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The lack of vaccine supplies in Africa and Latin America, parts of Asia, is a major problem in 2021. Of the 66 million doses of vaccine planned to be given to Africa under COVAX plan only 19 million have been delivered. In total about 49 million doses have been delivered. Vaccine shortages are a result of the huge wave of coronavirus in India in April, so that vaccine shipments from India have stalled. Of the countries in Africa a few have made some progress- Egypt, Ghana, Nigeria. Other problems in Africa are lack of trained people to give vaccination. Last week 2.3 billion dollars in additional funds were raised at a donor conference for COVAX, the initiative for poor countries vaccines. That is enough to buy 1.8 billion doses. US and UK have not exported vaccines. India has made a good start in shipping vaccines to many countries in Africa, Asia and Latin America as shown in the Ministry of External Affairs website of the Indian government. For India to do this once it meets its own needs and resume exports, vaccine patent protection needs to be lifted for sometime, which the US is now accepting. ...

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By August India will have tackled a shortage of vaccine supplies following the government decision to approve the use of Pfizer, Moderna, Novavax vaccines from US, Sputnik from Russia, and the US allowing export of vaccine manufacturing raw materials to India.

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Jenny Strasbourg of the WSJ provides this much needed report from London about the courageous decision by AstraZeneca and Oxford University to give vaccines away at no profit to the whole world, to billions of people in Africa, Asia, and Latin America. Without this brave decision by a British company and a British University the world would be a lot poorer, more variants could have happened, making us realize the great contribution Britain has made and how indispensable it is to the planet. Add to this the effort of Indian companies including Serum Institute that provided the manufacturing facilities and capabilities for making most of the British vaccine. AstraZeneca delivered 2.3 billion doses of the vaccine globally as of mid-December, according to the company. The International Monetary Fund estimates that low and middle income countries received 3.25 billion vaccines as of Dec. 11, About half of this or 1.6 billion doses were Astra Zeneca shots. This is a bigger share than any other vaccine by far and a life saver to the world. AstraZeneca stepped up early in a true to the best ideals in Britain to meet the needs of the world-  aiming to deliver 3 billion doses in 2022 and sell them at no profit as long as the pandemic continues. As the shot does not need cold storage it is ideal for India and other Asia, Africa and Latin America. "We are all very proud throughout the company of the impact we have had," says AstrZeneca CEO Pascal Soriot. By far the biggest manufacturing was done at Serum Institute of India which supplied 1.3 billion doses of the AstraZeneca vaccine to 70 countries. Mr. Modi pushed forward the export of vaccine made in India to the world from the beginning in the same spirit of cooperation and the best ideals that Britain was living upto. Serum Institute can produce as much as 250 million doses of vaccine a month making it possible for India to tackle the vaccination population of 1.3 billion people.   None of this could have happened without Oxford University and AstraZeneca and Indian companies with Mr. Modi's active support living up to the best ideals of Britain and India for the world. "When you add up the benefits to humanity, I think you'll find the vaccine holds up pretty well in terms of the ill health it has prevented, and the deaths it has prevented," says John Bell, a senior Oxford academic who in 2020 guided the University through its vaccine-partnership talks with Astra Zeneca. Because in the real world AstraZeneca shot has held up so well it is also a choice for booster shots. ...

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This video in The Indian Express shows how president Biden invoking US defense act provisions to ensure supplies of vaccine ingredients to US companies prevents exports to countries that badly need it. India has surpassed 300,000 daily cases of coronavirus on April 22, and India's largest vaccine manufacturer Serum Institute of India says vaccine manufacturing in India is restricted because of president Biden invoking that law. 

India's vaccination drive is stalling because of not enough vaccine supplies.

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The world's larges vaccine supplier Serum Institute of India syas it will not be able to meet its target production of 2 billion doses for 2021. It says vaccines will not be available for export from the Institute till the end of the year. The Indian government has initiated an effort to diversify its vaccine production by distributing it among many suppliers in India's large pharmaceutical industry so that constraints at any one supplier would not affect the overall supply for use inside India and the production that can be sent overseas.

Another setback was seen in the US as 100 million doses of J&J one dose vaccine at a Baltimore plant are being checked for contamination.

