THE GREAT INDIAN VACCINE QUEST

WITH HUMAN TRIALS ON FOR TWO POTENTIAL COVID-19 VACCINES, INDIA JOINS THE GLOBAL RACE TO HALT THE PANDEMIC, BUT FIRST IT HAS TO PROVE THEIR SAFETY AND EFFICACY

Covid-19’s worldwide rampage has so far killed 552,512 people and infected over 12 million. The respiratory illness shows no signs of slowing down. Closer home, India has displaced Russia to become the third country most affected by the coronavirus with over 767,000 cases and 21,000 deaths. There is thus a global clamour for either a drug to cure the disease or a vaccine to inoculate the healthy population.

Unfortunately, as of now there is neither a cure nor a vaccine for Covid-19 and that’s what makes the spread of the disease so terrifying. Worse, it doesn’t seem to be going away in a hurry. The pandemic has led to desperate measures like lockdowns, which as we have discovered in India, can at best be stop-gap arrangements to slow down the spread of infections, not long-term solutions.

There is currently no drug that can fight Covid-19, though initial trials of Remdesivir have shown it to shorten the time for recovery while Dexamethasone has reduced mortality among severely ill patients. The jury is still out on whether anti-malarial drugs like Hydroxychloroquine can help improve immune response. There is even a phrase to explain our frantic efforts to reach for a cure—‘desperation science’. Herein lies the rub. The lure of money for pharma companies and the desire of government health bureaucracies to stop the spread of the disease can end up short-circuiting the development of the vaccine. Any new vaccine has to have an independent evaluation of the risks and benefits. There have been vaccines in the past which have not only failed to achieve the desired result but also caused harm. Often, the after-effects of the vaccines show up after many years. In the United States, the federal government has actually had to give vaccine manufacturers indemnity from lawsuits and set up special vaccine courts to deal with such cases. I believe that the choice of taking a vaccine should be left to the individual and not made mandatory. In the heat of the battle against Covid-19, we must not be hasty but tread cautiously.

Undoubtedly, prevention is better than cure. Vaccines are the key to many of our global health successes—smallpox was eradicated in 1979 following a global immunisation campaign while other serious diseases like polio and measles were controlled largely by mandated immunisation programmes.

Globally, there are 21 Covid-19 vaccines in the trials stage. India is one of the countries. This is an interesting development for a country that was known only as the world’s largest provider of generic medicines. It shows we have finally arrived in the big league of countries capable of developing a vaccine. Yet, as the controversy over the ICMR’s August 15 deadline for a vaccine suggests, we must be realistic about time-frames. Vaccine development is a time-consuming process which must go through six stages: analysis of the virus, designing the vaccine, trials on animals, trials on human volunteers, approval procedure and mass production. Six Indian companies are in the fray to field a vaccine and two of them have been greenlighted for human clinical trials. Researchers still doubt whether a vaccine will be available even by the end of the year.

Fortunately, the genetic sequencing of the Covid-19 virus was known in January itself. The virus has a fairly simple genetic structure and is not mutating as fast as the influenza virus. There has also been great advancement in vaccine technology. All vaccines usually contain a form of the germ which helps the body programme an immune response specific to it. When we are exposed to the actual virus, our body already knows how to deal with it. The Covid vaccine depends on synthetically produced genes of the virus or on the virus grown in cell cultures in laboratories. This is particularly promising for India where companies like Bharat Biotech and Serum Institute have thousands of litres of such cell cultures.

Our cover story, ‘The Great Indian Vaccine Quest’, written by Group Editorial Director (Publishing) Raj Chengappa with Senior Deputy Editor Amarnath K. Menon and Associate Editor Sonali Acharjee, cuts through the clutter and brings you details about one of the greatest medical races of our lifetimes.

While we are obsessing over the daily death count of Covid-19, we tend to forget the other diseases people in India die of every day. Of the 28,614 deaths per day in India, an average 2,000 die of cancer, 7,000 of cardiovascular illness, 1,400 of TB. At 2.75 per cent of the total people infected, the mortality rate of Covid-19 is still quite low in India and if one were to look at it as a percentage of the total population, it would be even more minuscule. That the disease has spread in such a short period of time is what has fuelled fear all around and stressed the medical infrastructure, but the fact is that it is much less fatal than many other diseases. Of the total number of people infected in the country, 80 per cent recover, 20 per cent require hospitalisation, of which 4-5 per cent need ventilators.

While we await the promised breakthroughs, which are also safe, it is important we continue to follow all the precautions to protect ourselves and others against the spread of the coronavirus. We must save as many lives as we can and learn to live with the virus in the meantime. The human race is one of the most resilient species on earth. That is why we have survived for so long. (Aroon Purie)