the virus. And that’s what we do. When he attacks, we defend. When he hides, we find him. When he changes course, we are right behind. If necessary, we call for reinforcements.

Right now, as the world waits to see the pandemic in the rearview mirror, today’s superheroes are scientists: women and men who stay smarter than the virus, who change, adapt and innovate so that we may all have our chance at a better tomorrow.

Extracted with permission from Rupa Publications.

Going Viral: The Making of Covaxin: The Inside Story

By Balram Bhargava

published by
Rupa publications

pages 240;

price Rs295

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