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From now on the vaccination program in India will be run nationally by the federal government. This will ensure fair access to vaccines to all parts of the Indian population. Earlier vaccine costs were bid up as states and private hospitals bid up prices. Under the new national program 75% of vaccines will be given out by the federal government and 25%  by private hospitals and other private health institutions. The government in New Delhi under prime minister Modi will offer adults free vaccinations. Modi said "We will increase the speed of procuring vaccines and also increase the pace of the vaccination program." Even in private hospitals the cost of vaccine will be kept at Rupees 150 or $2.06. Experts say this is the right policy and the government has learned from errors in letting states and other private institutions run vaccine policy, which made it too fragmented and subject to too many variables, resulting in inequity, and slowing vaccination drives. The Supreme Court stepped in asking for clarity, leading to the clear policy from the federal government announced today.  Advantage of the new policy is that the responsibility lies in one place, and the federal government also has the clout to make things happen, to negotiate with companies and other parties involved effectively. India has vaccinated 222 million people but because of the population being so large at 1.2 billion this comes out to be a small fraction of the population. This puts the task of getting vaccine supplies and getting the vaccination drives to work in the only place that has the determination and the resources to deliver results by vaccinating 1.2 billion people by December 2021. It has never been done before in history says Mr. Modi, and it is a challenge that India is now taking up for itself and for the global community. It also lays the ground for India to help its neighbors in Asia and in Africa, Latin America in 2022.   ...

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On the first day of the new vaccine policy on June 21, 2021, India has vaccinated 6.9 million people. India has now vaccinated 287 million people out of a population of 1.2 billion. This is a race against time as new variants caused the second wave of coronavirus in April and May of 2021 with cases peaking at over 300,000 a day.  The shortcoming of the old vaccine policy are being corrected. The entire vaccine supply process and the vaccination drive is now being handled by the federal government. Earlier during the second wave vaccine supply and the vaccination drives were under an arrangement with no clear overall responsibility. States shared responsibility with the federal government and target vaccination goals were missed, vaccine supplies were inadequate.  A similar arrangement in Germany failed and Germany's vaccination supplies were inadequate and vaccination drive stalled. This caused immense frustration in Germany in April-May 2021. Germany's troubled history before World War II led to a reliance on decentralized actions, and state governments imposed different rules in a relatively small country compared to India. This was corrected with the federal government taking on the entire responsibility for the vaccine supply and vaccination drive leading to good results today in vaccines. With India's huge population and political process of different state governments, some lacking experience in administration for a complex process, and others failing to coordinate well with the federal government, the lack of overall responsibility at the federal government posed serious risks of missing targets for vaccines and letting the coronavirus wreck the economy and public confidence. Complex negotiations with other governments in Europe and the US for vaccine manufacture in India could only be handled at the federal level. The resources and planning at the federal level were already in place in India for infrastructure and other projects, experience and setting targets in that area at the federal level could now be transferred to this task in vaccines. Somewhere in the range of 8 million vaccines a day need to be reached and sustained from August to December 2021 for India to reach the goal of vaccinated all 1.2 billion people ahead of any further attack from a third or fourth wave, say experts. This is not a choice for the federal government, it is simply something India has got to accomplish to be a healthy nation that can grow with neighbors in Europe, the US, Australia and Japan and build confidence in its Asia-Pacific region. The entire Asia-Pacific region has a lot resting on how well India achieve this goal and moves on to the next phase of assisting its neighbors in the region.  ...

