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Prof Gagandeep Kang: ‘As more vaccines are introduced, there are lessons to be learned from the Indian rotavirus vaccine story’ | Pune News


The Indian rotavirus story offers four central lessons that are especially pertinent given the call for local and regional manufacturing in response to the vaccine inequity that occurred during Covid-19, said Prof Gagandeep Kang, Director of Global Health at the Bill and Melinda Gates Foundation, while delivering a lecture at the UK Academy of Medicine Sciences, which was published in The Lancet on Tuesday.

In her lecture, Prof Kang discussed the case of rotavirus — the leading cause of acute gastroenteritis in children under the age of five worldwide, with a high mortality rate, especially in middle- and low-income countries. In 2016, India became the first Asian country to locally develop and nationally introduce rotavirus vaccines. Prof Kang reflected on the successes and lessons learned from the rotavirus vaccine journey in India.

Speaking to The Indian Express, she also noted that it could be applied to improve global health in the future. “The story of rotavirus vaccine development in India illustrates many of the opportunities, the necessary enabling environment, and the challenges of creating products that are important to global health. Vaccine development and introduction do not occur in isolation or without external influence, it requires previous scientific and manufacturing capacity and the ability to implement public health programmes,” Dr Kang said.

“The Indian rotavirus story offers four lessons — the importance of commitment and partnership for the manufacturers and the stakeholders who support them, taking on challenges like building a manufacturing base for a new product, the ability to conduct rigorous community-based clinical trials and the need to communicate the emphasis on measurement of safety in clinical trials. As more new vaccines are introduced and anti-vaccine sentiments persist, it will be essential to generate data that accurately measures both benefits and risks,” he said.

Although manufacturing in India has several cost advantages, the Indian vaccine industry has relied on high volumes and low margins to allow the world’s poorest children to receive vaccines. However, this business model means that vaccine manufacturers in LMICs do not have the resources to support their own research and development of new products. If prices are to be kept low, then development support will continue to be essential for products that are intended for public markets. However, competition is possible even at low prices, since the two producers (BBIL and Serum Institute of India) now sell vaccines to public markets at less than $0.60 a dose, Dr Kang said in The Lancet report.

Festive offer

The experience of developing oral rotavirus vaccines and taking them both to the market and to WHO pre-qualification resulted in greater confidence within the companies, compared with previously (ie, end-to-end development of the oral rotavirus vaccines). When Covid-19 started, BBIL and Serum Institute of India, along with other companies in India, actively sought partnerships within and outside India for potential vaccines, Dr Kang said and pointed out that without its vaccine industry, the Indian government would not have been able to provide the 2.2 billion doses that its 1.4 billion people have received.

For rotavirus vaccines and subsequent products, the Indian vaccine industry has partnered effectively with academic, research, and governmental organisations to keep clinical development costs low. “In a world of continuously increasing healthcare costs, we need models that deliver accessible and affordable interventions,” Dr Kang said.





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