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As the coronavirus surges in India with over 300,000 cases a day on April 26, a clear picture on the vaccination drive in the country is critical. The following is the picture of the vaccination progress from Union Health Ministry in India as shown in The Hindustan Times. India has vaccinated 140 million people with at least one dose says this report in The Hindustan Times.  On Saturday 24th April 2.4 million doses were given for that day at 8 pm. This was done over 99 days. This means about 12% of the population of 1.2 billion has been vaccinated.  This compares with the vaccination in Germany for about 21% of people vaccinated with over 18 million getting the first dose in Germany by around April 25. Both Germany and India have suffered from vaccine shortages, some skepticism about vaccinations. Gradually sentiment is shifting in both countries so that once skeptical Germany now has about 75% of people willing to take vaccine on April 25, 2021. In India about 6 million healthcare workers have 2 doses of vaccine, and about 9 million have 1 dose. About 6 million frontline workers have 2 doses and 12 million frontline workers have 1 dose of vaccine.  There is a shortage of vaccine supplies and a bold decision was made by the Indian government on April 25th 2021, after the surge of cases to a world wide maximum of over 300,000 cases a day. The decision was to give immediate regulatory approval for the three major vaccines in the US to be brought and used in India. And delivery will be speeded up - no customs duties and fast processing of supplies access to speedy logistical supply routes. This is a huge step forward for the vaccination drive as this means Pfizer, Moderna and J&J vaccines can now be used in India. The government is also urging the companies to make in India or export to India with prices that provide flexibility in pricing for the private market. The locally produced Covishield Astra Zeneca based vaccine produced by Serum Institute will be allowed to be sold to the private market at 600 rupees or close to about $10. Pfizer and Moderna, J&J can price in a way that would be somewhere around this price range. The access to more vaccines and the ability of the companies to make a reasonable profit in the Indian private market means that vaccine supplies should open up in May and June.  This could give a huge boost to vaccination numbers so that India's vaccination percentage of population vaccinated should keep up with that in countries like Germany and France that were slower to get started in Europe but are now catching up quickly. This is a massive achievement because the population numbers are huge compared to Europe. ...

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In Britain, in India and in the EU, the race is between the vaccination drive and the infection case growth, as each country and region takes steps to accelerate and organize production, distribution and administering of the vaccine to all parts of the population.

The latest late stage trial for Astra Zeneca vaccine in US, Chile and Peru, offers new hope. It is shown in that trial that it is 100% effective in prevention of hospitalization and deaths, and 79% effective in prevention of symptomatic illness from the coronavirus. It is also seen as safe by experts as it goes for FDA regulatory approval in the US. It is provided at cost, and storage is in ordinary refrigerators for long periods, with production in India of large quantities of the vaccine, making it a vaccine that could reach large parts of the world's population.

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This report in The Guardian says what India urgently needs is for the US to lift export restrictions on supplies for India's vaccine factories, and tools such as genome sequencing to identify and control emerging variants of the coronavirus.

The report also points out that of the 1 billion vaccine jabs about half are in the US and Europe and the low income countries have only a tiny fraction of vaccinations. India which sent 64 million vaccine doses to countries including Brazil and Morocco, Bangladesh, in 3 months prior is reported to have sent only 1.2 million doses this month.

The crisis in India also shows the need says The Guardian for an international approach to the crisis no a country by country approach. It says the Bush plan for Aids and the the 2014 plan for Ebola in West Africa are models of an international approach that is needed now.

 

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Contrast the slow US vaccine export response with that of India, Russia, EU and China. Only in May 2021 after India's daily Covid cases were close to 400,000 a day did the US make a serious offer of vaccines to other countries in need of assistance. U.S. president Biden says that 80 million vaccine doses would be exported by the end of June 2021. The WSJ says citing Airfinity, a London research firm, as of May 10 more than 333 million doses of vaccine were produced by the US and only 3 million vaccine doses were exported. Contrast that with the European Union which has shipped 111 million doses overseas one third of its total production, Russia which has exported 27 million doses.  India has exported 66 million doses according to the Ministry of External Affairs website as of May 17, 2021. This includes 4 million doses to Brazil, 4 million to Nigeria. Within its own region Bangladesh received 10 million and Sri Lanka 1.2 million doses, Afghanistan 1 million. Mexico received about 1 million doses. In Africa the Democratic Republic of the Congo which has suffered from many epidemics including Ebola virus received 1.7 million doses, Nigeria 4 million doses, Kenya 1 million, Uganda 1 million. Of the 66 million about half of it is a direct grant assistance and Brazil, Mexico, Morocco received all vaccine as grant assistance, 70% of Bangladesh's is grant assistance. The list on the Ministry of External Affairs site of the Government of India shows 95 countries including many of the most struggling nations of Latin America and Africa, bringing hope to countries which are struggling to hold onto hope for a better life beyond the pandemic. Sending help overseas through vaccine supplies is suspended for the moment but will resume in July after India has pulled in all of its pharmaceutical manufacturing industry under a government guided effort to go all out. Never has so much help bringing much needed hope gone to so many countries of the world in the twentieth or twenty first century from a nation that is struggling to meet its own needs. The US in pursuing a US first policy of vaccinating all its citizens has not taken into account the need to bring this evolving vaccine technology into the hands of as many qualified pharmaceutical manufacturers as possible. This in a rapid response to expand manufacturing capabilities to meet world wide demand. The risks of not doing so were not taken on early- the very same way the virus spread in January to March of 2020 can be repeated as people travel around the world particularly for tourism, business family reasons. This risk takes on anew dimension of contagious mutations of the virus which are 50% more- the Indian variant being 50% more contagious by some estimates than the UK variant, which itself was estimated to be 50% more contagious than the original one.  The result a pandemic that stretches out indefinitely unless billions of doses are made in a short timetable to beat the timetable of Nature through the coronavirus. India is doing this for the first time with plans to produce billions of doses by engaging the whole of the Indian pharmaceutical manufacturing industry in the effort in a rapid response so that July to December would see 1.2 billion people vaccinated. The US effort, the European effort is left to the individual effort of pharmaceutical makers in the US and Europe, not a government guided effort to engage the entire pharmaceutical industry of the US and Europe in a rapid response timetable of 2-6 months.  ...

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Share of US Counties where 95% of Kindergarteners are vaccinated against Measles drops to 28% from 50% in Washington Post Investigation of 44 states December 2025. 95% vaccination rate is what experts say is needed for "herd immunity" or overall protection in a class. Washington Post examination of data shows marked deterioration from 2018-2019 school year to 2024-2025 school year data and public records. That is 5.3 million children are exposed from lack of herd immunity from measles now compared to 3.5 million children earlier increase of 1.8 million children. This Wash. Post investigation shows 19,000 schools are exposed and one can go to this article to find on a map how your school district and country are doing in the 44 states. A big problem is emerging from public skepticism and politics in vaccination. For generations schools required vaccination proof- by 1980 all 50 states had laws covering students first entering school. And caught in vaccine politics legislatures are creating religious and other exemptions that have weakened laws. Wash. Post says it's examination shows not a single County in Idaho, Louisiana, Oregon Tennessee, Utah, and Wisconsin meet the 50% vaccinated requirement for measles required for herd immunity. This could mean more of these diseases will be brought back home including whooping cough to affect elderly and infants. Democratic districts such as in St Louis and Chicago also see drop in measles vaccination rates. In the sense that newly decolonized countries since 1950 such as China and India have emerged with good health systems and mandated vaccination , other public health action, there is a great need for the US to focus on bringing back the public awareness that existed after the 1940's in the US that resulted in significant advances in public health in the US in the FDR, Eisenhower, Kennedy, LBJ and Reagan administrations. It shows there is no victory in public health. A lot of work needs to be done, as much of the gains can get undone by events and public awareness is necessary. As pharmaceuticals, chemicals and plastics and bad nutritional habits took over American lives there is an effort under Kennedy at HHS to tackle that health crisis, but it brings with it challenges that date from the pandemic and different responses in different parts of the US to mandatory vaccination which also have to be met through education not social media. ...

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How a deficiency in trust is affecting the US effort to vaccinate its whole population in 2021. The US government took steps early to build vaccine supplies, and was one of the first countries with the UK to begin its vaccination drive. Then after 6 months something went wrong. The deficiency in trust led to about 80 million people many of them young, to avoid getting vaccinated. US president Biden said the country was losing patience with these people. He setup a vaccine mandate and required all employees in private sector in companies with more than 100 employees to get vaccinated. This applied to about two thirds of American workers. All federal government workers were also required to get vaccinated. Yet even after the vaccine mandate the number of vaccinations has not exceeded 900,000 a day. By contrast India was doing 20 million a day. By September 2021 the US had fallen behind all nations in the G-7 in percentage of people vaccinated with one or two doses, behind Italy, France, UK, Germany, Japan, Canada. Trust was also needed, not just vaccine supplies to make a vaccination drive effective. By September the US passed the 675,000 deaths that happened in 1918 pandemic. The deficiency in trust leads one expert to call it breakthrough without followthrough. Other experts see the entrenched social forces that had diminished American health and life expectancy since the 1970's also affecting the vaccination drive. ...

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Each year malaria kills 500,000 people mostly in Africa, including 260,000 children. A vaccine jab for malaria has finally been developed. It took 34 years for Dr. Ripley Ballou, 70 years, to refine the technology while working at GSK in Britain to get this done. Ballou himself had malaria and could experience its debilitating effect. This made him resolve to find a solution. The vaccine jab is the first for a parasite and the first developed from scratch for African children. Its effectiveness wanes over months so that its use is intended for the rainy season. By giving 3 shots just before the rainy season when malaria is at its peak it can reach 70% effectiveness, say British experts. It is cost effective as other prevention measures as nets over beds- it will cost about $2 -$10. When combined with other anti-malarial medicines it is about 90% effective. Its safety is proven after having given 2.3 million jabs of the vaccine in African countries. Experts estimate it will prevent 5.4 million cases of malaria, from Mali to Kenya, and from India to Indonesia where malaria is still a danger. Malaria can repeat itself many times for the same person over a lifetime, increasing the health risks and damage to health. The vaccine was developed using technology that produces a protein that is also found on the outside of the malaria parasites in the early stages of its lifecycle. It exposes the immune system of a person to this protein to build up immune defenses. This British discovery will help African  Asian, and Latin American countries build confidence in their health systems ability to cope with dangerous diseases. In doing this it will improve the quality of life and combined with other health actions provide a better life in the poorest countries.   ...

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All three countries in the South Asian neighborhood now face economic crisis of large proportions - Sri Lanka, Pakistan, and Bangladesh, all turning to the IMF for help. In the case of Sri Lanka there was help from the beginning from India. It was lack of jobs and not enough jobs generated even with a decade of 7% economic growth. It was in protests over job quotas reserved for independence soldiers that led to the ouster of Sheik Hasina's government. This report in NYT shows overdependence on garment exports which generated growth for decades under PM Hasina as having a drawback during Covid. The disruptions in the supply chain during Covid hurt Bangladesh when garment earnings dropped. At one point the industry was closed for months. India provided assistance including vaccines during Covid and India is the largest destination for Bangladesh exports with economic ties to 5 Indian states. The recovery from Covid has not been strong and has led to reduction in foreign exchange reserves. In 2022 Bangladesh turned to the IMF for assistance. Not enough jobs were being created for a large population. In 2000 the population was 129 million, in 2019 before pandemic 165 million. Today in 2024 it is 171 million, increasing by 33% from 2000. By contrast in a communist state Vietnam population increased by 22 million to 99 million or 29% in 2024 from 2000   Foreign exchange reserves dropped during the pandemic to $23 billion in July 2023, in the last 11 months it dropped by $4 billion to $19 billion. By comparison Pakistan's are at $13 billion, up $4 billion in 11 months. Foreign remittances from Bangladeshis overseas are another source of foreign exchange. The major problem of getting tax revenues with people and business not paying taxes due is a problem for Bangladesh and for Pakistan. India has made huge gains through GST and digitization of economy to get tax revenues to support economic growth and infrastructure. And under the leadership of prime minister Modi there is discipline, girt, a strategic focus, with good governance, that is similar to what helped transform Japan and China into industrialized nations. This is missing in Sri Lanka, Pakistan and Bangladesh and in Burma. This gives some idea why in the present budget north and eastern Indian states of Bihar, Orissa, Andhra Pradesh, with a combined population of 230 million people are in a specially designated region for development. It is a gathering momentum against centuries of foreign occupation and neglect similar to that seen in China. ...

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The low number of confirmed cases and small number of deaths in India and Pakistan is being analyzed for what to expect in the coming months from June to August. Some experts see this as just the beginning that the peak will come later on. India has about 75,000 cases and Pakistan 35,000. Testing has lagged behind with only 1.5 tests per thousand people compared to 26 per thousand in the U.S.  one reason the confirmed case count is lower. Some confidence is being drawn from the deaths- 2415 in India and 737 in Pakistan. This is because only 2.2% of cases in India and 3.3% in Pakistan led to deaths, compared to 14.3% in UK and 5.5% in China, 6% in U.S., using John Hopkins database. One reason given is that only 6.4% of India's population and 4.3% of Pakistan's is over 65 years age. Compare mean age in Italy 46 years to 27 in India and 23 in Pakistan. And there is plenty of sunlight which appear to destroy the virus. Other factors that may influence the virus- taking of the tuberculosis vaccine and routine exposure to more pathogens in both countries. Prime minister Modi in India is taking no chances considering the size of India's population. He has put forward a $280 billion economic package and is moving in deliberate carefully prepared steps to lift lockdowns with the current phase No. 4 allowing more reopening. The shift now is to a more self reliant economy in industrial production making "local more vocal."  During the lockdown the large rail network and postal networks with their millions of employees, IT technology driven banking with Aadhar identification for direct deposit to hundreds of millions of the most needy citizens, and farmers, proved to be the most reliable and supportive. ...

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Speaking for the Biden administration Anthony Blinken says that "on the current trajectory, if we don't do more, if the entire world doesn't do more, the entire world won't be vaccinated until 2024." What is needed he said is to "speed this up, and get that done, I think, in a much shorter time." Experts say the immediate impact of the Biden decision to give waivers on transfer of patents technologies is to get drug companies to cooperate with each other and for them to voluntarily join in the manufacture of vaccines globally. This would be done through global manufacturing alliances in major pharmaceutical manufacturing nations such as France, India and other countries that can quickly ramp up manufacturing if they have access to the technologies involved and the knowhow itself. The Biden decision is then the first of many decisions that would lead to voluntary action by pharmaceutical companies cooperating say Novartis and Sanofi in France and Switzerland with a Pfizer or Moderna in increasing manufacturing capacity or a Serum Institute or Reddy Labs in India working with Pfizer and Moderna or Novavax. These companies already have the basic structures to ramp up. This would take months yet the process has to start immediately. Today many companies such as Glaxo Smith Kline in UK and US are in a position to get involved in manufacturing but need access to the technologies and knowhow. Leadership by the US plays a huge part in making that happen.  ...

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The Biden vaccination target of 70% of American adults at least partially vaccinated with one dose by July 4, 2021 remains elusive as vaccination rates have dropped. From a high of 2 million a day vaccinations have dropped to 400,000 a day during the first week of June 2021. Vaccination skepticism particularly in the south and western part of the US is making it harder to vaccinate the rest of the US population. This poses increasing risks as the new variants of the virus such as the Delta variant found in India, and now the most widely prevalent strain of virus in the UK, remain a serious problem. The unvaccinated population in the US is too large for any degree of safety in numbers vaccinated. Consider that at the press briefing given by the White House on June 3, 2021, only 28 states out of 51 states have fully vaccinated 50% or more of their population. There is a large variation between different states with states in the south such as Mississippi as low as 34% at least one dose and a similar situation in Alabama. In Arkansas, Georgia, Carolinas, and Louisiana  it is higher at about 50% with at least one dose. Even these figures are deceiving as in some parishes in Louisiana only 20% have even one dose. Studies show that only after the second dose are enough antibodies released to protect well against coronavirus. This is why vaccine experts at Baylor College of Medicine cited in NYT foresee a second wave in the southern US because of the South so underachieving in the case of vaccination.  ...

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India achieves an initial vaccination target of 3 million vaccinations in a single day on March 14, 2021. Much of recent increase is from people over 60 getting vaccinated. For healthcare workers the first priority group about 50% still need to be vaccinated. This sets the stage for taking the vaccination drive to the next level in India. Increasing number of people are now getting their second dose.

Health experts see not vaccinating the vulnerable population fast and wide enough as a missed opportunity. The need has never been greater to vaccinate with better organization, vaccinating staff, and supply of vaccines at locations, so that this beats any second surge.